Independent Living Classes hosted by Saddle Rock Ranch

Program aids teens in foster care

Harrison, Lauren, Long Island Newsday, 12/8/12

Teenagers sat at tables in a Middle Island classroom equipped with a kitchen, watching as a professional chef demonstrated how to chop a cucumber.

"See your fingers? We don't want to lose them," said Richard Freilich, Suffolk County Community College's culinary program director, tucking his fingertips away from the blade. "Use your fingers to control the vegetable."

Food safety and healthy cooking were among several skills 30 teens in New York's foster care system learned Saturday at the launch of a special respite program.

Held at the 15-acre Saddle Rock Ranch, the program aims to prepare teens transitioning out of foster care, with workshops on topics ranging from managing money and enrolling in college to grooming horses.

"The goal is that it will make a difference in some of their lives. They'll be able to start feeling confident," said Lauri Sherman Graff, director of Heart Gallery NYC, which created the program with Family Residences and Essential Enterprises Inc., the ranch operator.

About 100 teens will take part in the monthly program, with some courses taught by Suffolk County Community College instructors, through a $25,000 grant by HSBC, the global banking and financial services firm.

Foster children face "tremendous challenges" in entering the real world, Sherman Graff said.

"A significant percentage of children who age out of foster care end up incarcerated or homeless; the girls end up pregnant," she said. "So we're hoping to just interject before that happens and give them some hope."

Hope is central to both nonprofits. Heart Gallery NYC has helped find permanent homes for many foster children, featuring their photographs in public exhibits since 2007, Sherman Graff said. Family Residences offers a variety of programs, especially centered around equestrian therapy, for Long Island residents with special needs, said Christopher Long, the group's chief of operations.

"One of the important components . . . is how the handlers develop relationships with the horse," he said.

Jasmine, in foster care for 14 of her 16 years, called it "a little bit" overwhelming to learn how to budget the money she makes in a work-study program at a nursing home. "It's going to get harder because when I get more jobs, I gotta learn how to spend my money and how to save it," she said.

For Amanda, 14, who has been in foster care since she was 6, the program takes her "one step closer" to becoming a young adult.

Amanda said she hopes to become a therapist, adding, "Because I've been through so much during my past . . . it would be easier to understand a kid, because I've been through it."

Dental Partnership With Child Welfare

NYU Dentistry, foster care agency partnership, improves child health, aids student training

Press Release, October 21, 2012

The New York University College of Dentistry (NYUCD) and Graham Windham, a local NYC-based foster care agency, have partnered to provide regular dental care to more than 650 children since spring of 2011. The success of the program, Partners Against Caries (PAC), both for the participating foster children and the dental school students, may serve as a model for other dental schools' outreach programs. PAC's successes were outlined in an oral as well as a poster session at the American Academy of Pediatrics (AAP) National Conference and Exhibition in New Orleans, October 20-23, 2012.

"The program has been an overwhelmingly positive experience for both the children and families in foster care, as well as for the NYUCD dental students," said study author Elizabeth A. Best, MPH, Department of Pediatric Dentistry. "The pediatric patients enjoy receiving care from the dental students, who are very engaged with the children."

For the dental students, the experience has been eye-opening.

"Most of the dental students have little knowledge of the foster care system," commented Best. "At NYUCD, we are now graduating dental students who have worked with this population, and are aware of their unique health care needs," she said.

Poor dental and oral health can affect children's growth, school performance and attendance, and can contribute to physical and mental health problems. According to Healthy Foster Care America, approximately 35 percent of children and teens enter foster care with significant dental and oral health problems.

"Dental health has been described as a "window" to a child's well-being," said Mitchell Rubin, MD, FAAP, Medical Director, Graham Windham. "We believe that an optimal dental state is a necessary ingredient for the interrelated spectrum of medical, mental and social health," Dr. Rubin said.

Low-income children, especially those in foster care, are less likely to receive regular dental care, and, as a result, face a greater risk of tooth decay. These children, as they grow older, are susceptible to a myriad of oral health related problems– from heart disease, diabetes, and oral cancer, to low self-esteem and depression.

"Our exciting partnership with the NYU College of Dentistry not only addresses a heretofore gap in this service, but also serves as an invaluable tool for the dental students – introducing them to a most vulnerable pediatric population. We are so happy that the children are getting such wonderful care," Dr. Rubin said.

The abstract presented at the AAP conference, "An Approach to Dental Healthcare in an Inner-City Foster Care Population: The Partners Against Caries (PAC) Program," describes the partnership, which shifted dental services for these children from multiple providers to a single "dental home" in spring, 2011. The goal was to improve care quality and continuity for the participating foster children, and to provide a unique learning experience for dental students.

Through PAC, the children, ages 18 months to 21 years, receive dental exams, cleanings, fluoride treatment and family education at two foster care facilities, as well as transportation and referrals to NYUCD's dental clinics for more complex care.

"We definitely think that other schools could benefit from a similar experience and curriculum," Best said.

Source: New York University

A Medical Guide for Youth in Foster Care

A Medical Guide for Youth in Foster Care
New York State’s Office of Children and Family Services has released a 28-page booklet to guide youth in care through the health care system. The booklet covers informed consent, rights to privacy and to refuse medication, and information about how to get and pay for medical care. (2011)

http://www.youthsuccessnyc.org/PDF/2011_medical_guide_for_foster_youth.pdf

Overmedication of Foster Youth - and Yes, the Drug Companies Are Making Money

Drugs Used for Psychotics Go to Youths in Foster Care

Carey, Benedict. New York Times, Nov. 20, 2011

Foster children are being prescribed cocktails of powerful antipsychosis drugs just as frequently as some of the most mentally disabled youngsters on Medicaid, a new study suggests.

The report, published Monday in the journal Pediatrics, is the first to investigate how often youngsters in foster care are given two antipsychotic drugs at once, the authors said. The drugs include Risperdal, Seroquel and Zyprexa — among other so-called major tranquilizers — which were developed for schizophrenia but are now used as all-purpose drugs for almost any psychiatric symptoms.
“The kids in foster care may come from bad homes, but they do not have the sort of complex medical issues that those in the disabled population do,” said Susan dosReis, an associate professor in the University of Maryland School of Pharmacy and the lead author.

The implication, Dr. dosReis and other experts said: Doctors are treating foster children’s behavioral problems with the same powerful drugs given to people with schizophrenia and severe bipolar disorder. “We simply don’t have evidence to support this kind of use, especially in young children,” Dr. dosReis said.

In recent years, doctors and policy makers have grown concerned about high rates of overall psychiatric drug use in the foster care system, the government-financed program that provides temporary living arrangements for 400,000 to 500,000 children and adolescents. Previous studies have found that children in foster care receive psychiatric medications at about twice the rate among children outside the system.

The new study focused on one of the most powerful classes of drugs, antipsychotics. It found that about 2 percent of foster children took at least one such drug, even though schizophrenia and bipolar disorder, for which the drugs are approved, are extremely rare in young children.

“It’s a significant and important finding, and it should prompt states to improve the quality of care in this area,” said Dr. Mark Olfson, a professor of clinical psychiatry at Columbia University who did not contribute to the research.

In the study, mental health researchers analyzed 2003 Medicaid records of 637,924 minors from an unidentified mid-Atlantic state who were either in foster care, getting disability benefits for a diagnosis like severe autism or bipolar disorder, or in a program called Temporary Assistance for Needy Families. All of these programs draw on Medicaid financing. The investigators found that 16,969, or about 3 percent of the total, had received at least one prescription for an antipsychotic drug.

Yet among these, it was the foster children who most often got more than one such prescription at the same time: 9.2 percent, versus 6.8 percent among the children on disability, and just 2.5 percent of those in the needy families program.

Antipsychotic drugs, the authors said, also cause rapid weight gain and increase the risk for metabolic problems in many people, an effect that may be amplified by the use of two at once.

Doctors who treat such children are aware of the trade-offs and often prescribe lower doses of the medications as a result. And when they add a second such drug, it is often to counteract side effects of the first medication.

Still, the relatively high rates of these drug combinations in such a young and vulnerable group have prompted policy makers across the country to take notice. A consortium of 16 states, in collaboration with Rutgers University, has drawn up guidelines to improve care for foster children and others dependent on state aid.

“The psychiatrists who are treating these kids on the front lines are not doing it for money; there are very low reimbursement rates from Medicaid,” said Dr. Ramesh Raghavan, a mental health services researcher at Washington University in St. Louis. “There’s enormous anguish because everyone knows that this is not what we should be doing for these kids. We as a society simply haven’t made the investment in psychosocial treatments, and so we are forced to rely on psychotropic drugs to carry the burden.”

One-fourth of New York City foster youth age out immediately into homelessness

A Deal to Help Foster Youths Find Housing

Secret, Mosi. New York Times, October 20, 2011

New York City has reached an agreement on a proposed settlement of a lawsuit that claims the city allows older children to leave foster care only to become immediately homeless.

Each year, roughly 800 to 1,100 people age 18 to 21 are discharged from foster care to fend for themselves, the plaintiffs complained in the class-action suit.

There is no current data on the youths’ housing after foster care, but previously the city’s Department of Homeless Services and the City Council estimated that more than a quarter of youths discharged from foster care because of their age end up homeless almost immediately, according to the complaint, which accuses the city of shirking its responsibilities to those youths.

The city is required by state law to supervise and assist in providing housing for people who have left foster care until they reach age 21.

The accord calls for the city to maintain a unit in the Administration for Children’s Services for those people, initiate training for foster care agencies, revamp its procedures for helping youths find stable housing and improve their access to services.

The agreement is the product of two years of negotiations among the Administration for Children’s Services, the Legal Aid Society and the advocacy group Lawyers for Children. The parties said they had agreed to settle to avoid protracted litigation, and they actually reached the agreement before the lawsuit was filed in Manhattan Supreme Court on Monday.

The plaintiffs’ lawyers filed the suit to provide for court enforcement if problems develop down the road, said Pat Bath, the spokeswoman for Legal Aid. A judge has to approve the settlement before it goes into effect.

The four lead plaintiffs remain anonymous. Three are 21 years old and at risk of being homeless at discharge because they do not have stable housing lined up, according to the complaint. One is 20, has already been discharged and is at risk of becoming homeless, the complaint says.

“An alarming number of young people are being discharged from foster care into homelessness,” Tamara Steckler, the lawyer in charge of the juvenile rights practice at the Legal Aid Society, said in a written statement.

Ronald E. Richter, the commissioner of the Administration for Children’s Services, said in a written statement, “We are committed to helping young people leaving foster care achieve successful adulthood, which includes appropriate stable housing.”

Under the accord, the children’s services agency will develop permanent housing plans for youths living in foster care. It will work with foster care agencies to create the plans in time to find adequate housing. The city and the agencies will monitor the young adults discharged under the plans until they turn 21.

Children’s Services will also track and monitor data on their housing until they turn 21.

Also, a new unit in Children’s Services will oversee the foster care agencies’ adherence to the new requirements.

New York foster youth "aging out" into homelessness

Deal reached to help older foster care children

Associated Press, October 21, 2011

NEW YORK — New York City has reached an agreement on a proposed settlement of a lawsuit that claimed it allowed foster care children to fall into homelessness after leaving the system at age 18.

The lawsuit said the Administration for Children's Services failed to abide by state laws that mandate children be prepared for independent living when they leave foster care.

The agreement calls on the ACS to maintain a special unit for children who turn 18. It also calls on the ACS to initiate training for foster care agencies, update its procedures for helping youths find stable housing and improve their access to services.

The agreement was reached after two years of negotiations among the ACS, the Legal Aid Society and the advocacy group Lawyers for Children.

"Aging Out" of foster care - and into a harsh, new world

The "Aging Out" Dilemma Plaguing the Foster Care System
Baccaglini, Bill. Executive Director of the New York Foundling.
Huffington Post, September 25, 2011.

Imagine that because you've been abused or neglected as a child, you've spent the first 21 years of your life separated from your biological family, bouncing from one foster home to another and changing schools every few years. At 21-years-old, you have never paid rent, bought your own groceries or managed your own expenses.

With an education that's spotty at best, and no family or other support systems in place, you're told that you're now an adult and responsible for functioning in the world on your own. Would you be able to do it?

That is precisely the situation facing many young adults who age out of our child welfare system. And while outgoing ACS Commissioner Mattingly did a tremendous job on many fronts, he would probably agree that the "aging out" population is one that still requires urgent attention. As new Commissioner Richter takes over the agency, this would be an excellent time to take a fresh look at how we serve - or fail - these young people.

While local statistics are hard to come by for a population no longer under the city's care, nationally, one in four of the 20,000 foster care youth who age out of the child welfare system each year are incarcerated within two years; one in five become homeless, only half graduate from high school. With more than 900 young people aging out in New York each year, these numbers reflect a real problem.

Under the current system, when young people in foster care turn 21, they have the rug pulled out from under them.

They must sink or swim. But if they sink, we all pay a price. Unable to manage on their own, with none of the support systems in place that we all take for granted, all too often, they end up homeless, or turn to drugs and crime - all of which take a toll on government budgets and the quality of life in our communities.

Because of their life experiences some kids need more support than others - and they may need it for longer. A 21-year-old who has lived most of his life in either the child welfare system or a dysfunctional family setting is not at the same level emotionally or cognitively as other 21-year-olds. And as every parent knows, you can't set an arbitrary schedule for maturity.

As nervous as we may be to send our own children away to college, for example, we recognize that we could not have gotten them more ready simply by training them better or earlier. Most of the kids we're talking about are not going away to college; they may not have graduated high school. There are no teachers or mentors or parents they can call when run out of money or get into trouble. They're on their own and, for many of them, 21 is simply not old enough. And no amount of training or better programming by the child welfare system could have hastened their readiness. Because of their many pressing needs and challenges, they have not been the beneficiaries of structured or guided exposure to life experiences that naturally facilitates the maturation process.

What's the solution? First, we need more and better programs to prepare these kids for life on their own. Once they are on their own, they are likely to still need help with housing, jobs and enrolling in some form of academic or vocational higher education. They may also need social work or mental health assistance to deal with issues like parents coming out of prison or siblings with drug problems. For those kids, providing this kind of support until age 23 could mean the difference between a productive life and a life in the corrections system or a homeless shelter. These age appropriate programs that work beyond the system are a very good investment indeed.

At the same time, we need to make it clear that this support for young adults is temporary, and that the recipient must ultimately bear responsibility for his or her own success. These young people must stay enrolled in school and hold a job, even if part time. There must be high expectations, no free rides, and a path toward independence in a relatively short term.

For Hispanic youngsters today, we're seeing particular challenges, at least partly due to changing immigration trends. Many young immigrants, coming here from a variety of countries, do not have the generational, family and community support that has existed for previous immigrant groups. Whatever extended family they may have to fall back on may already be stretched thin. Combine lack of family with language barrier and overall cultural differences, and that child is at even greater risk.

Critics may argue that at some point we need to stop supporting these kids and cut them loose, and that 21 seems like a logical age. After all, we spend hundreds of thousands of dollars on each of these kids up until that point - When is enough enough? If release from the child welfare system is no more than a path toward a homeless shelter or a jail cell, what have we accomplished? If by creating short term programs to teach the necessary skills prior to turning 21 and by providing some additional support for a limited period of time afterwards, we can put that young adult on the path to a successful productive life. Isn't that worth it?