Impact Feature Issue on Children with Disabilities in the Child Welfare System
Serving Youth with Disabilities in Minnesota: Two Case Worker's Experience
Billy,* a 12-year-old with developmental disabilities, was picked up by the police for the third time in as many weeks at 3 a.m. while attempting to sleep at a bus shelter. He was brought to the 24-hour Child Protection intake shelter. His speech was very difficult to understand and he only responded in two- or three- word phrases. He was easily agitated during the interview and looked tired. The Child Protection worker noted that Billy appeared disheveled, wore dirty clothes, and had an unpleasant order.
Through Child Protection involvement Billy was placed out of his home, and referred to receive services and case management from county Disability Services. The hope was that more and specialized resources could be gained through Disability Services. While under the care of the child welfare system, Billy was increasingly aggressive and continued to run. Until his order to permanent foster care, he had 13 different placements over a three-year period. All the while attempts were being made to structure a community-based support system that would allow him to reside in his family home with supports and services.
Billy did not fit into the practice model for Child Protection due to his disabilities, and he did not fit into the model for disability case management due to his Child Protection involvement. We struggled to adjust, dug deeper and deeper into resources, and often came to blows with our enormous bureaucracy filled with payment streams, processes, and procedures. In reviewing this case, several issues became clear to us involving the interaction of child welfare services and youth with disabilities.
The first challenge we encountered with Billy was the high number of disrupted placements. It was clear to us that the resources of the foster care system and other residential providers were not equipped to meet the complicated needs of adolescents with developmental disabilities. Ten of the thirteen placements were temporary emergency shelters and Billy resided there until his behavioral issues resulted in his being removed from the programs. The focus became just finding a bed for Billy as opposed to locating an appropriate placement that would meet his needs. The placement issue was more complicated by the fact that for most of the Child Protection case, the option of a long-term community group home was closed since the child welfare system’s legally prescribed goal is reunification with the family. It became evident early on that even though Billy’s family was concerned and willing, they could not meet his needs.
Another challenge was the needed yet complicated interactions between multiple systems including child welfare, the public schools, medical professionals, and disability services. With data privacy, and each system having its own set of rules to govern it, coordinating services was difficult. It also was evident to all the systems involved that there was a lack of early intervention for Billy when he was young and first identified as having a developmental disability. The first known comprehensive assessment was requested by the child welfare system when he was 13 to satisfy a requirement for residential consideration. His needs, and support for his family in trying to help meet those needs, would have been much easier to address when he was a young child rather that an aggressive teenager.
The child protection system model is based on reaction to specific safety events. Meeting a child’s need for ongoing services and developmental assessments is voluntary on the part of caregivers. A family’s reluctance or inability to engage in services for a child’s developmental needs can have the potential to profoundly impact the child’s life. This is especially true for children with disabilities. This raises the larger question: Should the child welfare system mandate early intervention services for this population?
Due to legal issues within the child welfare system, Billy was unable to be placed voluntarily; the case required court supervision from the initial Child Protection intervention. Most disability services are engaged in voluntarily. Billy’s family had always been resistant to outside services, therefore Child Protection made involvement with Disability Services a requirement for the case plan. The failure to fully engage in disability services became part of the Child Protection legal argument for neglect by the family; however that took 18 months to document and prove. During this time the court required reunification efforts and that impeded the ability to find a long-term stable placement. Ultimately the court ordered the family to make use of Disability Services.
Throughout this case the two systems struggled to find appropriate services for Billy while at the same time satisfying their respective, sometimes conflicting, program policies. To better meet the needs of youth such as Billy, child protection units could have a developmental disabilities social worker attached. This simple programming change would help navigate the landscape of legal, resource, medical, payment streams, and policy hurdles. Furthermore, juvenile courts could be better trained as to the special needs and services available to youth with developmental disabilities. Finally, we urge the identification and service/support intervention for these children at a very early age.