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DSS Provides Update on Child Residential Reform

Significant Progress Made, Focus Turns Toward Revising Standards

February 05, 2009

BATON ROUGE (February 5, 2008) -- Louisiana Department of Children & Family Services (DSS) Secretary Kristy Nichols today announced that significant steps have been taken over the past 90 days to reform child residential care, including the review and inspection of all 64 facilities and the formation of a task force to make recommendations on licensure standards.

We have made great strides over the past 90 days in righting a system that was overburdened, not as transparent as we would like, and did not guarantee the continuity of care that should be expected, Nichols said. We must continue to hold these facilities accountable, as well as make sure that our licensure standards are updated to ensure that children in these facilities are in a safe environment.

At the end of October 2008, DSS announced that the agency would implement a series of reforms to child residential care in Louisiana to ensure continuity of care and the safety of children in residential facilities, including:

• Developing Corrective Action Plans with identified facilities (completed)
• Developing steps for implementation of Corrective Action Plans within 90 days (11 of 13 facilities successfully completed their plan)
• Conducting a survey of all child residential facilities within the next 90 days (completed)
• Reviewing of licenses of each child facility (completed)
• Initiating the formation of a licensure task force (completed)
• Reviewing existing and proposed licensing standards (ongoing)
• Reorganizing the licensure department at DSS (ongoing)

Last year DSS identified 13 child residential facilities that failed to meet specific thresholds as part of a safety and risk assessment. Those facilities signed corrective action plans in October of last year and agreed to implement those plans immediately.  Nichols said that 11 of those facilities have successfully fixed sited deficiencies, with Lester Roberts facility in Baton Rouge and Sanctuary Boys in Eunice failing to comply.

Examples of deficiencies still outstanding at Lester Roberts include improper staff to child ratio and failure to train staff.  Sanctuary Boys deficiencies include failing to complete repairs to the physical environment, failing to adequately train staff and failure to have a behavior management program in place.

It is irresponsible for these two facilities not to take the action they agreed to back in October to bring their facilities into compliance, Nichols said. "Our top priority must be the safety of children and will continue to use the resources available to the department to take action against these two facilities until they are in full compliance.

In addition, an interagency team visited all 64 child residential facilities over the past 90 days, finding no action was needed at 29 sites, with the remaining 35 facilities flagged with deficiencies that will require a compliance plan and follow-up visit in the coming weeks.

Our goal is for facilities to correct all deficiencies that exist in their facilities licensed by our agency, prevent any further deficiencies in the future and provide a safe and nurturing environment for the children placed in their care, Nichols said.

In January as a result of the visits, DSS recommended the revocation of licenses for two child residential facilities due to deficiencies and failure to meet licensing standards.  Although DSS' Bureau of Residential Licensing is responsible for licensing the facilities, it can only make recommendations to the Louisiana Advisory Committee on Child Care Facilities and Child Placing Agencies, which revoked the license for Novice House of Tallulah, while giving Sanctuary Boys in Eunice an additional 30 days to comply.

Sanctuary Boys is currently under a moratorium by OJJ, who contracts with Sanctuary Boys to house youth.  No OJJ youth are currently housed at Sanctuary Boys. Moratoriums put in place last October by DSS and OJJ for Hope Youth Ranch in Minden and Christian Acres in Tallulah have been lifted.

Some of the most frequently cited deficiencies by DSS licensing staff at child residential facilities over the past 90 days include:

• Cases of suspected child abuse or neglect were not reported immediately to the Bureau of Licensing and other appropriate authorities and were not properly documented in the childs record with all required information;
• Critical incidents (i.e. serious incident, accident or injury to a child, hospitalizations, overnight absence without permission) were not reported in a timely manner to proper authorities and not properly documented in the childs record with all required information;
• All areas of the facility were not maintained in good repair and free of health and safety hazards;
• Medications were not administered in accordance with the physicians orders and childrens medical records were incomplete; and
• Direct care staff did not have current CPR and First Aid certification and/or did not receive certification within the first 30 days of employment.

DSS has met with child residential providers on a regular basis since October to not only update them regarding reforms, but also to receive feedback on the current system and standards.  Nichols said that DSS will continue these meetings and include mandatory training on regulations, reporting and the quality of care expected for the youth.

Nichols said one of the last major pieces of reform involves a review of the current residential licensing standards.  Children in residential facilities are among the most vulnerable in our care, Nichols said. It is our duty to continue to do everything we can to ensure their safety by giving clear guidelines, direction and oversight to the facilities we license.

The Systems of Care Residential Reforms Licensing Task Force, which consists of 12 members representing child care advocates, providers, state partners, and staff from various state agencies, is reviewing the current child residential licensing standards and the revised standards proposed early last year.  Recommendations of the task force will be submitted to the Secretary of the Department of Children & Family Services by March 1.

Some of the possible recommendations discussed at a January 16 meeting include the creation of "core" standards that would be adhered to by all Child Residential facilities, baseline criteria on which providers would base client assessments and a tiered response to deficiencies that is based on the scope and severity of the noncompliance of standards.

Nichols also noted that functional oversight of the Bureau of Residential Licensing was provided to OCS  as of February 1.  This will allow greater continuity and consistency of monitoring facilities and will improve communication with providers.  Previously oversight of this Bureau was in the Office of the Secretary. This follows changes Nichols made to the licensure department late last year by putting a new management structure in place, doubling the number of licensing staff in the field, and providing additional training for license specialists. In the upcoming legislative session, DSS will propose the formal transfer of the Bureau of Residential Licensing to OCS.

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