Child welfare watchdog investigates near deaths of two foster care youth

A number of recommendations come after the near death of a 4-month old infant and a two-year-old child in foster care.
Published: Sep. 19, 2023 at 9:52 PM CDT
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LINCOLN, Neb. (KOLN) - Despite the Attorney General’s opinion calling the legislature’s child welfare oversight mechanism unconstitutional, Jennifer Carter, inspector general for child welfare released her annual report this week, making a number of recommendations to the state.

In part, Carter’s report made multiple recommendations following the near-deaths of a 2-year-old child and a 4-month-old infant in foster care.

“One involved a 2-year-old who ended up in the hospital with an altered state and difficulty breathing,” Carter said. “This 2-year-old had ingested THC, probably through a gummy.”

Throughout the Inspector General’s investigation, Carter said they discovered a number of ways DHHS could have prevented this situation, including the process the agency follows when it wants to place more children in a home than the foster parent is licensed for.

“Part of that process is to make sure, can the foster home handle that and is this going to work out.... we discovered there could be improvements in the overfill process to make sure that before you make that decision, you’re really communicating with the people who know that home....after the serious incident and the serious injury there was some conversation about ‘oh if I had known, if I had been asked, I might have recommended that you not put young children in that home.”

Carter’s report laid out a number of issues previously known about the foster home the toddler was placed in, including the foster parent not being forthcoming in the licensing process, the foster parent not following rules, and issues with appropriate supervision.

The report recommended DHHS revise policies to create a method to ensure quality assurance and accountability in the overfill process and to ensure concerns about foster homes are communicated in a timely manner. DHHS accepted the latter recommendation and requested a modification to the former.

The second death involved a 4-month-old infant who nearly starved to death after not receiving the proper feedings to combat a failure to thrive diagnosis.

“We found On that DHHS did all of the things that are currently in policy to do. There’s many forms to fill out and put medical information,” Carter said. “But there was no one place where somebody could just simply say, this youth, this baby has this issue and this baby needs this kind of feeding and we have to make sure that that is happening in the foster home.”

DHHS accepted a recommendation to create a new healthcare management plan that ensures everyone involved is aware of the child’s medical needs.

Carter’s office also checked in on an increase in the number of families using the state’s Alternate Response program, which instead of getting families involved in the child protective court process, provides them with stabilizing resources.

There were 20 incidents and complaints within that program this year, up from 17 last year. There were none the previous years of the program.

“By definition, those cases don’t have the normal oversight you’d have from a court,” Carters said. “So we think having some kind of external oversight or accountability for those cases is important.”

Carter said as the year goes on they’ll have a better understanding of any trends related to that program.

Another topic they’re hoping to better understand as time goes on are sexual assault allegations within state wards, as they got complete allegation data for the first time this year showing 311 sexual assault abuse allegations involving 205 individual kids. About six of those determined to be substantiated so far.

“This year was a little bit more of a baseline review, but I think that was the ultimate goal, provide us with the allegation,” Carter said. “So there’s someone paying attention to how these are being handled in the system.”

Of those sexual assault allegations, many are still under investigation by either the state or law enforcement.

Carter is also required by state law to provide oversight into Nebraska’s Youth Treatment and Rehabilitation Centers.

The report notes that with rising youth populations at the state’s three YRTC’s, incidents are up too compared to last year.

At the Hastings YRTC for girls, the number of staff assault has doubled, the number of self harm incidents has nearly tripled and mechanical restraints are being used twice as often. At the Kearney YRTC for boys, the number of staff and youth assaults has nearly doubled and the use of mechanical restraints has tripled. At Lincoln’s YRTC, which houses a small number of both boys and girls, staff assaults doubled, self harm incidents are up by 10 and the data shows restraints are used, on average at least once a week.

“The census got so low during the pandemic, that I think it has been a challenge for the YRTC’S to see those numbers go up again and make sure they’re staffed in the way they want to be staffed,” Carter said.

Mental health staffing is particularly problematic at the YRTC’s, according to the report.

Hastings doesn’t have any mental health staffing so they’re sharing with Kearney. This leaves both Hastings and Kearney without full time mental health resources for kids.

When asked about the role Carter’s office places in Nebraska, she said transparency and accountability for this vulnerable population is keep to keeping them safe.

Read the full report here.

10/11 will have more on this topic later this week.