Consolidating Health Services Would Hurt L.A. Child Welfare System

Youth Moving On, YMO, Pasadena, Los Angeles, Board of Supervisors, Michael Antonovich

Thomas Lee, division director of transition-aged youth services (second to left), shares information on Youth Moving On’s Peer Resource Center with Los Angeles Board of Supervisor Michael Antonovich (right). Looking on are Monique Holguin (left) and Jessica Petrass from Youth Moving On.

The Los Angeles Times reported recently that the Los Angeles County Board of Supervisors has renewed its commitment to addressing the recommendations of the much-anticipated report by a Blue Ribbon Commission on Child Protection.

The Commission was established to advise the Supervisors on how to make Los Angeles County more effective in avoiding the deaths of children in the care of the Los Angeles County Department of Children and Family Services (DCFS) and create an overall supportive environment within which to deliver essential services to vulnerable children and their families.

The renewed focus is much needed. Without it, we run the risk of more tragedies, which, with the proper resources, could be avoided.

This renewed attention by the Supervisors on this issue so soon in the new year may seem like a New Year’s resolution. We can only hope that it will not have the same fate as many New Year’s resolutions that fail because of a lack of will or commitment.

The Blue Ribbon Commission’s recommendations include training of first responders from a number of key public service and safety agencies to better address cases of abuse and neglect, the integration of an array of public services that impact the safety of children, and the establishment of a new entity to oversee the efforts of DCFS and others to monitor the delivery of services and advocate for the needs of these children and youth.

Some of these recommendations, according to the latest LA Times article on the subject, have been adopted, such as the pairing of public health nurses with social workers to investigate allegations of abuse involving children under two and ensuring that children are taken to specialized county medical clinics for health screenings when a nurse in the field deems it medically necessary.

Yet other recommendations, such as the appointment of a child welfare “czar,” have stalled. According to the LA Times story, part of the slow-up is due to opposition by Supervisor Don Knabe, who has concerns that a “czar” would second-guess the work of county departments.

It also seems it has been difficult to find candidates for this position – currently there is only one identified candidate — perhaps because of the enormity of the task and the reluctance of some very qualified people to take on the politically charged environment associated with LA County government.

To commit to this renewed focus on child welfare will require the Supervisors to muster the political resolve to tackle very sensitive issues and require additional resources. Only time will tell if their “resolution” will translate into decisive action.

What has surfaced however, at a recent Supervisor’s meeting, is a resolution by Supervisor Michael D. Antonovich to incorporate the Departments of Mental Health, Public Health and Health Services into a new department.

On Tuesday, the Supervisors voted to move toward consolidating the three departments.  The recommendation left most advocates of mental health services surprised and dismayed. Antonovich has been a tireless advocate for children’s services, in particular children and youth served in the foster care system. There is every reason to believe that his intentions are good, but the recommendation is ill-advised at this time.

As with most of the children we serve both in our residential program and in our community-based programs, mental health services are essential to successfully treat children’s challenges. There are legitimate concerns a department of mental health that would be subsumed into a new integrated public health department could easily be marginalized in a system driven by the pressing needs of the public health system.

A report is due back in 60 days on the proposed structure of such a move and potential benefits and disadvantages. Such a plan must recognize the voices of mental health services consumers and advocates to clearly identify the risks associated with this plan. More time is needed for a fuller discussion and analysis.

This also represents a considerable distraction for the Board of Supervisors at a time when the pressing issues identified in the Blue Ribbon Commission are once again the subject of renewed attention. Child safety and well-being would clearly be impacted by such a plan to integrate the Department of Mental Health with Public Health.

While theoretically there may be advantages, the risks to quality of care and delivery of essential services are considerable, and deserve due consideration before any plan is adopted. This is indeed turning out to be a very busy new year for the Supervisors, and we can only hope they choose their courses of action wisely and in the best interests of the vulnerable children and families they oversee.

Joseph Costa is CEO of Hillsides, a multi-service provider in California. 

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