Child & Family is private non-profit human and health service agency that has proudly served children, families, and seniors throughout Rhode Island since 1866.

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RI’s child welfare system must learn from St. Mary’s crisis.
 

Marty Sinnott  
Guest columnist

Marty Sinnott is president and CEO of Child & Family, a private, nonprofit organization to help the most vulnerable children, families and seniors across Rhode Island.

 

What happened at St. Mary’s Home for Children could happen again if systems changes are not made. Child & Family has as broad an array of services for youth and families involved in the child welfare system as any organization in the state. Our positive program outcomes for youth and families lead the sector.

Although St. Mary’s must accept the final responsibility for such serious lapses in care and gross mismanagement, other entities in our child welfare system must evaluate their own culpability in what has occurred. The problems at St. Mary’s did not evolve in a vacuum. Frankly, the undercurrents that created the environment that ultimately turned toxic are the same undercurrents that any provider that contracts with DCYF for the care of acute youth must contend with. The Child Advocate’s report had 34 recommendations directed at St. Mary’s. An additional 31 recommendations were made at DCYF.

 

What are those undercurrents? Inadequate rates from DCYF and a culture of No. In my 10-year tenure at Child & Family, we have made numerous rate appeals to increase program supports and direct care salaries. The answer from DCYF: No. Most DCYF congregate care contracts had not been increased for five years leading up to the pandemic, which only exasperated the workforce crisis. Child & Family’s response to inadequate rates was to close four group homes rather than run the risk of unsafe care for youth.

 

Child & Family, other providers and the Rhode Island Coalition for Children and Families have for many years clearly articulated the crisis in recruiting and retaining staff to the General Assembly, the governor’s office and Family Court leadership. Our message was either not heard or acted upon. It was only with federal pandemic relief funds that providers began to see modest rate increases. The workforce crisis in congregate continues today. The solution must be comprehensive in nature and will at best take several years to achieve.

The state’s current array of services for acute youth who require intense interventions, including residential treatment, is inadequate in capacity. This is the byproduct of administrative change within government (DCYF and the Executive Office of Health and Human Services) and General Assembly budget priorities that are made and reset every 12-month legislative cycle. This undercurrent has contributed to the DCYF culture of No where providers are pressured to accept difficult referrals which have needs beyond their program capacity. Absent placement alternatives, DCYF is very slow in responding to providers who request that youth be placed in more intensive programs. The Child Advocates’ push for a comprehensive assessment of overall program capacity is an important step in the right direction.

 

St. Mary’s practice and leadership needed to change. That appears to be underway. Will other elements of our child welfare system learn from what has occurred and change? The General Assembly must take a multi-year approach to making investments in a child welfare system that is inadequately designed and funded. Family Court should learn more about the practices and challenges facing providers. Providers are partners, not vendors.

DCYF and other state agencies should adopt a culture of “Yes and How,” rather than just “No.” DCYF Director Ashley Deckert has begun to change the relationship with providers to one of shared collaboration directed at innovation and better outcomes.

 

It takes courage on all our parts when we as a state fail to meet the needs of vulnerable youth in our care. Let’s have the courage to look honestly at changing all of the undercurrents.
 
 

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