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Report: State system helping disturbed children fragmented

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Published Monday, May 26th, 2003

GREENVILLE, S.C. (AP) - The state system that places and monitors emotionally troubled children in South Carolina often overlooks their needs, a review of state records by The Greenville News found.

Most of the children have been abused or neglected by family members. The newspaper's review showed the children are moved several times, given therapeutic evaluations more than once and work with several case managers since the responsibility in caring for them rests with at least 10 separate agencies, officials say.

Rochelle McKim, a child advocate attorney, says the system can lead to additional problems.

"They get further behind at school, they become more violent and then they either wind up really getting very sick and in a very expensive group home or residential treatment facility or they end up in the Department of Juvenile Justice system," McKim said.

State records and officials who work with children say only the most seriously disturbed young people get the necessary care.

"It needs fixing bad," said state Sen. Verne Smith, R-Greer, who chairs a Senate budget committee that oversees children's services.

The Children's Services Study Committee was established by the Legislature last year. It found a lack of central oversight, too many agencies involved and no consistent quality control.

"Children must become seriously disturbed before adequate care is available," according to committee documents. "Along the way, as their condition deteriorates, families report delays, restrictions, and duplications in getting care."

The job of monitoring the children's care is generally split between two agencies: Department of Social Services and the Continuum of Care, which is part of the Gov.'s Office.

Other agencies with some responsibility in watching juveniles include the Department of Juvenile Justice, the Department of Health and Human Services, the Department of Health and Environmental Control, the Department of Mental Health, and the Department of Disabilities and Special Needs.

House Majority Leader Rick Quinn, R-Columbia, said the current system leads to more moves for children, something that often does not help emotionally disturbed youth. Quinn said one child was sent to four facilities in 18 months.

Critics say DSS should not monitor child care and the facilities.

"If you're going to have a clean ship, you don't have the fox guarding the hen house," said Candy Waites, who led the Division of Children's Services under Gov. Jim Hodges. "The risk is if you have a lot of children that need to be placed, they could just look the other way if there are some problems in the way the facility is being run."

Kim Aydlette, who heads DSS, says she understands those concerns, but her agency always watches over children in their custody.

"I would never allow the agency to license or renew a license of a facility that we thought was unsafe because they were providing placements for our children," she said. "I don't think anyone in the agency would allow that to happen."

However, she said "it would not hurt my feelings for someone else to pick up the job of licensing and monitoring."

Some of the improvements talked about will cost money the agency doesn't have, Aydlette said.

DSS faces cuts of about $10 million in the budget starting in July.

"Everybody sort of agrees on what kinds of services these kids need," she said. "But the question is, do all those agencies have what they need to be able to provide it? To me, that's the bigger issue."

Lawmakers have debated solutions.

"I think if we could centralize this, it would cut down on the problems that have existed in the past," said Rep. David Weeks, D-Sumter, part of a House panel that examines spending related to children's services.

Studies show duplication can bring problems.

"Families report their children undergo multiple assessments, which is a burden to the child and family and incurs excessive cost," the Children's Services committee found. "Children sometimes have multiple case managers but no or few services that are direct, core therapeutic services to address their problems."

House lawmakers two months ago approved a plan that would send state offices that deal with the children to the state Department of Health and Human Services.

Vicki Rinere visits children and adult homes for the state Department of Mental Health. She said having one agency to license and monitor has worked well with adult homes and makes sense here.

Waites said one agency also would prevent the problem of agencies not monitoring a home adequately because each thought the other was on the job. "There is no way to pass the buck," she said. "There wouldn't be this risk of things occurring that shouldn't, or the treatment being not as it should."

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