IN THE UNITED STATES DISTRICT COURT
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
OF
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
law.
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
2
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.
3
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
development.
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
rationale.
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.
4
deliberations and reports. The experts reports appear in the
Appendix.
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
families.
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
5
demonstrate that it can meet its legally mandated responsibilities
and effectively keep its promise to Illinois children and their
families.
II. CONSENSUS OF FINDINGS AND RECOMMENDATIONS
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.
FINDINGS:
-- 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.
-6-
-- 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.
RECOMMENDATIONS:
-- 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.
-7-
-- In its role as "parent," DCFS should assure that every
child receive adequate food, clothing, shelter, health care, and
education.
-- 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
staff.
-- 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.
FINDINGS:
-- 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
-8-
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
health.
-- 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.
RECOMMENDATIONS:
-- 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
-9-
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.
FINDINGS:
-- 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
immunizations.
-- 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
beds.
-10-
RECOMMENDATIONS:
-- 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
child.
-- 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
reviewed.
FINDINGS:
-- 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
-11-
drift, failed placements and a failure to provide permanency for
children.
-- 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
plans.
-- 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.
RECOMMENDATIONS:
-- 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.
-12-
-- 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
family.
-- 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
objectivity.
FINDINGS:
-- 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
-13-
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.
RECOMMENDATIONS:
-- 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
-14-
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
future.
FINDINGS:
-- 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
-15-
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.
RECOMMENDATIONS:
-- 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.
-16-
-- 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
source.
-- 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.
-17-
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.
FINDINGS:
-- 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.
RECOMMENDATIONS:
-- 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
-18-
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
representatives.
-- 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.
FINDINGS:
-- Regular court case reviews are rarely completed in Cook
County.
-- 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
-19-
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.
RECOMMENDATIONS:
-- 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
previously.
-- 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
wards.
9. Training.
Adequate training is lacking for at least two of the key
segments of the service delivery system: caseworkers and foster
parents.
FINDINGS:
-- 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.
-20-
-- 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.
RECOMMENDATIONS:
-- 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
problems;
-- 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
records.
-- 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.
FINDINGS:
-- 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.
-21-
-- 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.
RECOMMENDATIONS:
-- 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
staff.
-- Worker accountability and development of performance
standards must be addressed, with union involvement.
-22-
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,
![]()
-23-
APPENDIX
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
II. SETTLEMENT PROCESS
L. Description of Settlement Process
III. COURT DOCUMENTS
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)
Last updated March 22, 1998