Legislative Program Review and Investigations Committee

Department of Children and Families
Chapter Five


Chapter Five
DCF Activities

The major activities DCF undertakes to carry out its mandates for protective services, juvenile justice, mental health and substance abuse, and prevention are outlined in this chapter.   Agency programs and facilities as well as the key steps the department follows in providing services to clients in each mandate area are described.  An overview of the DCF client population is also provided.     

Client Population   

            DCF receives clients from a variety of sources including the courts, schools, police, hospitals, private service providers, neighbors, and parents.  There is no single point-of-entry into the department nor is there a single intake or case management process for all cases.  In fact, protective services, juvenile justice, and voluntary mental health services case processes are distinct and rarely integrated within DCF. Each service area has a separate case management system and staff as well as its own facilities, contractors, and programs.  

The majority of DCF clients are involved in protective services cases; a portion receive mental health and substance abuse services and a small number are "dually committed."  These are children committed to DCF care by the court as a result of an abuse or neglect case and as a delinquent in a juvenile justice matter.  Typically, the juvenile justice commitment takes precedent in terms of services and case management until the end of the 18-month or 4-year commitment period and, if the protective services case is still active, the case is then managed by the regional treatment office. Protective services may continue to be provided to the juvenile's family as part of the ongoing abuse or neglect case.  Juvenile justice and protective services staff, however, do not routinely coordinate services or consult on treatment planning.  

Data lacking.  Program review staff had planned to include an analysis of the cross-over among major DCF client groups -- protective services, juvenile justice, and mental health -- in terms of services provided, and had requested data necessary to conduct the analysis from DCF in April 1999.  The department was unable to provide the information as requested or an alternative method for accurately identifying the proportion of its clients who are single- versus multi-service cases.   

Ultimately, the department responded in an August 1999 letter that its automated information system: (1) was not capable of generating data on the cross-over between child protection and juvenile justice; and (2) could not provide information for any client population receiving mental health services unless those services were provided in a residential placement paid for by DCF.   Therefore, the following descriptions of major DCF activities contains no quantitative analysis to support the department's position that the children it serves under each mandate are very similar and often move from one service area to another.

Protective Services   

Protective services is a specialized DCF responsibility extended to families in behalf of children who are abused, neglected, uncared-for, or abandoned.  It is involuntary in that the parents or guardian of the child generally do not ask for department services and DCF cannot allow the child to continue in the unsafe situation.  Protective services continue until the agency determines the child is receiving proper care in the birth home, has been permanently placed in another home environment, or has aged-out of the child welfare system at 18 or, under certain circumstances, 21 years old.  

Reports.  Figure V-1 outlines the protective services case process.  It begins with a report of alleged abuse, neglect, abandonment, or endangerment of a child made to the DCF Child Abuse and Neglect Hotline.  Reports are evaluated by hotline staff for severity and classified as low, moderate, or high risk.  The classification level determines the appropriate response time for beginning an investigation.  The response time for investigation ranges from two hours for a report involving a death or serious injury or the risk of death or serious injury to 24 or 72 hours for other, non-life threatening situations.  

Table V-1 shows the total number of calls processed by DCF's hotline, not all of which were reports of abuse or neglect.  The number of calls investigated has increased over the three-year period, rising by 3.4 percent in FY 98 and 3.7 percent in FY 99.   At the same time the percentage of calls investigated by DCF decreased slightly.   

 

Table V-1 Reports to DCF Hotline and Investigations: FY 97 – FY 99.

 

Activity

FY 97

FY 98

FY 99

Total Reports

34,316

38,682

42,164

Total Investigated

28,786

29,769

30,938

 

Source of Data: DCF

 

Investigations are conducted by regional office investigators or by hotline investigators during after-business hours.  All investigations must be completed within 45 days -- including the mandated 30-day investigation period plus an additional 15-day extension period if needed.  The investigation has two objectives: (1) ensure the child's safety; and (2) begin the process of service delivery to the family. 

Treatment.  Substantiated reports are referred within the regional office to a treatment unit for case management and service referral.  Treatment is aimed at assessing and addressing 

 the child's and parents' needs in order to preserve the family unit and protect the child. The treatment relationship between DCF and the family, which is often long-term and can be multi-generational, frequently addresses various related problems that contribute to or exacerbate abusive or neglectful behavior, such as poverty, homelessness, physical or mental illness, alcohol and substance abuse, criminal activity, and a lack of educational or employment opportunities.  

A written treatment plan for every child under DCF supervision is required to be developed and reviewed every six months.  A treatment plan is a working agreement between DCF, the child, family, and any treatment service provider (e.g., foster family or residential facility).  A treatment plan states the diagnosis of the child's and/or family's problems and the services to be provided; based on assessment information, observable and measurable treatment goals are also defined.  DCF treatment plans provide a "dual track" -- one that outlines the primary case management and service delivery aiming for reunification of the family and a contingency plan, or secondary track, for permanent placement (e.g., adoption or independent living) should reunification efforts fail.           

Out-of-home placement of a child can occur at any point in a protective services case.  For example, a child in imminent danger of serious physical or sexual abuse can be removed from his or her home within hours of a report to DCF or a child can be placed at the conclusion of the 45-day investigation or any point during DCF's involvement with the family.  Children may also be placed more than once.  Some children are placed in several different foster homes, some rotate between foster care and residential care or hospitals, and others return home to their birth families only to be replaced in foster care when the reunification efforts fail.  Multiple placements occur for a variety of reasons including inappropriateness of the placement, lack of resources, clinical error, or problems of the child.   

Removal.  The four primary ways in which children are removed from their homes are: a 96-hour hold; an Order of Temporary Custody (OTC) by the court; court commitment to DCF; or voluntary placement.  A 96-hour hold, used by the department when serious conditions pose imminent danger to a child, can be granted by a regional administrator, DCF commissioner, or medical personnel in a hospital setting.  The hold is issued without the parents' permission or prior knowledge, and is not reviewed by the court. To continue custody of a child beyond the 96 hours, DCF must be granted an order of temporary custody by the court.  

            An order of temporary custody is granted by the court when a child is in need of court protection.  DCF becomes the child's guardian for an initial 10-day period, during which a show cause hearing is held.  The court may continue DCF's custody of the child for 30 days or return the child to his or her family.  In either case, a full hearing is scheduled by the court within 30 days to determine whether or not the allegations can be substantiated warranting the child's commitment to DCF care.  

            The third way a child can be removed from home is through a commitment proceeding. A child is committed when a court finds the child, while not in any imminent danger, is still in need of protection.  DCF may be granted care and custody of a child for a period not to exceed 12 months.  The department can petition for a revocation which is a return of a committed child to the home, an extension of the commitment for another 12-month period, or termination of parental rights.  

            The fourth method of removal is voluntary placement.  Parents may request their child be removed from the home for a period of up to 90 days, usually for short-term problems within the family, such as children who run away, have psychiatric, emotional, or medical problems, or exhibit unusual or uncontrollable behavior.  The parents retain all rights to and responsibilities for the child and, at their request, the child must be returned immediately to the home.  

            Placements.  During 1999, the department contracted with 14 private providers to operate Safe Homes, a new type of residential placement for children between the ages of three and 12 who are removed from home for the first time.  Safe Home programs include a 45-day intake and assessment process, which serves as a pre-placement period and allows the department to evaluate a child's needs and determine the most appropriate longer-term placement.  It should be noted, DCF was unable to complete its Safe Homes project – several homes were not opened as planned – and subsequently the state funding for this project lapsed during 1999.    

The department also requires all placements in a residential facility or program, for any reason, be approved by a central office child placement team (CPT).  The CPT is responsible for managing placement resources and assuring the appropriateness of a placement.  The team is comprised of DCF staff and, on the request of the family court, a probation officer.  

            During FY 99, DCF reported serving 42,041 children in 16,635 families involved in protective services cases, in FY 98, it served 38,283 children in 14,706 families and, in FY 97, 38,771 children in 15,111 families.  Because a protective services case often results in long-term involvement between DCF and its clients some children and families are counted in all three years, and many DCF-involved families consist of more than one child. 

            As shown in Table V-2, DCF has made more than 6,000 protective services placements in foster care, relative care, and various types of residential programs each year since FY 97.  It is important to note this is a count of placements made and not individual children placed.  A

Table V-2. Number of Out-of-Home Placements by DCF

Placement

FY 97

FY 98

FY 99

Foster Care

4,313

4,161

4,163

Relative Care

929

1,203

1,425

Residential Program

948

1,131

1,090

Other*

183

117

138

TOTAL

6,373

6,612

6,816

 

*Other placements include independent and adolescent living programs.

Source of Data: DCF

child may be placed more than once, with each placement counted separately.  The most common type of placement is a foster family home followed by placement with a relative and then residential programs.  Residential program placements increased (4 percent) in FY 98, but slightly decreased (3 percent) in FY 99.  The total number of placements have increased at an annual rate of 3.8 percent and 3.1 percent over the past two fiscal years.  

The department conducts administrative case reviews every six months on all abuse and neglect cases.  The process is designed to review compliance with required case management practice as well as the treatment services identified as needed by the client, those used, and those needed but not provided and why.

Juvenile Justice   

The Department of Children and Families has a limited, but important, role in the juvenile justice process.  It is responsible for the supervision and treatment of delinquent youth committed by the court.   To accomplish its juvenile justice mandate, DCF operates Long Lane School, a secure care facility, funds residential treatment and custody programs, and provides community supervision of "paroled" delinquents.  DCF considers any delinquent not housed at Long Lane School to be "paroled", however, this program bears little resemblance to the adult parole system.  

Adjudication.  The bulk of the juvenile justice system is administered by the judicial branch, specifically family court and juvenile court support services.  The judicial branch is responsible for adjudicating youths under 16 who are charged with delinquency or a serious juvenile offense (SJO). [1]    The court also handles youths under 16 who come before it as a member of a family with service needs (FWSN) [2] .  The adjudicatory phase -- judicial and nonjudicial -- involves an extensive pre-trial intake and assessment of the youth and, in most cases, probation supervision.  The judicial branch also operates the state's three pre-trial juvenile detention facilities, which are the only secure custody state facilities, besides Long Lane School, for youths under 16. [3]

Commitment to DCF.  DCF has no role in the juvenile justice adjudicatory process.  The agency first becomes involved in a delinquency case when its central office child placement team receives a placement application for either Long Lane or a private residential facility from the court.   

Currently, there are two conflicting state laws that establish the delinquency commitment authority of both the juvenile court and DCF.   Since the 1970s, the court has had the authority to commit a convicted delinquent to the Department of Children and Families -- for up to 18 months and a serious juvenile offender for up to four years.  The department is statutorily empowered to then determine the most appropriate placement and the length of the commitment period to be spent in such a placement.  The department is responsible for custody of the youth for the total 18-month or four-year period, no matter how short the stay in a secure placement. Over the past 10 years, the court has lost confidence in the department’s ability to provide secure confinement of convicted delinquents for a sufficient period of time.  This lead to the court’s current practice of ordering DCF to provide specific commitment arrangements in either Long Lane or a residential program.  In effect, the court overrides the department’s decision-making authority with respect to delinquency confinement arrangements.   

In 1999, the legislature recognized this practice in state law (P.A. 99-26).  The new law permits the court to specify a placement facility in its commitment order to DCF.  However, the prior law was not repealed.  

As previously discussed, DCF implemented a central child placement team to manage its placement resources.  The department requires all placements, even court-ordered delinquency commitments, to be approved by the placement team.  DCF and the court maintain a working relationship through the appointment of a judicial branch juvenile probation officer to the CPT.  

During the past few years, the court has also begun to order juveniles placed in DCF's Riverview Hospital for psychiatric evaluations as part of the pre-dispositional assessment process.  Riverview does not have a special assessment unit and the juveniles under court-ordered evaluation are placed on the general population wards.  Carrying out the court-ordered evaluations put a serious strain on DCF resources because Riverview is routinely at capacity, must be able to respond to emergency cases, and has a continual waiting list of children in need of hospitalization because they pose a threat to themselves or others.   

In an effort to be responsive to the courts and to manage its limited hospital resources, DCF entered into a memorandum of agreement with the judicial branch to reserve 20 inpatient beds at Riverview for court-ordered mental health evaluations of youth pending before the court as FWSNs or delinquents.  The children may remain at Riverview while awaiting placement in a residential facility if the judge does not want to place the child back in juvenile detention; however, the court can not use more than its 20-bed limit.  As part of the agreement, the judicial branch has provided one part-time staff person to assist DCF with the intake and discharge processes for the youths it orders to Riverview.  

Long Lane School.  Convicted delinquents between the ages of 11 and 15 are committed by the court to DCF.  The department can place the delinquent in a residential treatment or custody facility, in the community under supervision, or in its own juvenile justice facility, Long Lane School.   The 240-bed school provides the most intensive level of residential care and supervision for adjudicated boys and girls.  It has four residential cottages, one for girls and three for boys.  

All new admissions to Long Lane are assigned to an intake unit and have a treatment plan developed.  The school operates a secure 20-bed intake unit for boys that is separate from the general population cottages.  The boys are housed in this unit while participating in mental health, health, educational, and social history screening.  The school does not have a separate intake unit for girls but does maintain a secure mental health unit for them.  The girls are placed directly in the general population cottage or, if necessary, in the mental health unit for intake and assessment.  The intake and assessment process generally takes 30 days, for girls it runs a bit longer because it is not separated from the daily activities of the school.  While in this initial phase, the youth still regularly attends educational classes at the facility.

After intake, the youth are placed in a general population cottage or may be "paroled" to an in- or out-of-state residential treatment program or their community.  Long Lane has no specialized units, except for the girls' mental health unit.  The general treatment program offered to all youth at Long Lane consists of a year-round five-hour academic day, clinical treatment for the youth and, if possible, his or her family, recreational activities, and some substance abuse education.  

Currently, the average length of stay at Long Lane is five months, after which delinquents are "paroled," again, either to a less restrictive residential program, or to their community.  Regardless of the post-Long Lane option used, delinquents are under DCF supervision for the remainder of their commitment period.  

Parole.  The department does not have a minimum time served requirement before a delinquent can be "paroled" nor does it have release criteria or standards.  DCF uses a case management team, consisting of a the direct care staff, case manager, and clinical, educational and medical staff, to determine a youth's “parole” eligibility and develop a parole treatment plan.  In addition, administrative and recreational staff as well as the youth's family may participate in the review. “Paroled” delinquents sign an agreement that sets out the conditions of release.   

The department contracts with several private residential treatment programs in Connecticut and other states to provide services to "paroled" delinquents.  Some of these programs are designed to treat special populations, such as sexual offenders or sexually reactive youth, substance abusers, or children with severe behavioral problems like fire-setting.  The length of stay varies from six months to two years.

If the "paroled" delinquent is not placed in a residential treatment program, he or she is returned to their community.  Under this circumstance, treatment services are provided on an out-patient basis with supervision by a DCF parole officer.  The youth is generally required to attend school or a training program and abide by certain conditions to control behavior, such as a curfew, restrictions on contact with certain people or groups, and attendance at counseling or recreational programs. DCF contracts with community-based outreach and tracking programs to provide daily supervision and contact with the youths.

A youth who violates a condition of “parole” or fails to adapt at a residential facility often has his or her “parole” revoked and is returned to Long Lane School.  The youth may spend a period of time at Long Lane before being “paroled” again or may be directly place to a more restrictive or appropriate residential program.  

Release.  Once the commitment period is completed, the youth is released from the custody of DCF.  The department can continue to provide residential treatment services only if the youth voluntarily agrees to extend commitment.  This is usually done if the youth is in a residential treatment program and requires an additional period of commitment to complete the treatment.  DCF, the child, and his or her parents must sign a service agreement that specifies the continued length of commitment.  The department can extend commitment of a child who does not agree only if it can show cause the child has an overwhelming need for treatment or the youth's release from commitment will pose a threat to public safety.  In this case, only the court can extend the commitment period.  DCF also may retain responsibility for the care or custody if a youth was a dually committed delinquent and remains part of an active protective services case.  The protective services case manager regains responsibility for such a child as part of the family case once the delinquency commitment ends.  

Statistics.  Table V-3 shows the total number of delinquency and serious juvenile offender cases adjudicated by the family court and the number of those committed to DCF.  As shown, only 12 percent of all adjudicated delinquents and SJOs are committed to DCF; most (88 percent) are sentenced to a period of probation which is administered by the judicial branch.  The percentage of youths committed by the court to DCF has decreased over the past four fiscal years from 17 percent in FY 96 to 12 percent in FY 99, however, the total number of youths adjudicated has increased.  

The number of court commitments to DCF has remained fairly consistent except for an increase in FY 96 -- the year after the 1995 Juvenile Justice Reorganization Act was passed.  Also shown is a breakdown of where the committed delinquents were placed.  Less than one-half of the committed delinquents are placed at Long Lane School.  The percentage of committed youth directly placed in a residential treatment program has been steadily increasing, rising from 55 percent in FY 95 to 73 percent in FY 99. 

Table V-3. Delinquency Commitments From Court to DCF

Commitments:

FY95

FY96

FY97

FY98

FY99

Total Cases Adjudicated by Court

 

4,641

5,189

5,941

5,760

Total Committed to DCF

679

783

661

678

684

Long Lane Admissions

306

293

246

228

186

Direct Placement Admissions

373

490

415

450

498

Source of Data: DCF and judicial branch

            Table V-4 contains information on the total number of delinquents placed on “parole”.  The department, however, could not provide data on how many youths are "paroled" to the community or to residential programs.  The available data show slight year-to-year changes in the number of youth on “parole”. 

Table V-4. Total Number of Delinquents Placed on Parole

 

Boys

Girls

Total

FY 96

1,106

201

1,307

FY 97

1,084

219

1,303

FY 98

1,076

286

1,362

FY 99

1,043

317

1,360

Source of Data: DCF

Mental Health and Substance Abuse  

The Department of Children and Families, directly and through contractors, provides a variety of mental health and substance abuse services to children and their families.  Children and youth in the custody of department, as either a protective services or a juvenile justice case, may receive these services as part of their required care and overall treatment plan. Children who are not part of a protective services or juvenile justice case can receive behavioral health from the department if they are admitted to DCF's voluntary services program.  Services are also provided to children committed for psychiatric reasons to the agency's mental hospital by court order or a physician.  It is important to note, while DCF is responsible for overseeing a comprehensive and coordinated system of services for emotionally disturbed and mentally ill persons under 18, mental health services are not an entitlement program for children in Connecticut.    
   
         The department relies, for the most part, on private providers to supply the behavioral health services its clients require.  Among the types of treatment it purchases are: substance abuse prevention and treatment; emergency psychiatric services; outpatient treatment from clinics, day treatment, and extended day treatment programs; and inpatient treatment in private psychiatric hospitals, residential treatment programs, therapeutic group homes and specialized foster homes.  In FY 99, about 72 percent of the more than $121 million DCF spent on behavioral health was for residential treatment and inpatient hospital services; the remainder was expended for community-based treatment services.  

            In many cases, contractors funded in part or in whole by the agency provide mental health and substance abuse services to children and families who have no active involvement with DCF.  Table V-6 provides some basic information about the status of clients served by community-based facilities and programs that receive department funding.  As the table shows, the about two-thirds of the clients served by two types of providers, emergency mobile psychiatric services and child guidance clinics, were not involved in DCF cases in FY 98.  In contrast, at least half of the clients served by DCF's day treatment and substance abuse treatment contractors were active department cases.   

            The Department of Children and Families also operates three facilities that provide mental health treatment to children and adolescents.  Two DCF facilities -- Riverview Hospital and High Meadows Residential Treatment Program -- primarily serve children involved in protective services cases, although their beds are available for use by other children and youth who meet their admission criteria.  The third, the Connecticut Children's Place, a diagnosis, evaluation, and brief treatment facility, only serves abused and neglected children committed to DCF who are especially difficult to place. 

 

Table V-6.  Status of Clients Served by Selected DCF Contractors: FY 98

 

 

Total No. Cases Starting Service

 % DCF

Clients

% No DCF Involvement

Emergency Mobile Psychiatric Services

3,209

32%

68%

Child Guidance Clinics

10,280

33%

66%

Day/Extended Day Treatment Programs

468

65%

34%

Substance Abuse Treatment Programs

874

52%

47%

 

Source of Data: DCF

Basic budget, staffing, and client data for each DCF treatment facility are presented in Table V-6.  As the table indicates, these facilities are expensive operations that provide intensive residential care and treatment to a relatively small numbers of clients.  

 

Table V-6.  DCF Treatment Facilities: Resource and Activity Data

 

 

FY 99

Budget (No. Staff)*

Client

Statistics*

FY 95

FY 96

FY 97

FY 98

FY 99

Riverview

$18.2 million

(263)

Avg. No.

72

75

77

90

91

Avg. LOS

112

92

104

132

n/a

High Meadows

$7.3 million

(104)

Avg. No.

n/a

19

50

64

102

Avg. LOS

n/a

208

532

342

243

Connecticut Children’s Place

 

$6.2 million

(127)

Avg. No.

174

183

208

128

127

Avg. LOS

111

101

163

189

161

* Notes:

Budget = operating budget for FY 99; Staff = Number of filled full-time equivalent positions FY 99

Avg. No. = Average number clients in treatment per month

Avg. LOS = Average length of stay in days

Source of Data: DCF

As noted earlier, overview information on what behavioral health services are provided by DCF and who receives them is not available through the agency’s automated case management system.  Examination of FY 99 expenditure data, however, shows the majority of mental health and substance abuse services the department provides directly or purchases from outside contractors are used by clients involved in protective services and juvenile justice cases.  About $91 million  (76 percent) of the agency’s total behavioral health budget last fiscal year, was spent for DCF committed children, another almost $11.5 million was related to the department’s voluntary mental health services program (described in more detail below), and the remaining approximately $18 million was expended for services used by children without any DCF involvement.  

Services for DCF Committed Children.  As discussed in the previous descriptions of the department's protective services and juvenile justice activities, the assessment and treatment planning processes for children committed to the agency includes to some extent an evaluation of the child's mental health and substance abuse needs.  If needs are identified, the social worker assigned to the case is responsible for including services to address them in the child's treatment plan.   Inpatient or other residential mental health treatment, like any out-of-home placement, is subject to review and approval of the department's central office child placement team, discussed earlier in the protective services overview. 

Access to behavioral health services has become an increasing problem for clients covered by Medicaid managed care contracts, which includes the majority of the children in DCF care.  The department recently assigned health care advocate positions to each regional office to assist social workers in resolving managed care issues that interfere with a child's treatment plan.     

Since most regional office social workers responsible for case management do not have special training in mental health and substance abuse issues, they rely on the experts in their office's regional resource group for advice when determining what services to provide for children and families with problems in these areas.  At Long Lane, as noted earlier, clinical staff are available to assist in evaluating behavioral health needs and developing appropriate treatment plans for adjudicated delinquents.   

            The department's responsibility for children in its custody, in most cases, ends when they turn age 18.  Those who still require behavioral health services move to the jurisdiction of DMHAS or possibly the Department of Mental Retardation (DMR), depending on their diagnosis and needs.   All three departments, in conjunction with the Office of Policy and Management have been working on ways to improve the transition process for DCF clients who "age-out" of the children's system but have still have significant treatment needs.  Several memoranda of understanding, as discussed in Chapter VI, have been developed to address each agency's roles and responsibilities regarding some specific client populations with special needs.    

            Due to the limitations of its automated case management system, the department was unable to provide a compilation of the amount and types of mental health and substance abuse services provided to children the children in its care and custody at present or over time.  The special budget analysis prepared by DCF fiscal staff for the program review committee, discussed in Chapter III, did provide some information on behavioral health services used by DCF clients.  According to that analysis, 98 percent of the nearly $29 million expended on behavioral health services for juvenile justice clients in FY 99 was for in-patient hospitalization and residential treatment.  Eighty-seven percent of the approximately $62 million spent on mental health and substance abuse services for clients involved in protective services cases was for residential treatment and in-patient hospitalization. 

Voluntary Services.  Since the agency was first created in 1969, the DCF commissioner, in his or her discretion, has been permitted to admit children and youths to the department for services on a voluntary or noncommitted basis.  Over the years, the noncommitted program has developed a focus on children and youth with serious emotional disturbances, mental illness and/or substance dependency, whose cases do not involve abuse or neglect issues.  Statutory provisions, added in 1997, clarified that commitment to the department is not a condition for receiving services, established a probate court process for reviewing voluntary admissions and a mechanism for appealing the commissioner's decision to deny a voluntary admission.  The main steps in the process according to current law are shown in Figure V-2.   

Under current law and department policy, to be eligible for voluntary services a child or youth must meet the following criteria:  

·       has a serious emotional or behavioral disorder;

·       has an emotional disturbance and/or is substance dependent;

·       treatment needs cannot be met through existing services available to the parent/guardian;

·       the disorder or disturbance can be treated within a reasonable time and within available department resources; and

·       not reached age 18 at time of referral.

In addition, a person under DCF care and supervision who is over 18 but under 21 may be permitted to stay voluntarily admitted if in the commissioner's discretion the person would benefit from further department care and support.  A child or youth will be found ineligible if the family is under investigations for abuse or neglect or is part of an active DCF protective services case or if the child or youth:  

·       has a primary diagnosis of mental retardation;

·       has been arrested under the adult criminal system; or

·       requires placement because of special education needs.

By statute, any of the services DCF offers, administers, contracts for, or otherwise has available can be provided to a child or youth voluntarily admitted to the department if they would be of benefit in the commissioner's opinion.  According to the agency, an array of services, which may vary among regions, is available under the voluntary admission program and can include intensive family preservation, after-care services, mentor services, in-home therapist, intensive behavior management training, respite care, extended day treatment, and out-of-home treatment.  According to department policy, eligibility for out-of-home placement under the voluntary admission program is limited to the following circumstances:  

·       in-home services and intensive outpatient care attempts, which are documented, have been unable to remediate the child or youth's impairment;

·       the parent-child relationship will be maintained during and after implementation of the service plan; and

·       it is expected the child or youth will return to the family when the service plan is completed.

At present, each regional offices organizes its voluntary services staff differently; in some offices, social workers only handle voluntary services cases while in others, voluntary services are just part of a worker's protective services caseload.  Voluntary services cases generally are managed like protective services cases in that a treatment plan is developed and monitored through a case review process.   No single central office unit oversees the program although the head of the administrative law unit of the quality management bureau, in developing regulations for the program and handling appeals regarding denial of services, has become the primary contact for voluntary services issues.  In addition, the agency requires anyone wanting to apply for voluntary services to call the DCF abuse and neglect hotline for forms and information.  

Proposed regulations for the program, which have taken nearly two years to develop, were finally published and subject to a public hearing in September 1999.  They are currently being revised to incorporate comments received through the hearing.  While the regulations have been pending, each region has developed its own application forms and procedures. As a result, there have been inconsistencies in who is admitted and what services are provided under the voluntary services program.  Each region also maintains its own statistics on requests, admissions, denials, and other program activity. The central office periodically compiles statewide data on the program but does not collect information on trends in demand for voluntary services.  The latest statewide statistics on voluntary services are from March 1999 and are shown in Table V-8.   

Table V-8.  DCF Voluntary Services Cases: March 1999

 

Regional Office

Total No.

Accepted

No. Out-of-Home

Services

No. In-Home

Services

East

31

11

20

South Central

61

26

35

South West

21

11

10

North West

61

27

34

North Central

129

48

81

   Total

303

123

180

Source of Data: DCF

Systems of care.  In addition to traditional types of mental health services, the department is also involved in a pilot project to establish local systems of care to serve children with severe emotional disturbances.  This effort began in the 1980s in response to the federal Child and Adolescent Services System Program (CASSP) initiative.  A system of care is defined by the federal government as:  

a comprehensive spectrum of mental health and other support services which are organized into a coordinated network to meet the multiple and changing needs of children and adolescents with serious emotional disturbances and their families.  The creation of such system of care involves a multi-agency, public/private approach to delivering services, an array of service options, and flexibility to meet the full range of needs of children and their families.  

            Under the system of care concept, state and local agencies including schools, community service providers, families, advocacy groups, and other organizations, from one or more contiguous towns or cities, collaborate to deliver an array of services to meet children's emotional, behavioral and educational needs.   Participants usually formalize the collaborative arrangement through memoranda of understanding and one entity takes on the chief administrative and fiduciary role for the system.  Currently, there are 19 active systems of care in various stages of development throughout Connecticut.  The number of participating cities and towns per system ranges from one to 21.  

State legislation enacted in 1997 established in statute the process for developing and implementing individual system of care plans for children who are mentally ill or emotionally disturbed and are at risk of, or already are in, an out-of-home placement primarily for mental health treatment.  DCF is required, within available appropriations, to develop and implement such plans for at-placement-risk children and youth.  Under the act, the department also is required to prepare annual reports on the status of local systems of care and allowed, again within available appropriations, to establish case review committees and system coordinators in each of its regional offices to assist in developing, implementing, and monitoring care plans.

To date, the department's role in systems of care has been relatively minor.  Even the enabling legislation was initiated outside the agency by child advocacy groups and parents.  Over the years, DCF has distributed federal grant funding available to Connecticut for CASSP development and provided some in-kind support to communities implementing local systems of care.   Federal funds have and continue to be used to pay for family advocates, who assist parents of severely emotionally disturbed children obtain services, and system of care case managers.  

At the time of the committee review, there were eight full-time family advocates and 16.5 case manager positions, which the department recognized as insufficient to meet the current workload for the existing systems of care.  In addition, while DCF had designated system coordinators in each regional office three of the five positions spend as much as 60 percent of their time on other duties.  

Prevention

            Preventive services, while not defined in statute, have been interpreted by the Department of Children and Families to incorporate efforts to address all areas within its purview – child abuse and neglect, delinquency and juvenile crime, and substance abuse and mental illness among those under age 18.  However, the agency’s actual role in funding and operating primary prevention programs for children and families, which are generally viewed as activities aimed at preventing the occurrence of problems for populations at risk, is relatively small.   

According to a prevention budget document prepared by the Office of Fiscal Analysis for the period FY 97 through FY 99, DCF is just one of at least 20 state agencies and the judicial branch that are involved in more than 100 prevention programs that directly or indirectly impact the well-being of children and families.  Spending on all child and family prevention programs identified in the OFA report totaled about $240 million in FY 99, while DCF expended just over $5 million on prevention services that year.

Programs funded and operated by the department include the state’s Healthy Families initiative, a small grant program for community-based prevention programs that provide parent education, family support and similar services, and some substance abuse prevention efforts.  (Most of the state’s substance abuse prevention efforts for children as well as adults are carried out through the Connecticut Alcohol and Drug Policy Council, of which the DCF commissioner is a member.)   The department was also responsible for administering grants for youth service bureaus, community-based agencies involved in prevention programs for delinquency and other purposes, until 1995 when legislation transferred the program to the education department.  

The department also administered the Children’ Trust Fund from 1983, when it was created as a mechanism to supplement state resources for funding child abuse and neglect prevention programs, to 1997.  The DCF commissioner is now one of 16 members of the independent trust fund council whose main duties include: (1) soliciting and accepting federal funds, grants, and gifts for the fund; and (2) making grants from the fund to eligible programs.  The council also is required to adopt regulations for administering the fund and setting eligibility requirements for programs seeking funding.  Since the council was established, the fund’s annual budget has increased to over $3 million, while it never reached $1 million when administered by the department.   

In terms of budget expenditures, the activities of the Children’s Trust Fund make up the bulk of DCF’s primary prevention efforts.  In FY 99, the trust fund budget accounted for nearly two-thirds (62 percent) of the agency’s total expenditures (approximately $5.3 million) on its prevention mandate.  



[1] A delinquent child is one who has violated any federal or state law, municipal or local ordinance, or a Superior Court order, such as a FWSN order or condition. A child is adjudged a serious juvenile offender when convicted of any one of several specific offenses set out in statute.  These crimes include the most serious and violent crimes which if committed by an adult would be serious felonies.  The serious juvenile offender law categorizes the offender differently from other juveniles and transfers the case from juvenile to adult criminal court.

 

[2] FWSN cases involves children who are runaways, truant from school, beyond the control of their parents, or engaged in immoral or indecent conduct.  FWSN cases are generally handled in a nonjudicial manner by the court.  However, the judicial branch and DCF have entered into agreements to establish a process for DCF to provide more intensive intervention when court services are deemed insufficient and a process for transferring FWSNs needing residential treatment from judicial probation to DCF.

 

[3] A 1996 consent decree (Emily J.) covers almost all operational aspects of juvenile detention centers.  Currently, the judicial branch is not in full compliance with the consent decree.


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