Last month, a Miami child welfare judge ordered the state to find beds at mental health treatment centers for two siblings, both of whom had become grievously ill from abuse or neglect.
When administrators from the Department of Children & Families returned to court Wednesday, they had met the judge’s order half-way.
One of the two children, DCF said, had been admitted to a residential treatment center for psychiatric care. The other was still waiting for a bed.
Miami-Dade Circuit Judge Michael Hanzman chided lawyers and administrators at both DCF and the Agency for Health Care Administration — which runs the state Medicaid program for needy Floridians, and is responsible, at least indirectly, for securing treatment beds — for making children like the siblings wait for necessary care. Hanzman set another hearing for Feb. 19, saying he expects the state to have found another treatment bed by then.
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“It is not my job to set policy or to say how to budget resources,” Hanzman said. But, he added, the two children at the center of the dispute are entitled to adequate “mental health care, and the state is required to provide that care.”
At the hearing, DCF said it had found a spot at a treatment center for the remaining child, I.S., and the agency expects the bed will be available in about two weeks.
“The Department of Children & Families is strongly committed to serving the children placed in our care and ensuring their needs are effectively addressed,” said DCF spokeswoman Alexis Lambert. “We have worked with our partners to identify a treatment facility for this child to be placed as quickly as possible.”
The dispute involves a sister and brother, identified only as I.S. and D.S., who have been in DCF’s care for several years after they were removed from their parents’ custody. D.S. is now 10, and his sibling, I.S., is a year older.
In an order signed Dec. 29, Hanzman said that D.S. has been committed involuntarily for psychiatric evaluation under the state’s Baker Act nine times since the judge first ordered that the boy be admitted to a treatment center “equipped to treat his severe mental health needs.” The boy was living in a shelter operated by the Children’s Home Society, a private child welfare group that contracts with Our Kids, another private agency that oversees foster care in Miami-Dade in Miami for DCF.
Hanzman expressed frustration Wednesday at what appeared to be a complex web of privately run social work entities that contract with the state to manage foster care and mental health treatment services. None of the groups, he suggested, seemed answerable to anyone. “The court understands that there are social ills that are intractable, and there are unlimited needs. The state government is the entity responsible for meeting those needs.”
Under a new state law that took effect this summer, both D.S. and L.S. were entitled to have their own attorney present at court hearings. Their lawyer, Richard Joyce, told Hanzman he believes the judge has the authority to hold state agency heads accountable if they fail to provide necessary services to children in the state’s care.
“I believe the court has the ability to enforce this child’s rights,” Joyce said. “I believe the court has the ability to protect these children from harm, and the ability to force the state into compliance with your orders.”
Hanzman’s order was one of two signed by judges in late December that accused state health and child welfare administrators of failing to provide adequate care or services to Florida children. In the other case, U.S. Circuit Court Judge Adalberto Jordan ruled that the state’s Medicaid program was so badly underfunded that it reimbursed pediatricians and specialists for children well below the market — and sometimes below cost — driving most practitioners away from the insurer.
With a serious shortage of doctors in many parts of the state, especially in rural areas, children insured by Medicaid often must travel long distances, or wait months, for an appointment, the judge wrote.