Billable Hours and Foster Care: Made for each other.
We have received a few communications of late about a program called “Wrap Around.” Below are 2 letters the author has received that makes some important points. The author’s comments are in paragraphs and the writer of the email chooses to remain anonymous.
Wrap Around works to keep families together. And in foster care, an abused or neglected child may expect to have up to 3 different individuals visiting them during the week. These individuals are expected to help the child adjust, and or deal with the various problems or difficulties that arise from being placed into a foster home.
Wrap Around seems to have a mixed record, some question the abilities and credentials of the individuals that are hired; (“Para-professionals), others want to know how they are measuring a success rate. Three individuals visiting a home once or twice a week for a single child represent a lot footsteps being tracked around the carpet.
Below is the first email:
I only worked in wraparound for a couple of months, so I cannot give you a very objective view of what’s really going on there, and/ or with other agencies. I had to get out of there because it is a very high paced and aggressive approach to work with families.
Workers, as usual, are pressed to bill weekly hours to DMH, (Department of Mental Health) so there is a lot of “harassment” to the families to make use of the services. The team ( parent partner, child specialist, facilitator, and therapist) meets weekly at the family’s home, and in addition, the parent partner, the child specialist, and the therapist go to the home at least once per week, so in total the family receives wraparound visits up to 4 times a week. (Wow, that’s a lot of billable hours)!
It’s a very intensive program, with the goal of keeping children in the home, and avoiding out of home placements. It’s said to have a 90% success rate. It might be so, but my impression at this agency was not that one. (Hmm, 90% success rate…where have I heard that before? Oh yeah, elections in dictatorships…)
To me, the team was just another extension of a dysfunctional family. Usually what happens are the moms and the parent partner (who is assigned to work with the moms) engage in a battle with the child and the child specialist (who is assigned to work with the child). There is much miscommunication between members of the team, lots of cancellations, errors in scheduling, and disorganization, because each member of the team works on other teams which work with different families. (Got that?) (Just remember, billable hours.)
DMH, probation, parent advocates, and county representatives meet with the team twice a month in order to review the plan and progress of the family. They might have the best of intentions to monitor the effectiveness of these services, but like I said in my prior communication, not everything is brought up on the table. (Gee, I wonder what is not discussed?)
In the short time that I was there, workers were having anxiety attacks, and going on stress leave. A very high turnover. (This is not a rare occurrence, we have seen this at many agencies, especially since musical chair workers are brought in and fired at a ridiculous rate. One agency, for example, almost had a 100% annual turnover rate)
The money assigned for the family is called flex funds, but it is usually given as the last resort, supposedly because they want the families to make use of community resources first.
So in summary, the system not only profits from the families, but also burns out honest workers who initially want to make a difference in these children’s lives, but who ultimately end up running the rat race set up by the system, because they need to earn a living too! And in order to do that they need to bill, bill, and bill. (Well heck, it’s only taxpayer money…)
When did the helping profession paradigm change from service to productivity? Maybe it changed while I was going to school, or maybe things have always been the way they are now; maybe I was too naive in thinking that it was all about helping people.
And with regards to Wraparound services, here is a brief previously published comment from another worker:
“Wrap around programs are supposed to include the community and be extremely flexible. I have had to deal with a lot of wrap around programs. Once in a great while they know what they are doing and try to help the children.
They usually they follow a happy talk formula that does nothing to help the children and create more tension and are more likely to cause a failed placement. They are a waste of funds and time. Most of the families I work with will not accept a wrap around child if they have to continue with wrap around. If they would do something other than there boring meetings and actual follow the Sonoma model they are based on they might be a help.
As it is, it is another stupid program that does nothing (and sometimes) hurts the children.”
So what is one to make of all this? A program paved with good intentions. How dare we criticize our meager efforts to keep families together.
“Does anybody really care?”