Not designated for permanent publication

A-08-076

SUMMARY: Once the court establishes a guardianship, the responsibility and authority of DHHS no longer exists other than that related to subsidized guardianships. However, the court has continuing jurisdiction over the case even after appointment of guardianship.

On December 20, 2007, the court appointed Jazzmine’s aunt, Tammy, as her guardian and ordered that DHHS not be relieved and continue to participate in 6-month review hearings. DHHS appealed. The Nebraska Supreme Court held that once the court approves a guardianship, DHHS no longer has authority or responsibility for the child except that which might exist with subsidized guardianships. Guardianship is more than mere placement; it essentially appoints the guardian as the child’s parent. Requiring DHHS to continue in its responsibility and authority in a guardianship would create dual custody by two “separate agencies.”

However, the court is within its authority to continue its jurisdiction over the case as “a guardianship under the Nebraska Juvenile Code is subject to the continuing jurisdiction of the juvenile court which retains the power to terminate the guardianship.” In re Interest of Antonio S. and Priscilla S., 270 Neb. 792, 799 (2005).

Full Opinion

A  concerted effort by both the courts and the state  human services agency to get children out of the foster care system and into permanent homes is paying off.

In two years, the number of children in the state’s child welfare  system has dropped 12 percent, to 6,829 in June, state leaders said.

More children have left the child welfare system than have entered it in the past two years, Gov. Dave Heineman said at a Thursday news conference with Supreme Court Chief Justice Mike Heavican.

Gov. Dave Heineman

In the past two years, the state has focused on some of the easier cases — younger children and kids who are at home but still being supervised by the juvenile court.

The state closed 80 percent of the 1,184 cases identified as a priority.

Now the state is going to take a look at the harder cases — children who have been in the child welfare system for more than two years.

The state’s Foster Care Review Board, a separate monitoring agency, will study 550 cases, involving 700 children who have been in the child welfare system for 24 months or longer and who have a plan to be reunified with their family.

Foster care board staff members will look at the demographics of those children. They also will examine the barriers to either going home or being adopted, and the lost opportunities during their time in the system.

Caseworkers will use the data to help find permanent homes for the children.

The state also will use the data to look at potential trends and problems inherent in the system itself, said Todd Landry, director of the division of Children and Family Services, part of the Health and Human Services Department.

The Foster Care Review Board staff members will conduct the study in August, with a report expected before the first of the year.

It will be useful to identify the larger issues, said Georgina Scurfield, chairwoman of the review board.

“We know that parents who are struggling with addictions take time to get well. We know that parents who have mental illness need time. And that children need their parents,” Scurfield said.

Case workers and courts are always looking at this  balancing act between giving parents time and allowing children to have permanent homes, she said.

The study should give the state more information about the barriers to permanent placement, she said.

HHS and the courts made improving the foster care system a priority several years ago after a statewide task force recommended reform in 2003.

In June 2006, Gov. Heineman set out a six-point plan that included the focus on younger children.

Over the past two years, case workers were asked to review cases on the priority list monthly, to remove any paperwork obstacles to ending a case.

At the same time the total number of children has been dropping, there also has been a slight decline in the percent of children who come back because of new problems, Landry said.

“That’s a very good indication that this isn’t just about the numbers. It is about moving kids into permanent homes and they are able to stay there safely,” Landry said.

The state courts have set up 25 local teams to improve the process, and created guidelines and a training program for the attorneys who represent the children’s interests, said Chief Justice Heavican.

Juvenile judges also have tried to speed up the process by holding pre-hearing conferences within days of an incident where a child is removed from the home, rather than wait for weeks for a formal hearing, Heavican said.

These families typically have serious, longstanding and complex problems, he said.

“Drug and alcohol addiction, mental illness and/or domestic violence affect most of these families.”

The court’s goal is to protect the children, to  preserve relationships with parents if possible and to be fair, Heavican said.

The court emphasizes looking at all the court processes through the eyes of children, especially considering a child’s sense of time, he said.

The partnership between the administration and the courts will continue, Heineman said. “We can get the number lower.  We intend to get that number lower.”

But the issue is “much more than numbers,” he said.

“Every child counts. Every child is a human being, not a number for us.”

Reach Nancy Hicks at 473-7250 or nhicks@journalstar.com.

Lincoln Journal Star

The state’s decision early this year to curb the use of child welfare dollars for adults could make it more difficult for parents to be reunited with children, according to some local human service leaders.

Some agencies and counselors believe they have lost clients as a result of a memo from the Department of Health and Human Service.

And local human service leaders believe the end result of the memo will hurt the system that provides help to low-income Nebraskans.

A memo to caseworkers and others in late February indicated HHS should not use “child welfare” money for adults.

The “child welfare”money is intended for services to children but was sometimes used to pay for counseling or treatment for parents in a troubled family when  those parents had no insurance, Medicaid coverage or money for treatment.

That memo was simply a “clarification” of HHS’ long-standing policy, said Todd Landry, director of the Division of Children and Family Services, part of HHS.

The memo was not in response to any particular issue or internal assessment that HHS was spending too much of its “child welfare” budget for adults, he said.

The state spent about $4.9 million in “child welfare” money, all of it state tax dollars, last fiscal year for services to more than 5,050 people.

And Landry pointed out that the state has increased its “behavior health” funding recently by about $17.1 million. This means there is money for these services to parents, he said.

Some local human services leaders have a different interpretation on both issues.

They believe the February memo was more than clarification.  It meant less  “child welfare” money is being used to pay for  services to parents.

The Independence Center, a BryanLGH substance abuse treatment program, has not seen a client in this category since the February memo.

The memo “was not a blanket no, but a new filter system,” said Jerome Barry, Independence Center director. “However, we have not had any clients since then.”

And local mental health leaders say the recent $17.1 million for local services is not “additional” money but money promised them several years ago as part of mental health reform.

The state promised that local programs would get the savings that occurred when regional centers were closed or downsized, said C. J. Johnson, administrator of  Region V Behavioral Services, which coordinates services in southeast Nebraska.

“That $17.1 million wasn’t additional,” and it isn’t “new money,” he said. The bottom line is that the state is spending less money than expected on mental health and addiction programs overall.

But because of that $17.1 million and because these parents have a high priority on waiting lists, most nonprofit agencies are still serving these parents without much delay.

At St. Monica’s, which provides treatment for many women who participate in the Lancaster County drug court, additional state funding has allowed them to continue working with these women.

In addition Lancaster County juvenile court judges have ordered a reluctant HHS to pay for these services when it appears a parent will have to wait on a waiting list.

Local agency directors say HHS just shifted services from one pot — child welfare — to another — behavioral health.

Shifting doesn’t solve the larger problem of an overloaded system, said Topher Hansen, executive director of CenterPointe, a treatment program primarily for adults with mental illness and addiction issues.

It’s like having too many cats and not enough bowls of milk, he said. There are still more cats than bowls of milk.

An attorney who represents some parents whose children are in foster care points out that HHS is required to pay for children’s treatment by law.

Often the goal is to reunite children and parents, if the parents’ behavior changes. And the law says HHS has to make reasonable effort to reunite the family, said Pat Carraher, an attorney with Legal Aid of Nebraska.

So if a mother has a meth addiction, it is reasonable to assume that HHS would pay for her treatment with child welfare money, Carraher said.

Carraher says serious problems have been avoided in this region after the memo because Juvenile Court judges have been requiring HHS to pay for services in some cases.

“Child welfare has a responsibility (for these services to parents to help with reunification) and they should not be draining scarce resources for other mentally ill adults,” said Dean Settle, executive director of the Lancaster County’s Community Mental Health Center. The center has seen some increase in its waiting list recently, he said.

“I see this as a knotty problem for this state. Now all of a sudden the deck chairs are getting rearranged. It is a net loss to adults with severe mental illness,” Settle said.

Landry says the memo did not represent a change in department practice. It was a response to questions from caseworkers and others, he said.

And he doesn’t think the costs for adult services from the “child welfare” budget has dropped  since the February memo, but he doesn’t know for certain because he does not have monthly data.

“Our aim in this process is to ensure that we are meeting our statutory responsibilities to make reasonable efforts for reunification of the child when that is the court order on the case, and to do so in a fiscally responsible manner,” he said of the reason for the memo.

Reach Nancy Hicks at 473-7250 or nhicks@journalstar.com.

Lincoln Journal Star

Omni Behavioral Health will not be one of the private agencies working with troubled families when the state begins its new contract arrangement next week.

By July 1, the Health and Human Services Department will contract with fewer than a half-dozen private agencies to provide all in-home and emergency services to families in jeopardy of losing their children because of neglect and abuse.

In the past, the state had more than 100 contracts.

Omni had been on the list of agencies with contracts to provide services in the Lincoln and Omaha regions.

But the state decided not to contract with Omni after the company refused to “accept all referrals,” said Todd Landry, director of the Division of Children and Family Services, a part of Health and Human Services.

Omni Executive Director Bill Reay said the state wanted to put a cap on the amount of money the agency would be paid, but would not allow a cap on the number of families an agency would serve.

“They capped the expenditures, but you have to serve everyone,” he said.

Omni had originally bid successfully to provide services in four of the six regions. After several weeks of negotiations, Omni was listed as a contractor in two regions, Eastern (Omaha) and Southeast.

This week, the state dropped Omni from the list of bidders.

Omni has about 60 open cases in Southeast Nebraska that must be taken over by the remaining two contract agencies July 7, Reay said.

And there is no plan for this transition, he said.

But HHS spokeswoman Jeanne Atkinson said the two contract agencies in Southeast Nebraska — Visinet and Cedars Youth Services — will take over those cases.

In the Eastern service area, Visinet, Boys Town and Child Saving Institute will provide services, according to information provided by HHS.

Reach Nancy Hicks at 473-7250 or nhicks@journalstar.com.

Lincoln Journal Star

The state is changing the way services are provided to troubled families by dramatically reducing the number of contracts it has with agencies to provide services and making a few private agencies responsible for keeping families together.

Instead of more than 100 contracts — with many agencies providing  a single service — the state will contract with six, large private agencies.

Beginning July 1, those six agencies will provide all the services required to work to keep children safe and living with their families.

Each agency’s success rate will be evaluated and the results posted on the Health and Human Services Department Web site.

It is a major reform intended to improve the services and the outcomes, said Todd Landry,  director of the HHS Division of Children and Family Services.

Landry anticipates the new system will improve services to children, as well as oversight of those services, and help the state determine what works best.

Last year, the state worked with more than 8,500 families providing in-home services and safety-related services through 116 contracts, at a cost of about $20 million, Landry said.

The goal of the new system is not to save money but “to change the way we deliver services to get better outcomes,” he said.

The winning bidders had to commit to serving the entire region, not just one county. And the agency had to commit to providing all the services, Landry said.

One result should be that families in western Nebraska have access to all services, something that currently isn’t the case, he said.

The contract agency generally will have subcontracts with other agencies in order to provide the full array of services.

For example, the Lincoln-based Cedars Youth Services has subcontracts with Lutheran Family Services and Epworth Village,  said Katie McLeese Stephenson, Cedars chief operating officer.

HHS case managers will do the initial investigation, then turn over cases to the contracting private agency, which will provide all services.

Under the new system, HHS case workers will not have to make a number of calls trying to arrange for services.

“They will make one phone call, one referral to a provider,” Landry said. “It makes for a much more efficient and timely response.”

The new system also creates a partnership role between case worker and provider, he said.

The private agency will indicate what services the family needs, and, if documented, the case worker will authorize the services.

The private agency and HHS will monitor the progress, Landry said. HHS also will track how successful each network is and post outcomes on its Web site, he said.

The agencies will be rated on  issues such as their timely response to a crisis call and the reduction in substantiated reports of maltreatment for the families they serve.

In regions with several contract agencies, families will be assigned to agencies on a rotating basis. That assures a fair distribution of the work, risk and reward. It also allows the state to better compare results, Landry said.

Carol Stitt, director of the state’s Foster Care Review Board, sees both benefits and potential problems with the new contracts.

Stitt says it’s unclear how the state will maintain oversight of  providers. She also has concerns about the short timeline for agencies setting up new services, a two-week period between contracts being signed and the beginning of the new system.

In addition, her agency and others have questioned the quality of services by some of the agencies with state contracts.

“Why wasn’t past performance considered?” she asked.

But Stitt praised the requirements that many of an agency’s employees have college degrees and the agency provide training.

When the new system begins, some disruptions may occur as some families transfer to new providers, Landry said.

“We believe that is going to be minimal,” he said.

How it works now:

The following example, which shows how the state investigates and handles reports involving troubled families, is fictional:

A Health and Human Services case manager investigates a report that young children in a family have been seen outside playing at midnight several times in the last few weeks.

The case manager finds the young, single mother is overwhelmed. Her own mother recently died. Her boyfriend left. She admits she has been drinking too much and has not heard the children leave the house, which is filthy and has little food.

The case manager decides the children are in danger of neglect, but the family might be able to stay together with help: counseling for the mother and a few months of family support, where a worker comes into the home to teach her how to discipline her children, manage her money, and plan and prepare meals.

The case manager decides to put the children into an emergency shelter while things are being sorted out. So the HHS worker starts making arrangements for services, contacting several local agencies.

How it will change

Under the new consolidated system that begins July 1, the HHS case manager will still do the initial investigation. But then the manager will call just one number, and the family will be assigned to an agency that offers, through its network, all the necessary services.

If it is a crisis situation, that private agency must have a worker at the family home within two hours.

If there is no crisis but some serious issues, the agency should contact the family within a day.

If there are no serious safety concerns, the HHS case manager will set up a meeting with the agency worker and the family to discuss services.

The private agency will provide all services, and both HHS and the agency will monitor progress.

Agencies to provide services

These agencies have signed contracts to provide services in a specific region under the new system.

Southeast Service Area: OMNI Behavioral Health, $2,846,347; Cedars Youth Services, $3,580,925; and Visinet Inc., $2,730,983.

Western Service Area: Boys and Girls Home of Nebraska Inc., $5,096,562.

Central Service Area: Visinet, $1,899,229; and Boys and Girls Home of Nebraska, $2,488,125.

Northern Service Area: Boys and Girls Home of Nebraska, $7,674,062.

Eastern Service Area: Boys Town, $1,953,930; OMNI Behavioral Health, $3,931,574; and Child Saving Institute, $957,967.

Reach Nancy Hicks at 473-7250 or nhicks@journalstar.com.

Lincoln Journal Star

GRAND ISLAND— The Hall County prosecutor says he can’t file child-abuse charges against the mother of a newborn who tested positive for meth.

Hall County Attorney Mark Young says Nebraska law doesn’t consider injury to a fetus to be child abuse.

Young says it is outrageous that a pregnant woman would use methamphetamine. He says the case shows that users need more treatment options.

The baby girl was born June 14 at St. Francis Medical Center and soon after tested positive.

Her mother, 26-year-old Sandra Wetzel, is under arrest on other allegations. Court documents say she bounced checks in Sherman and Howard counties.

State officials have taken the baby, and a case has been opened to determine who will have custody of her.

Lincoln Journal Star

The numbers tell part of the  story at 6601 Pioneers Boulevard.

It’s a story of children in crisis, of 382 young people who stayed at  Cedars Youth Services emergency shelter last year and of the more than 1,300 cases of abuse and neglect in Lancaster County in 2006.

It’s also a story is about changing times and changing needs, which make the shelter that’s been the cornerstone of the organization’s services since 1953 due for an upgrade.

A drawing of the Cedars Youth Services addition. (Davis Design)

And so, that’s the plan, and organization leaders are asking for help from the community to build a $3.5 million addition.

On Wednesday, Cedars Youth Services officials kicked off the $2 million Room to Grow capital campaign to raise money from private donations for the two-story addition. Cedars is working to secure the other $1.5 million from federal grants.

Plans for the addition grew out of a two-year facilities plan for the organization that eventually includes moving the central offices their current location at 620 N. 48th St. to the original building on Pioneers.

All the money raised, however, will be used for the 17,000-square-foot addition, said Cedars President Jim Blue.

“We decided that our No. 1 priority is that we create a new environment for the kids who are in that immediate crisis of abuse and neglect and homelessness,” he said.

The existing building is adequate but outdated, he said. Built at the tail end of the orphanage movement, when the philosophy of child welfare was to place children in large group living situations, children often were raised there until they were eventually adopted.

But the long hallways, old staffing stations and individual rooms don’t meet the needs of today’s system, which tries to get children as quickly as possible back into their homes or into stable foster care, Blue said.

The new building will have a more open design, as well as room for family counseling and for children to meet with families or prospective foster families. It will have an indoor recreation area to replace the existing area, which is in an old nuclear fallout shelter in the basement. And it will include areas for group and individual study and for tutoring.

The addition will increase the capacity of the building — the only emergency shelter in southeast Nebraska — from 16 to 27.

The addition will include 12 bedrooms on the second floor for older children. They will be single bedrooms and all but one handicap-accessible room will have the capacity for double occupancy when the need arises, Blue said.

Downstairs will be four bedrooms for younger children with more living space to create a more homelike environment. That space can also be used for family visits with children.

Blue said the average stay of children in the shelter is about two weeks, but can be just a couple of days or as long as a month.

Cedars has grown considerably since its story began in 1947 with one child living on the streets and a Lincoln couple who wanted to help.

The Rev. Charles and Alberta Danner offered their home to children, then bought a farmhouse at 66th and Pioneers and incorporated their efforts into Cedars Home for Children.

Cedars merged with Youth Service System in 1996; the non-profit organization has 27 programs in Lincoln, Broken Bow and North Platte that include a range of housing for children, juvenile diversion, child care and in-home family services.

Blue says the addition to the emergency shelter builds on the organization’s original mission.

“This is right at the core of what Cedars does today and what it did when it began 61 years ago,” he said.

Reach Margaret Reist at 473-7226 or mreist@journalstar.com.

Not designated for permanent publication, A-07-1295

SUMMARY: The mother did not challenge DHHS parameters on visitation or timely appeal the court’s order permitting DHHS’ restrictions, and her argument therefore has no merit on appeal. Termination of parental rights was proper as to all children as the mother did not truly begin working on her rehabilitation plan until after the termination petition was filed three years after the children were removed and the three oldest had been out of home more than 15 of the past 22 months.

The children, Courtney (DOB 2/18/96), Jaden (10/21/98), and Payton (1/17/01) were removed from the home of the mother, Dana, on February 23, 2004. On allegations of failure to provide necessary care and support in part based on drug abuse. On August 10, 2004, the children were adjudicated at risk for harm based on Dana’s failure to take medication and improper parental care, and the mother was ordered to complete a psych evaluation, paternity affidavits and therapy progress report. Disposition was held on October 15, 2004, where Dana was order to obtain housing and income, complete several evaluations and engage in visitation. On January 27, 2005, Grace (DOB 1/25/05) was added to the case. Additional allegations were alleged in a supplement petition, and Dana admitted to placing Grace at risk for harm. Multiple dispositional hearings were held over the next year. On April 24, 2006, Hannah (DOB 12/24/05) was added to the case by supplemental petition. Motions to terminate Dana’s parental rights as to all children were filed on May 9, 2006. After trial, the court terminated Dana’s parental rights. Dana appealed the order, challenging that the court improperly delegated visitation restrictions to DHHS and that the termination was improper.

On the issue of visitation, the evidence established that Dana was initially given visitation rights, but that they were restricted twice to a “dual confirmation” status after Dana missed several visits, causing transportation problems. The Nebraska Court of Appeals found that Dana did not properly object to DHHS actions to the trial court, and her argument therefore had no merit.

On the issue of termination of parental rights, the Nebraska Court of Appeals held that termination of Dana’s parental rights was in the children’s best interest because Dana made little progress in the three years she was given to work on a rehabilitation plan. She was homeless, did not comply with UAs, did not attend counseling and did not complete all ordered evaluations. The progress she claims she made after the motion for termination of parental rights was filed was still minimal and made too late. The Court of Appeals held that the evidence satisfied the statutory basis that Dana substantially and continuously or repeatedly neglected and refused to give her children necessary parental care and protection, that the older three children had been out of home more than 15 of the past 22 months and that termination was in the children’s best interest.

Full Opinion