FOR THE NORTHERN DISTRICT OF ILLINOIS            
                                  EASTERN DIVISION                       
 B.H. et al., individually and on           )                             
 behalf of all others similarly             )                             
 situated,                                  )                             
                  Plaintiffs,               )                             
           v.                               )           NO. 88 C 5599
                                            )           Judge Grady      
 GORDON JOHNSON, Director of                )                             
 the Illinois Department of                 )                             
 Children and Family Services,              )                             
                  Defendant.                )                             
                         FINAL CONSOLIDATED REPORT                       
                         RULE 706 PANEL OF EXPERTS                       

      JOSEPH T. MONAHAN and DONALD M. HALLBERG  submit the following      

 report of the experts empaneled pursuant to Rule 706 of the Federal     

 Rules of Evidence and this Court's orders.                              

 Preliminary statement
      As required by this Court, this report "reflects the consensus     

 of  the  experts"  in  their  duties  "to  assist the Court and the 

 parties  in  developing  recommendations, where necessary to ensure        

 that the Department of Children and  Family  Services  (DCFS) meets        

 its statutory and constitutional obligations as to  children in the      

 custody  of  DCFS  who  are  placed someplace other than with their          
 parents . . . ". 1                                                   

    1  August 31, 1990  Order  (para. 4)  (duties  of  experts),  as
 amended  by  the October  26, 1990  Order (para. 10)  (reporting of
 findings and recommendations).  Appendix M and N.                       

 The Children in Custody                                                  

      Over  20,000  Illinois children are in DCFS custody and placed        

 in settings outside their homes.                                         

      Virtually all enter the system as victims of abuse or neglect,      

 already compromised.  At the time children are placed in substitute      

 care, they are usually experiencing a crisis.                            

      It is indisputable that these children are high risk  as  they        

 enter the system.  While  in  DCFS  custody these children manifest         

 an increase in  chronic  medical,  developmental,  educational  and          

 emotional problems.  They predictably require extensive care.            

      It  is  the  consensus  of the  panel  that the risk  to these         

 children's health,  development and well-being is not significantly       

 diminished,  and  is  many  times aggravated while in DCFS custody.          

 The  children  remain  high risk until they are finally pushed from         

 or exit the system.                                                      

 The DCFS System                                                          

      The  panel  found that DCFS's present organizational structure        

 and capacity frustrates the provision of adequate shelter, care and      

 ,education,  as  well  as  the achievement of family  preservation,

 reunification,  and  permanency,  as  required by federal and state          


      There  is  no  uniform  screening which identifies  a  child's

 individual  needs  upon  entering  the  system.    A  comprehensive
 assessment  is  rarely  completed while the  child  remains in  the

 system.    Record keeping is largely unrelated to the child's needs

 and situation.   One expert stated   "...[t]he DCFS records contain

 much useless information,  little  useful  information,  are almost        

 impossible to obtain in a timely manner,  and impose an unnecessary     

 burden on the children by this inadequacy and lack of timeliness."2

      Service  planning  is  fragmented  and  incomplete,  based  on

 available  rather  than appropriate placement settings and services,     

 in apparent disregard of a child's specific needs,  age,  culture or     

 race.  Children experience  multiple  placements,  fail  to  receive        

 necessary care, and  do  not  attend  school.  They are not provided       

 stable,  permanent  homes.   Adoption  is  often  not  considered  a

 resource for these children.                                           

      There  is  no   operative   case   management   or   meaningful        

 administrative  case  review.   Cases are unattended and unassigned.      

 Caseload  levels  are  unmanageable.   There  is  no  assignment  of

 responsibility  or  clear  delegation  of  authority  for  decisions

 affecting the child.                                                   

      Service  and  placement  resources  are  inadequate in kind and        

 number.   Children  are  deprived  of  existing resources because of     
 the  lack  of  inter-agency agreements and intra-agency  cooperation

 which  impedes  access  to service resources administered  by  other

 state and local agencies and private community service providers.      

      The  assessment  of  the  individual needs of the child and the

 family,  and  a linkage to appropriate services  is not  enhanced by
      2  Education report, at p. 11.  Appendix E.  The expert further
 stated  "With data so poor it is reasonable  to conclude  that  DCFS
 has no  idea what  the educational circumstances of its wards may be.
 DCFS  wards  might  well be benefitted  over the current  state   of
 affairs if DCFS kept no records at all."  Id p. 13.                    

 the  role  of   the   court  in  juvenile  court   and  pre-adoption
 proceedings.  The courts are overcrowded,  understaffed  and  rarely     

 provide meaningful review of children in custody.                     

      There is no effective training  for DCFS casework personnel and

 foster parents.                                                       

      DCFS has  no  data base  or meaningful performance standards to     

 permit  the  use  of quality assurance mechanisms to measure service     

 delivery  outcomes  and  to  improve  policy, planning, and resource       


 Recommendations to the Court and the parties                          

      A  panel  of  thirteen  experts was selected by the parties and      

 appointed by this Court to investigate  ten subject  areas3 related     

 to the provision  of  services  by  DCFS.    Each expert submitted a       

 written report4,  totalling in the aggregate over five hundred pages

 of  findings,  recommendations,  with   supporting   and  compelling


      This  report  of  the co-managers consolidates the findings and     

 recommendations  where  there  was  clear  consensus  in the panel's        
     3  1) Sue A. Gant, Ph.D.,  Case Management Administrative Review
 (Quality  Assurance);  2)  Patricia  Schene, Ph.D., Child Protective
 Services; 3) Mary Anne Brown, Placement Services Under 12;   4) Earl
 P. Kelly, D. Ed, Placement Services 13 and Over;   5) Joy J. Rogers,
 Ph.D.,  Education;  6)  Paula  K. Jaudes, M.D., Health;,7) Arthur F.
 Kohrman,  M.D.,  Health; 8)  Arnold L. Miller, Ph.D., Mental Health;
 9) Kathleen  A. Schwaninger, Developmental Disabilities;  10) Edward
 Page-E1,  M.D.,  Developmental  Disabilities;   11)  Levern  Murphy,
 Substance  Abuse;  12)  Carol  W.  Williams,  D.S.W., Adoption;  13)
 Judith K. McKenzie, M.S.W., Adoption                                  
     4  See Appendices A-J.                                           

 deliberations and  reports.   The  experts  reports  appear  in  the


 The Challenge                                                       

      DCFS  has  a  broad  mandate  and it is increasing.   Whole new     

 populations of children,  such  as infants born to substance abusing

 mothers,  children  suffering  from   AIDS,  and  children  born  to

 children, will continue to pressure  an already overburdened system.

 How DCFS responds to its current  inability  to  serve  children and

 families and how it addresses the new  demands  will  determine  the

 future of those children and families.                              

      The   experts  discovered   a  DCFS  system  dedicated,  tired,

 overworked, yet motivated for change.   The  experts  reported staff

 have hope for change  and  view  the  B.H. process as an opportunity

 to effect change.                                                   

      The experts conclude  that fundamental change must be initiated

 for  DCFS  to  meet its mandate and keep its promise to children and


      Leadership  throughout  DCFS  is  essential  to  implement  the

 recommended  changes.    Illinois  does  not  take full advantage of     

 federal dollars,  which  contributes  to  the scarcity of resources.

 Illinois  must  develop  strategies  to  leverage  federal  Medicaid

 dollars.  DCFS  should  commit  itself to raising practice standards

 so  Illinois  can  become  eligible  and  take advantage of Medicaid      

 Clinic Option dollars and Targeted Case Management funds.           

      The  panel's  "consensus"  recommendations   detail   pragmatic

 strategies which,  if implemented,  provide  DCFS the opportunity to


 demonstrate  that  it can meet its legally mandated responsibilities
 and effectively keep its promise  to  Illinois  children  and  their         



 1.  Organizational Structure                                           
     DCFS lacks a clearly identified  and  understood  organizational
 purpose.   The present DCFS organizational  structures  have  failed
 to  facilitate the realization of the goals that actual  parents are
 expected  to fulfill,  i.e.,  the provision  of  adequate   shelter,
 health  care, education, and, most importantly, love, nurturance and
 the  inculcation of values.      The structures have also  failed to
 realize  the  systemic  goals of family preservation, reunification,
 and permanency.                                                         
     -- DCFS lacks a clearly articulated,  recognized  and understood       
 mission   statement,  impeding   DCFS   leadership  and  staff  from       
 performing their tasks in  a manner which is consistent and faithful     
 to the desired values of the organization.                              
     --  DCFS  lacks  policies  and  procedures  in essential  areas.     
 Where  there  are  policies  and  procedures, they  are  not clearly        
 communicated, understood by the staff,  or  used  as  the  basis for         
 decision-making and action.                                             
     -- The practices of  DCFS  evidences a set of operational values       
 and objectives which are contrary  both  to many of the stated goals      
 of  the  department  and  to  the  goals and  values  recognized  as
 appropriate  by  the  experts.    These  include   an  emphasis  on:     
 enforcement,  rather than service;  process,  rather  than  outcome;         
 triage  and  crisis  management,  rather  than  prevention and early          
 intervention; exclusion of the natural,  foster or surrogate parent,     
 rather than support and inclusion of them;  placement  of  the child       
 wherever a place is available,  rather  than  where  it  is  in  the           
 child's best interest; and pushing kids out of  the  system,  rather       
 than on insuring that the system has met their needs.                   
     -- Standards  and   expectations  for  staff  are   not  clearly      
 communicated, are not measurable, and are not outcome oriented.         
     -- There is little accountability  for  failure  to meet process        
 objectives, let  alone for  failure  to  achieve  desired  outcomes.          
 The system  lacks  the  capacity to identify inadequate performance,       
 either on an individual or system-wide level.                           

     -- Quality  assurance  is  neither  a  valued  nor  an effective       
 process within DCFS.                                                  
     -- Staff   feel  they   lack  authority  to   make   decisions.      
 Decision-making  responsibility  at  the local and regional level is     
 often unclear,  with  many  layers  of bureaucracy involved before a      
 decision is made.                                                     
     -- Among the  many  areas  of  inter- and intra-agency confusion       
 and  dispute  which  impact  DCFS  and  its  clients,   the lack  of
 cooperation and coordination between  Child  Protective Services and
 Child Welfare Services  serves  as  a  major  barrier  to  accessing      
 appropriate services for many wards,  and for high-risk children who
 are not wards.                                                        
     -- The system is not well-suited  to  respond  to  children with       
 special  needs,  with  respect  to  identification,  assessment  and
 services.   The  tendency  is  to  ignore  special needs children or       
 place them in  excessively  restrictive  settings,  rather  than  to        
 provide intervention  and  support services which will allow them to
 remain in their family or community.                                  
     -- DCFS should adopt  a mission statement  which is based on the     
 input of the various  constituent groups of the organization,  i.e.,
 management,  staff,  service  providers,  foster parents,  community       
 representatives,  and  the  children and families to be served.  The     
 mission statement  should be broadly disseminated within and outside
 of DCFS.   It  should  serve as a reference point for DCFS planning,     
 decisions, and day to day operation,  and  as the starting point for
 changing  the  operational  objectives  and  values.    The  mission
 statement  is to be adopted  within six months  of  the entry of any      
 consent decree.                                                       
     -- DCFS's mission statement should  acknowledge  and  articulate      
 a mandate for:                                                        
       -- family  integration  and  reunification  wherever possible,
          and, in all cases, permanency.                               
       -- involvement  by  and  support  of  the natural, foster  and
          surrogate parents, as appropriate;                           
          prevention and early intervention;                           
          attendance in and benefit from school;                       
       -- keeping children in  their  own  community,  or at least in      
          the same community, over time.                               

      -- In its role as "parent,"   DCFS  should  assure  that  every         
 child receive adequate food, clothing,  shelter,  health  care,  and        
      -- DCFS should develop statewide  policies and procedures which      
 are consistent with its new mission statement  and  are aggressively      
 communicated to staff.   They  should focus on outcome,  rather than       
 process criteria,  and  should  be  measurable.   Staff must be held        
 accountable for fulfilling these objectives.                            
      -- DCFS staff at the local  and  regional level should be given       
 sufficient  authority  to   be  able  to  function  efficiently  and     
 effectively,  without  involving  multiple  bureaucratic  layers  in
 routine decision-making,                                                
      -- DCFS should  substantially  enhance  its  Quality  Assurance        
 system,  which  must  include  as a minimum requirement, the ability        
 to  identify  the  status and track the progress of every DCFS ward.       
 Performance criteria  should  be  developed and implemented for DCFS       
 programs and for private service providers,  as  well  as  for  DCFS         
      -- Child Protective Services and  Child Welfare Services should      
 be structurally integrated or functionally  coordinated  to  promote       
 a service orientation and appropriate  follow-up  at  this key entry       
 point into the system.                                                  
      -- DCFS should  concentrate  efforts to assure the competence of
 caseworkers   with   respect   to  special  needs  children  and  the
 availability  of  specialized  support   resources   at   the  local,
 regional, and/or state level.   Monitoring  systems  must be in place
 to insure  that  special  needs  children  are  being  identified and
 appropriately served.                                                   

 2.   Screening and Assessment                                        
      Little  or no meaningful screening is performed,  especially to
 identify the special  needs  of  children.     Some   children   are
 overassessed and  many  are not adequately  assessed.    Specialized
 assessment resources are not known or readily accessible.               
      -- Uniform  screening  to identify  high  risk  children is not
 completed  when  children  enter  the system.  This failure makes it        
 unlikely  that  a  more  comprehensive assessment  is  completed  to        
 ensure specialized services are delivered.                              
      -- Appropriate initial assessments are not evident in the child
 protection system at the present time.   Access to DCFS services for
 vulnerable children and their families through some "door" other

 than  a  "founded" child abuse/neglect report is almost nonexistent.
 The  current intake  model  for  DCFS  child  protective services is
 heavily  oriented toward  the investigation of the allegation, using
 predominantly  law enforcement rather than child protective criteria
 for intervention.  This effectively precludes an assessment  for and
 ultimately  access to  services  to prevent the escalation of family
 dysfunction and harm to children.                                       
      -- For  those children  who  manage  to  enter the DCFS system,          
 there  are  no  systemic mechanisms  in  place for DCFS to recognize         
 their  specialized  and highly  individualized   needs.    Essential     
 assessments of family history and family problems and  needs leading     
 to placement are not done  on  the  front  end  of the  system,  nor
 expectations  established   for  return  home.   Assessments  do not
 always even involve meeting with the family.                            
      -- DCFS  has  no  plan  to  evaluate  each  child  for medical,
 substance  abuse,  developmental  or  mental  health problems.   The         
 failure  results  in  extreme  risk  to these children, and at times         
 results in serious or life-threatening deterioration  of the child's     
      -- Children  entering  substitute care  are  compromised and at         
 high risk.   They  require  not just ordinary but extensive care and        
 evaluations   for    physical,  mental  health,   psychosocial   and         
 developmental  problems.   Without assessments,  DCFS  children  are        
 missing  opportunities  for  needed special  education  and  related         
 services.   Many  youth  and  families with substance abuse problems        
 go undiagnosed or misdiagnosed,  therefore  unserved or referred for      
 services they do not need.                                              
      -- DCFS's   failure   to  adequately  identify and  respond  to     
 problems  of  children  results  in  further deterioration  while in          
 care.  It seriously  compromises  children's ability  to  return  to         
 permanent placements and to successfully participate in society.        
      -- DCFS  should use a preliminary screening tool at the child's
 initial  approach  to the system, designed to identify special needs
 prior to placement and referral for more comprehensive assessments.
      -- The  preliminary screening  tool  is  to be developed within         
 three months of entry  of any  consent  decree  and  operationalized         
 within six months.   The screening  tool  will  be  administered  to         
 every child entering the DCFS system within  seven working  days  of       
 their entry into the system.                                            
      -- For  all  DCFS  children  now  in  the system,  and for  all
 children  upon  entry  to  the system, DCFS should conduct a uniform
 comprehensive assessment,  using a  multidisciplinary team approach,
 designed to thoroughly describe service needs and outcome

 objectives,  including   those   children   with   medical problems,
 emotional  or mental disorders, developmental disabilities, learning
 disabilities, or drug or alcohol use problems.                        
      -- The comprehensive assessment is to be developed within three
 months of entry of any  consent  decree and  operationalized  within      
 six months.   Depending on the results of the preliminary screening,
 each child when  necessary,  will receive a comprehensive assessment
 within thirty to sixty days of entry to the DCFS system.              

 3.   Record Keeping and Disclosure                                    
       DCFS   record   keeping   prevents   meaningful   supervision,
 monitoring, performance evaluation,  or planning.   On an individual
 level,  the  lack  of accurate,  or in some instances,  any records,
 interferes  with the delivery of educational and treatment services,
 and poses a threat to the health and safety of DCFS wards.            
      -- DCFS  does not  always  know  where its wards are located or       
 what is happening to them.                                            
      -- Children  are often  placed without adequate or any records.     
 The result is misplacements,  inappropriate educational  services or
 denial of access to school altogether, a lack  of  or  inappropriate     
 health   care,   and   sometimes   the  administration  of  multiple      
      -- Caseworkers, school,  personnel, foster parents, evaluators,
 and medical professionals, often lack even basic health  information
 with respect to their children.                                       
      -- The records of many children are voluminous,  but lacking in
 necessary or substantive information  about  the child.  Information     
 in  the   records   is  so  inconsistent  as  to prevent  meaningful
 supervision   of   caseworkers,   monitoring,   planning,  or   data       
 collection for departmental needs.                                    
      -- There is no mechanism for records to follow the child or for
 efficient retrieval of records.                                       
      --  Departmental  data  on children,  their  placement  status,
 educational,  health,  mental  health or  developmental  status  and       
 needs,  is  either nonexistent or so fragmented and inaccurate as to
 make monitoring, evaluation and planning impossible.                  
      --  DCFS  does  not  have  an  effective  system  for  tracking
 available  resources,  including available  foster  and shelter care      

      -- Accurate,  up-to-date information  on every child within the      
 DCFS system should be computerized and accessible  on  a  24-hour-a-         
 day basis.                                                                
      -- Medical,    psychological,   social,    developmental    and
 educational  records  should  follow the  child.   It  should be the
 responsibility  of  the  case  worker to  insure  that  records  are
 complete,   up-to-date,   and available to foster  parents, schools,
 placements,   and  medical professionals providing  services  to the
      -- DCFS should establish minimum standards for case records and
 should train all case workers in the maintenance of records.              
      -- An  evaluation  of  the  case  record  system  will commence
 immediately upon entry of any consent decree,  with  recommendations        
 for change, upgrading and retrieval within six months  of  entry  of         
 any consent decree.                                                       
         -- Data necessary to allow for tracking of  children and for        
 monitoring,  supervision, performance evaluation and planning should       
 be  standardized  and  should be  gathered  at  the state level on a
 consistent basis.   This data should be used locally, regionally and       
 statewide for performance evaluation and planning.                        
         -- DCFS should develop and maintain a data base of available       
 local, regional and state-wide  resources,  including an  up-to-date         
 and comprehensive inventory of  available  foster care, shelter  and         
 residential pLacements.                                                   
 4.   Service Planning                                       
      Individualized service planning  for  wards  and their families
 is  essential if wards removed from their home will ever be returned
 or  be  assured of  a  stable  permanent  placement.   Service plans
 reviewed  by experts often  were  boilerplate  and did  not  address
 wards'  individual needs.   To be  a  tool  in  service   provision,
 service   planning  must  be  timely,  comprehensive  and  regularly
       -- Service planning is fragmented and incomplete.                  
       -- Service plans are more often based on  available  services,       
 rather than on individual needs.                                          
       -- The failure to develop comprehensive individualized service     
 plans for wards and their families contributes to foster care             

 drift,  failed  placements  and  a failure to provide permanency for     
     -- Service plans  do  not incorporate specialized health, mental
 health,  developmental  disability  and  other  services provided by      
 agencies other than DCFS.                                            
     -- Service plans fail to state  goals  and  service  projections      
 in measurable terms.  Consequently,  evaluation of the service plans
 is difficult.                                                        
        Essential  community  professionals  are   not   invited   to
 participate in the development  of individual  service plans.   DCFS
 staff  rarely  attend educational,  health or  specialized staffings
 of their wards.                                                      
     -- Service plans fail to address the visitation of siblings  and
 wards' natural or birth parents.                                     
     -- Service  plans  do  not adequately address transitions to and     
 from placements,  independent living,  or  adulthood,  nor  do  they       
 adequately address  termination  of  parental  rights  and  adoption     
     -- Service plans do not address educational or career plans.      
     -- Caseworker overload,  other  fragmentation  of  services, and      
 little or no communication with agencies  involved  with  the  child     
 and family prohibit  the  development  and  execution  of  minimally       
 comprehensive service plans for wards.                               
     --  DCFS  should  require  case  managers  to  maintain  regular
 contact and coordination with professionals involved with  the child
 and the foster and natural family.    These  are  essential  to  the      
 implementation of a service plan.   All  relevant  actors  should be     
 included in the development of an individualized service plan.       
     -- DCFS workers should attend  educational,  medical  and  other      
 staffings  and  incorporate  these  plans  into  the  individualized
 service plan for the ward and family.                                
     -- Service plans should be reviewed,  evaluated  and  updated as     
 needed but no later than  every  six  months.   All relevant persons     
 should participate in the review.                                    
     -- An implementation plan for review of the  individual  service
 plan will be developed and operating three  months  following  entry
 of any consent decree.                                               

      -- All service plans should address  the  role  of  the  child,        
 natural or birth family, foster family or care provider,  and should
 ensure that permanency goals are stated.                              
     -- For wards preparing for adoption,  case plans  shall  address     
 the specific planning recommendations highlighted  in  the  adoption     
 section, i.e., plans for terminating and transition to  an  adoptive
      -- A  monthly  adoption  planning  review   process   will   be      
 implemented within each region within six months of entry of any      
 consent decree.                                                       
 5.   Case Management/Administrative Case Review                       
      DCFS  has  no  uniform  operative case management system.  DCFS
 cases  are  often  unattended  by  its  caseworkers.    Many  remain
 unassigned.      DCFS  files bulge with paper devoid  of information
 about the child as  a person, the child's situation, or  the child's
 need for service  or staff decision making.   The federally required
 Administrative  Case  Review process,  as implemented by DCFS,  is a
 cumbersome,  layered,  ineffective exercise  lacking  substance  and
      -- DCFS  caseload  levels  for  line  and   supervisory   staff
 guarantee that child protective  and child welfare services will not
 be managed or reviewed.                                               
      -- Child abuse hotline staff  handle an average of 40 calls per
 day.   A significant number (35%) of  callers fail to get through on
 the first call.                                                       
      -- Child protective investigators were expected to complete  12
 investigations per month,  but current practice is  15-17 per month.
 Child protective supervisors sign off on 150-200 cases per month.
      -- Child welfare follow-up staff have  an  established caseload
 standard of 35 direct service cases.   The  average  actual caseload
 is 50-60.                                                             
         There    is   no   locus   of   overall  responsibility  and
 accountability for what is happening  with the child, for what other
 people  are  or  are  not  doing,  or  for identifying  and assuring
 responses  to  newly  identified  or  changing  needs.   Performance
 responsibilities  of  the  DCFS  caseworker  and  supervisor  to   a
 particular case are undefined.                                        
     -- DCFS staff are victims of their work environment.   There are
 no  supplies,  inadequate  phone  systems,  few private offices, and
 uncooperative   clerical  support.    There  is  a  high  caseworker

 turnover  rate, due to or despite mass hiring practices.   Personnel
 generally  lack  the   qualifications,  training  or  experience for
 effective decision making.                                            
     -- Enormous  amounts  of  paper  are required to be produced and      
 shuffled,  with  no  demonstrated  relationship to service planning,      
 delivery or objective administrative case review.                     
     -- The Administrative Case Review process  is  without authority
 to effect actions to remove barriers  to  the  provision of services     
 to an individual child or within the system generally.                

     -- DCFS  should establish a case management system that for each
 case clearly designates roles  of  its  caseworker  and  supervisory       
 staff, integrates private  and sister agency service providers,  and
 identifies a case manager  with  the competence and direct authority
 to prescribe services,  assign responsibility,  and  delineate  case      
 objectives based on timely,  comprehensive, and accurate assessments
 of the needs of the individual child.                                 
     -- DCFS  should conduct administrative case reviews which verify
 and evaluate service delivery and outcome,  re-assess needs,  adjust
 service   plans   and   case   objectives,  and   redistribute  case       
 responsibility,  no  more  than  six months after placement and each      
 six months thereafter.                                                
     -- DCFS  should  provide  sufficient  staff  to   meet  accepted
 national standards for staff caseloads.                               
     -- A  workload   analysis,  using  national  standards  and  the
 participation of departmental and private providers,  shall commence
 within three months of entry of any consent decree.   A final report
 regarding case definition, case load  and  the  establishment  of  a       
 new case management system  shall  be  developed within 12 months of     
 entry of any consent decree.                                          

 6.   Resources                                                        
      Without exception, all experts found that DCFS needs  to expand
 resources inside and outside DCFS,  and expand its ability to access
 existing  resources.   For many reasons, resources for special needs
 children  and  specific  populations  are difficult  and   sometimes
 impossible  to  obtain.      DCFS does not have an  updated accurate
 inventory of its resources easily available to staff.                 
      Staff  do  not  effectively access or aggressively advocate for
 their  clients  so  they  can receive resources available from other

 state  agencies,  medical providers,  school districts   and   local
 providers.      The  failure to institutionalize cooperative service
 agreements  with  the  state  and  local agencies contributes to the
 scarcity of resources.                                               
      DCFS  wards are  vulnerable and  need more services if they are
 to  have  a  chance  to be  independent when they are adults.    The
 failure to adequately provide now  will increase the problems in the
      -- Less than  50%  of  families on founded cases of child abuse
 or neglect receive services from the Department.                     
      -- Sufficient community services are  not  currently  available     
 to meet the need.                                                    
      -- There is a pressing need for concrete services  in  the form
 of cash assistance,  housing,  transportation,  day  care,  respite,      
 emergency and ongoing child care,  shelters  for  battered women and
 children, substance abuse services,  medical and specialized medical
 and dental services.                                                 
      -- Due  to  the  severe  shortages  of placement resources  for      
 children,  workers  place  children  on  the basis  of  availability
 rather than on need.                                                 
      --  The  entire  continuum  of  placement options needs  to  be
 increased including regular foster care,  specialized  foster  care,
 foster care  of special populations,  locked  treatment  facilities,     
 and inpatient and outpatient hospital programs.                      
      -- Staff shortages  within  the  Department  contribute to poor      
 service.   Supervisory  personnel  cannot  function when expected to     
 oversee 150-200 cases per month.  Workers  cannot  provide  adequate
 services when caseloads  exceed  established  DCFS  and professional     
 standards.     Records   and   paperwork  cannot  be  generated  and
 maintained when clerical support is not available.                   
      -- DCFS'  use  of  purchase  of service contracts  for  private      
 agencies makes  it  difficult  to  address emergency needs,  attempt      
 creative  and  new programs  for  special needs children and to fund     
 start up for new programs.                                           
      -- DCFS' failure  to  fairly reimburse foster parents  for care     
 and out-of-pocket expenses contribute  to  the  shortage  of  foster      
 parent resources.                                                    
      -- Emergency shelter, diagnostic and assessment placements, and
      placements for difficult to place children are inadequate.  The

 shortage of such placements contributes to the inability  to provide
 adequate services to wards and their families.                       
      -- The current system  of  tracking  foster  care vacancies and      
 movement of children  is  inadequate.   DCFS  is unable to determine     
 vacancies because it does not know where children are placed.        
      -- DCFS  should  develop  a  comprehensive,  automated data and      
 management information system to  track wards  in  placement,  which     
 can be easily  updated  and  used  to  strategically  target  needed        
 resources for development.                                           
      -- DCFS  should develop resources to ensure that a continuum of
 out-of-home  services  is  available  to wards.   The continuum must     
 include:  assessment and diagnostic  placements;  emergency  shelter     
 care;   additional   beds   for   private   therapeutic  placements;      
 specialized  foster  homes;   and  regular  foster  homes  to  serve
 culturally specific and special needs children.                      
      -- DCFS should increase the number of clerical and professional
 staff.   Additional workers  are  needed  to  identify,  recruit and      
 license new substitute care resources, to process adoptions  and  to
 provide services to wards and their families.                        
      -- DCFS  should  provide  essential services to foster parents.     
 Transportation,  respite,  day  care,   training,   twenty-four-hour
 crisis intervention services, advocacy,  and  assistance for special
 needs  children  must  be  provided  to  enable  foster  parents  to
 effectively serve wards.   Providing  essential  support  to  foster     
 parents  will enhance DCFS'  ability  to  attract  and  keep  foster      
 parents in the system.                                               
      -- Basic  resources  to  wards  must  be  provided.   Clothing,
 medical,  dental   services   and  necessary  medical  supplies  not
 provided  by  Medicaid,  school   supplies,   tutoring,  enhancement
 services such as sports and  hobbies must be provided to wards.      
      -- Families must  be  provided resources to facilitate children
 returning home.    Workers  need  to  be  trained so they can assist      
 families  in   obtaining   housing,   employment,  substance   abuse     
 counseling,  mental health counseling,  family counseling, parenting
 training, day care and educational services.                         
      -- Information about resources needs to be disseminated to line
 workers.  Resources should be organized regionally,  ensuring access
 to resources wherever needed.                                        
      -- DCFS must provide basic health care for all wards.            

      -- DCFS  shall  actively  investigate  the  probability  of  an
 increase  in  Medicaid  Clinic  Option  dollars  and  Targeted  Case
 Management funds.   A report shall  be  presented  to  the  Director     
 outlining how these options will  increase  resources for DCFS wards
 within three months of entry of any consent decree.                 
      -- DCFS must perform,  as part  of  the  initial  screening,  a       
 resources health screening evaluation within  twenty-four  hours  of
 a child's entry into custody.   This  screening  mechanism  shall be
 implemented within sixty days of entry of any consent decree.       
      -- A   comprehensive  health  examination  should  be completed
 within thirty to sixty days of placement.    Periodic  reevaluations
 should be completed as necessary.   A  system  which  enables  those     
 examinations, should be in place  within  six months of entry of any
 consent decree.                                                     
      -- DCFS  should  institute  an  aggressive  campaign to develop     
 primary   health  care providers,  a  network  of  consultants  with
 specialties  in  a  variety   of  medical  practices,  and  specific
 services for chronically ill and special need groups.               
      -- To improve access  to  basic  health  care,  the  Department     
 should develop a "gold card" for wards  to  reimburse private health
 care providers at least 80% of the cost  of  care.   The "gold card"
 would also cover  non-Medicaid reimbursable equipment  and  services
 such as orthopedic shoes,  occupational and speech therapies, infant
 stimulation, orthodonture  and  ongoing dental care,  mental  health
 assessment an on-going treatment not covered  by  any  other funding
      -- A public/private initiative should  be  instituted to target
 specific needs so resources can be  developed  for  specific hard to
 service populations.  Incentives  should  be  developed to serve the
 most difficult populations.                                         
         -- A "medical passport" or abbreviated medical record should
    be developed that accompanies a child throughout the  out-of-home
  placement, and upon return to home or to adoption  or emancipation.
      -- The "medical passport"  should  be developed and implemented
 within ninety days of entry of any consent decree.                  
      -- DCFS will initiate steps to ensure foster parents  are  paid
 within   United   States   Department  of   Agriculture  guidelines.
 Incremental steps to reach this goal shall  be  taken  annually with
 the ultimate goal achieved no later than June 30, 1994.             

7.  Inter-agency and Intra-agency Cooperation

      Confusing,    competing    or     contradictory     interagency
 responsibilities  and  boundaries  have  resulted  in little  or  no
 cooperation between DCFS  and  other  state  departments  and  local
 agencies. At the same time, there  is  a  comparable  problem  among
 DCFS organizational units.


      -- The absence of interagency agreements precludes  or  impedes
 delivery  of  services,  including   access  to  education,  special
 education, services for children  with  developmental  disabilities,
 health services, mental health and substance abuse services.

      -- Service delivery  is  totally  fragmented  among the various
 state agencies providing services  to children  and  their families.
 Disputes over jurisdiction  and  funding cause many DCFS wards to be
 denied services by other state agencies and local school districts.

      -- The  general  lack  of  interagency cooperation at the local
 level between  DCFS  and  other  agencies  prevents coordinated case
 management and planning.

      -- There is insufficient interagency coordination  with private
 sector  providers,  both  DCFS  contract  agencies  and  independent
 providers.   This results  in  lack  of  planning,  coordination and
 awareness of what DCFS offers and what is available  in  the  way of
 private and community resources.

      -- Beyond the problems of interagency coordination, the experts
 found a lack of intra-agency coordination  within  DCFS.   The  most
 prevalent area of intra-agency non-coordination  appears  to  be  in
 the  relationship  between  Child  Protective  Services   and  Child
 Welfare Services staffs, but there is also  a  pervasive  impression
 that DCFS caseworkers are unable, unwilling,  or  do not know how to
 access contracts, resources, and support services.


      -- Written interagency  agreements  should  be  negotiated  and
 established at the state,  regional and local level between DCFS and
 other  state  agencies  (the Illinois State Board of Education,  the
 Department  of  Mental Health  and  Developmental Disabilities,  the
 Department of Alcohol and Substance Abuse, the Department of  Public
 Aid,   the   Department    of   Corrections,   the   Department   of
 Rehabilitation Services)  and  with  local  schools, local community
 service agencies, health providers and court systems.

      -- Inter-agency agreements and necessary regulations and/or
 policy should guarantee access of DCFS wards to the Department of


 Mental  Health  and   Developmental  Disabilities'  community  based
 mental  health   clinics  and   assure   access  to  both  intensive
 outpatient  and  inpatient substance abuse programs  funded  by  the
 Department of Alcohol and Substance Abuse.    The agreements between
 the Department of Mental Health and  Developmental Disabilities  and
 the  Department of Substance  and  Alcohol Abuse  shall  be in place
 within ninety days following entry of any consent decree.

      -- DCFS  should aggressively coordinate with other agencies  to
 utilize  more  fully  the  services  and resources which they offer,
 particularly the Illinois State Board  of  Education,  local  school
 districts,  and  the  Department  of Alcohol  and  Substance  Abuse.
 Where possible,  DCFS and other agencies should collaborate to avoid
 duplication and to maximize use of resources.

      -- DCFS  should  encourage  the  development  of public/private
 partnerships to further leverage DCFS  and  community resources  and
 to promote community support of DCFS' activities.

      -- DCFS  should  embark  on  a  review  of  actual cost-related
 reimbursement  with   appropriate    DCFS   and   private   provider

      -- Dollars should follow the  child  and  family,  rather  than
 following the program or agency, wherever possible.

      -- DCFS caseworkers should aggressively  seek  the  involvement
 of local school personnel and  other appropriate local providers  in
 their case review and planning meetings.

 8.   Role of the Court

      The courts  have  ultimate responsibility for wards in the DCFS
 system.   The courts  are  overcrowded and understaffed and serve as
 a barrier to services for wards.


      -- Regular  court  case  reviews  are  rarely completed in Cook

      -- Cases  are routinely referred to the "guardianship calendar"
 where they languish without intervention for months and years.

      -- After DCFS is appointed guardian, it is raze to have further
 court intervention.

      -- Judicial  review  of  cases  on  the "guardianship calendar"
 does  not  promote  permanency.  Hearings are held without notice to


 principals in the case and fail to meet  guidelines  for  permanency
 hearings mandated  by  the  Federal  Adoption  Assistance  and Child
 Welfare Act (P.L. 96-272).

      --  The  judicial  termination  of  parental  rights, necessary
 before  adoption,  is  delayed  because  workers  fail  to  document
 sufficient work with the family.

      -- DCFS staff and private agency staff  are  forced  to  attend
 court  hearings  to  make  progress  reports  to  the  court.   This
 practice  is  a  duplication of effort and requires workers to spend
 hours at court waiting for cases to be called.

      -- DCFS lacks  adequate clerical,  paralegal and legal staff to
 process  legal  work  necessary  to  finalize  adoptions  for wards.
 Approximately 500 adoption petitions currently need to be prepared.


      -- The  "guardianship  calendar"  should   be   replaced   with
 appearance hearings, with notice to  parents.  The  hearings,  where
 possible,  should  be  conducted  by  the  judge  who heard the case

      -- DCFS should coordinate and delegate  court  activities  when
 purchase of service agency workers are involved.

      -- DCFS should take immediate action  to  address  the delay in
 completing  the  legal  work  necessary  to  finalize adoptions  for

 9.   Training.

 Adequate  training  is  lacking  for  at  least   two  of  the   key
 segments of the service delivery  system:   caseworkers  and  foster


      -- DCFS caseworkers  lack  knowledge  and competence in various
 areas, yet are not offered adequate  training  in  family  dynamics,
 child  development,  developmental  milestones,  special  education,
 vocational  and  post-secondary  educational  resources,   needs  of
 children  with  developmental  disabilities  and  mental  illnesses,
 resources to  meet  special  needs, or legal rights and entitlements
 of wards and their families.

      -- DCFS  caseworkers  are   uninformed   or  misinformed  about
 internal resources and procedures of DCFS,  as  well  as  about DCFS
 philosophy and job performance expectations.


      -- Training  of  foster  care  parents  is woefully inadequate.
 Foster care children with special needs  particularly  suffer  from
 the absence of training for foster parents in the areas of behavior
 management,  access to health care and mental health services,  and
 access  to  or procurement of  appropriate  special  education  and
 related services.


      -- DCFS should train all caseworkers in the  following  areas:

      --   family assessment,  service  planning,  case  monitoring,
           outcome  evaluation,   family  intervention   techniques,
           especially with abused  and  neglected  children,  crisis
           intervention,  family  dynamics  and  child  development,
           maltreatment, substance abuse,  the  differences  between
           poverty and neglect, and the indicators for developmental

      --   community resources, access to health care  services  and
           management of health care services for  clients,  special
           education  and  related  services,  vocational  and  post-
           secondary  educational  services,  principles   of  least
           restrictive environment, and rights of clients;

      --   training and supervision in developing,  maintaining, and
           using  the  DCFS  record  system   and  individual client

      -- Foster care parents should receive training,  with  special
 emphasis on parenting skills,  behavior management  and  techniques
 for access resources for special needs children.

      -- Foster parents should  be  compensated for participation in
 initial and ongoing training programs.

 10.  Quality Assurance.

      DCFS,  has  little  commitment to meaningful quality assurance
 procedures and methodologies.  Appropriate and measurable standards
 are not utilized and reliable data  is absent.   Accountability  is
 not evident at any level of the DCFS  service delivery system.   To
 the extent that standards and expectations  are  articulated,  they
 are routinely disregarded throughout the DCFS structure.


      -- Timelines  are  not  met,  paperwork is  not maintained and
 procedures are not followed.  Recordkeeping  is  found to be so bad
 that any meaningful supervision, quality assurance  or  planning is
 next to impossible.


       -- Standards, expectations and quality vary  enormously  from
 region to region and from supervisor to supervisor.

       -- What  standards  and  expectations  do  exist are based on
 measuring the process which was used,  rather than the outcome that
 was achieved.  Thus,  the  system de-emphasizes the quality of work
 as an important value.

      -- In the way  it  manages  its clients and its own operation,
 DCFS  is  focused  on  triage  and  is   overwhelmed   with  crisis
 management, rather than devoting itself to proactive  planning  and
 prevention efforts.  Staff lack criteria by which to make decisions
 and  options  to  allow  for  appropriate   choices,  resulting  in
 decisions which are primarily dictated by expediency.

      -- Little  quality  control  is  maintained  with  respect  to
 selection and maintenance of foster homes.  Quality  assurance with
 respect  to  purchase  of  service  providers  is  also focused  on
 process, rather than outcome measures.


      -- A  quality  assurance  workgroup  should  be named  by  the
 Director to initiate  the  development  of  quality assurance tools
 which focus on outcome measures.   This workgroup will be appointed
 within thirty days of entry of any  consent decree  and meet within
 sixty days of their appointment. The workgroup shall  be chaired by
 a  Deputy  Director  and  include  DCFS  staff  and  private agency
 providers.   This  workgroup  will  make  its  final  report to the
 Director eighteen months following entry of any consent decree.

      -- DCFS must develop clear, specific  and  measurable criteria
 for staff performance and for client outcomes.

      -- A quality assurance unit should be created to  evaluate and
 provide feedback on all aspects of DCFS operation,  including  DCFS
 programs and staff, and services provided by contract agencies  and

      -- Worker  accountability  and   development   of  performance
 standards must be addressed, with union involvement.


      The consensus findings  and  recommendations,  as set forth in

 this Final Consolidated Report, formulate priorities  for immediate

 implementation.   Each  expert's report details additional findings

 and recommendations particular  to  their  area  of study to assist

 this Court and the parties in framing a plan of action.

                                      Respectfully Submitted,



      I.      EXPERTS' REPORTS

              A. Case Management/ACR (Quality Assurance)
                 Sue A. Gant, Ph.D., St. John, U.S. Virgin Islands

              B. Child Protective Services
                 Patricia Schene, Ph.D., Director, American Association
                 for Protecting Children, American Humane Association,
                 Denver, Colorado

              C. Placement Services Under 12
                 Mazy Anne Brown, Executive Director, Hephzibah Children's
                 Association, Oak Park, Illinois

              D. Placement Services 13 and Over
                 Earl P. Kelly, D. Ed., Executive Director, Orchard Place,
                 Des Moines, Iowa

              E. Education
                 Joy J. Rogers, Ph.D., Professor, Loyola University of
                 Chicago, Illinois

              F. Health
                 Paula K. Jaudes, M.D., La Rabida Childrens Hospital and
                 Research Center, Chicago, Illinois
                 Arthur F. Kohrman, M.D., La Rabida Childrens Hospital and
                 Research Center, Chicago, Illinois

              G. Mental Health
                 Arnold L. Miller, Ph.D., Clinical Director, Mental Health
                 Clinic of Champaign County, Champaign, Illinois
              H. Developmental Disabilities
                 Kathleen A. Schwaninger, M.S., Executive Director of SKIP
                 of New York, Inc., New York, New York

                 Edward Page-E1, M.D., Medical Director, Diagnostic and
                 Assessment   Program,  Institute   for   the   Study   of
                 Developmental Disabilities, Chicago, Illinois

              I. Substance Abuse
                 Levern Murphy, Executive Director, Garfield Counseling
                 Center, Inc., Chicago, Illinois

              J. Adoption
                 Carol W. Williams, D.S.W., Senior Research Analyst, The
                 Center for the Study of Social Policy, Washington, D.C.

                 Judith K. McKenzie, M.S.W., Executive Director, Spaulding
                 for Children, Farmington Hills, Michigan

              K. Experts' Resumes


              L.  Description of Settlement Process


              M.  Order to Appoint Expert Witnesses (August 31, 1990)

              N.  Amended  Order  Appointing  Expert  Witnesses  and  Order
                  Regarding Expert Witnesses (October 26, 1990)

              0.  Second Amended Complaint (October 16, 1989)

              P.  Order of the Court (May 30, 1989)

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