Illinois Department of Children and Family Services, Illinois Children and Family Services Advisory Council Met Jan. 14.
Here is the minutes provided by the council:
Attendance
Members: Anita Weinberg, Brittani Kindle, Jennifer Hansen, Lanetta Haynes Turner, Marge Berglind, Robert Bloom, Sherrie Crabb
DCFS: Kara Hamilton, Fayette Coleman-Gill, Greg Donathan, Jennifer Marett, Michelle Jackson, Yesenia Perez
Youth Advisory Board (YAB) Members: Gabriel Foley
Public: Uli Senz
Agenda
I. Welcome
Marge called the meeting to order at 3:01 pm. The council welcomed new youth advisory board member, Gabriel Foley.
Some DCFS staff joined to clarify and/or answer questions on assigned projects and discussion topics. Others will be invited depending on meeting agenda topics.
• Michelle and Jennifer – re: psychiatric hospital refusals.
• Fayette and Greg – re: COVID-19.
II. Approval of Minutes from December 10th, 2020
On a motion by Jennifer and seconded by Robert, the minutes from the December 10th council meeting were unanimously approved as submitted.
III. Discussion Item: COVID-19 updates and related information
The Department will put out guidance after January 31st, but decisions re: education and remote learning are handled at the local level in CFTMs and vary by area. Court system decisions also vary from county to county. In Chicago, CPS returned to classes as of 1/11. The Department works together with schools through educational liaisons as of March 2020. Previous and current efforts include provided Chromebooks to schools and DCFS offices for online learning and for staff and parent use; addressed daycare issues; incorporating video conferencing in processes via Zoom and MS Teams where appropriate.
Questions/comments/concerns from the council:
• Q. Will there be another extension to assistance for YIC aging out? The council urges the decision not be made last minute. Greg and team will follow-up on the timeframe.
• Q. Many youth are being affected by anxiety and depression. How are the Department and POS agencies handling this? The Department noted that youth are very resilient and there have been limited disruptions. Those that did disrupt already had a history of running. POS agencies, including congregate care facilities, have also been creative in trying to maintain mental health, like scheduling child/parent/sibling visits via video.
• Q. Is there aggregate data from CPS re: attendance? The council stressed the importance of tracking attendance for child well-being and COVID-19 outbreak reasons. Fayette and team will follow-up with educational liaisons to try to gather.
• Q. Does the Department know what percentage of youth have chosen to extend their stay in care, and has messaging been successful? The council stressed this data is important to adequately inform decision to extend, and for youth to know this option is available to them. Greg and team will try to gather data, but that information is not currently known.
• Q. What are the checks and balances re: ACR? Also, what is known about the success of CFTMs? ACRs are in full force via Zoom. Reports show that parents participate more via Zoom vs when done in-person. CFTMs are also seeing more participation.
• Q. What’s the plan and status of vaccinations for youth and direct service workers? The Department is working with IDPH to move up direct service workers (DCFS and POS) on the vaccination list; to add in the 1B grouping. Vaccines need to be administered by local DPH and coordination isn’t as good as it should be, but progress is being made. An announcement will be coming out soon.
• The council would like a report from the Department by the next meeting re: who took advantage of vaccine availability (e.g. who declined/accepted). As well as whether efforts are working, otherwise members can step in to assist. Michelle acknowledged the request but can’t promise the details the council wants.
Recommendations:
• Marge – The deadline to decide re: extension to assistance for YIC aging out should be moved up and known by February 1st.
IV. Discussion Item: Follow-up to Child Trends reports / Discussion of PIP
Kara will follow-up on asks from the council for additional information, as detailed below.
Questions/comments/concerns from the council:
• The council needs information from the Department related to trends and the PIP. That includes:
o IL-specific information on length of stay.
o Data/response on the Department’s theory that lower entries translates to longer times to achieve permanency. Is this still a prevailing theory?
o Data/circumstances on why youth are entering care to try to correlate with length of stay.
o Guidance on how the council should identify mechanisms to shift youth out of kinship care and into permanency over time.
o Clarification whether termination of parental rights is still a problem in IL. Does this affect foster care entries?
V. Discussion Item: Strategic planning directions (see attached January discussion notes) a. Member discussion
See related attachment re: strategic discussion in January between council members.
The council has various ongoing concerns outside the areas of focus assigned by Director Smith, including:
• Staffing and resources/Workforce – The council needs adequate resources and effective follow-up re: asks and recommendations to make a difference. The Department should also consider having a plan in place when there’s a personnel shift that affects the council so there’s no interruption in the work. What is the Department’s plan for consistency and sustainability?
• Council membership – Need clarity on finding members and treatment of youth in care members to move forward in collaboration with the Department and the Governor’s Office.
• Sex offender registry – Previous feedback from the Department is this wouldn’t be prioritized, but the council also wants to know whether they’re supportive of the recommendations. Anita will confirm whether a 2018 report that Kara found is the correct report for Department review.
• YIC well-being status – The council wants information on Department efforts.
Questions/comments/concerns from the council re: the areas of focus assigned by Director Smith
1) Psychiatric hospital refusals
o Q. Are these clinical or systems issues within the Department? What are the DCFS/POS workers telling the Department about these refusals? What is the Department’s current mechanism for discussing a rejection of a YIC? What type/extent of data should the council review and who can redact it? The Department notes this is a hot-button issue and that ACLU is aware of it. The main two reasons for deflection/refusals that hospitals offer: 1) no capacity, and/or 2) “the unit is too acute”, which means they are not equipped/staffed to admit them due to the current milieu; especially for youth with SPB, are DD or have self-injury behavior. Workers have also informed the Department that hospitals ask immediately for the discharge plan due to issues with youth going beyond medical necessity (BMN) because of no clear discharge placement. The COVID-19 pandemic has only made things more difficult.
o Q. Are rehospitalizations and no-payment also issues? For youth that are repeatedly hospitalized, hospitals respond that there’s no clinical benefit to readmit.
o Q. Re: no capacity, what about the vacancies at Roseland? The Department ensures all hospitals, especially those vacancies, are contacted. No explanation provided specific to Roseland.
o Q. What has the Department explored re: convening with all hospitals and discussing these issues? DCFS Director Smith and Chief Deputy Director of Clinical and Child Services, Michelle Jackson, have met with hospitals to discuss. The Department also compiles a monthly list of youth that experience issues and sends it to ACLU.
o Q. Youth experiences with mental health services while in care influence how they pursue those services when they leave. Does the Department have a system or provide guidance on how to get help while admission issues get resolved? SASS workers help regulate youth and/or help get them into placements.
o Q. Does the Department know how many youth they’ve had issues admitting recently? Approximately have eight youth at any given time with the inability to access that resource.
o Q. POS agencies have reported that youth “stabilize in the ER” while waiting for admission. What about the ER helps with stabilization? It depends on their presentation. Many youth just need a respite from the situation, especially those in residential facilities.
o Q. Does the Department still have and/or looked at expanding capacity at the UIC CARTS program? What type of youth do they take? CATU takes youth that other hospitals won’t, like those on the developmental spectrum, have severe aggression or self-injury behavior. Re: expansion, Jen will follow-up with Michelle.
o Bob will reach out to hospital contacts to find out how much of an issue refusals are with non-YIC.
Recommendations:
• Marge – DCFS should work with private providers to develop program components that mirror the response of an ER setting since those appear to calm youth sufficiently to return to their residential setting. This might avoid ER trips that don't result in hospitalizations.
b. Next steps
See related attachment re: strategic discussion in January between council members. The council reviewed the document and revised where necessary.
1) Psychiatric hospital refusals
o Sherrie, on behalf of SASS So., notes that providing this data to the Department may be difficult due to the turnover and issues at the HFS level.
o Will the council be reviewing information by specific timeframes, hospitals and regions?
o Re: records, not sure if the council has a legal right nor access to review since these are mental health records.
o Is there broader litigation? If there is, what is the council’s role in addressing this issue?
o Are these refusals part of/addressed in the current BH plan?
2) Indicated investigations involving YIC in unlicensed vs licensed HMR/HFK
o No comments
3) Subsidized-guardianship
o There was a federal waiver done on sub-guar in the past. The Department should search their archives re: a report on lessons learned. Has anything changed since then?
o The council needs data on how much sub-guar is being used as a placement.
o If there is pending legislation to make sub-guar a permanency option, what is this council’s role in addressing this topic? The council asks that a copy of the draft/approved legislation be submitted for review.
Kara will continue to work on getting these questions answered by the appropriate DCFS staff.
Miscellaneous Items:
• None
Meeting Adjourned: No formal motion to adjourn. Call ended at 4:32 pm.
https://www2.illinois.gov/dcfs/aboutus/policy/Documents/ICFSAC/ICFSAC_Minutes_011421.pdf
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