Miami-Dade County

The machinations used to deny care to one disabled foster kid

Barbara Palmer is the director of Florida’s Agency for Persons with Disabilities.
Barbara Palmer is the director of Florida’s Agency for Persons with Disabilities.

No one at Florida’s disabilities agency disputes that S.J. is an unfortunate soul who needs help from the state just to survive.

Agency heads just refused to pay for it.

S.J. is a 16-year-old foster child with a significant intellectual impairment, bipolar disorder, a severe behavioral problem, and the propensity for making decisions that are so ill-advised as to “put her safety and health at risk,” a hearing officer wrote. Her mother surrendered her right to raise the teen. Her father is expected to abrogate his rights, as well. Since November 2014, when S.J. entered foster care, she has burned through 11 foster homes and seven juvenile justice facilities.

But when S.J.’s guardians asked the state Agency for Persons with Disabilities to pay for S.J. — the Miami Herald is not naming the teen to protect her privacy — to participate in a residential program that would keep her safe and treat her disabilities, the agency balked. Though employees who evaluated the girl said she met all eligibility requirements, and recommended the girl receive aid, a Miami administrator overruled them, and then sought to cover up the prior recommendation, an opinion said.

Regional supervisor Stacie Cleveland said APD could not help S.J. because she’s a foster kid — and, therefore, the Department of Children & Families’ problem.

In an Aug. 18 opinion, hearing officer Patricia C. Antonucci said S.J. was APD’s responsibility, too. Antonucci declared that S.J. “is currently in a state of crisis, which is unlikely to be ameliorated without the provision of [community-based] services geared towards her specific and developmental needs.” Antonucci ordered APD to help the girl, adding that it didn’t matter “who should fund” the services.

APD Director Barbara Palmer said in a written statement to the Herald that her agency has enrolled 154 disabled foster children into its community-care program, the result of a 2015 law that requires the agency to move children in state care near the top of a 20,578-person wait list. Disabled children in the foster care system who are about to be adopted, reunified with family members or who are young adults in extended foster care might qualify for expedited enrollment, she said.

Responding to the hearing officer’s charge that Cleveland had tried to conceal information, Palmer wrote that she expects “all of our staff members participating in this process to behave in a transparent and respectful manner,” adding that “failure to do so will not be tolerated.” Cleveland “has been strongly counseled, and has been instructed on the importance of transparency and maintaining all accurate records. She will be monitored to ensure this does not happen again.”

In February 2015, a psychologist reported that S.J.’s intellectual disabilities and risky behaviors “place her in danger of being sexually assaulted, kidnapped, physically harmed, used in sex trafficking or even killed. She does not distinguish between the interests of someone who generally likes her versus someone who is seeking to use her.” She has been involuntarily committed twice, charged with battery seven times and reported that she wanted to commit suicide.

A year later, S.J., who has an IQ of 50, asked disability administrators to move her from APD’s wait list and into a residential program that could provide the kind of support and monitoring she requires. The teen’s caregiver, an application said, was “unable to continue providing care.” In order to be removed from the wait list, S.J.’s guardians would have to prove the teen was in crisis.

“She is at extreme risk of placing herself in dangerous situations,” the teen’s application read. The girl had been arrested the day before her hearing, the ruling said. When the hearing ended, her case managers weren’t sure where she would sleep that night.

At first, the application appeared destined for approval. Two APD staff members, including a highly trained behavior analyst, recommended the crisis application be granted. But on March 7, 2016, a local APD administrator wrote an email saying: “We are denying this crisis tool” because the teen was in foster care, and “APD cannot pay for placements for children who are in the care of DCF.”

“Please re-sign and mark ‘no’ as your recommendation,” the administrator, Stacie Cleveland, wrote. “Please print out a clean signature page instead of just crossing out the ‘yes’ and checking ‘no.’ She added such changes of heart have “led to questions from hearing officers in the past.”

In a letter to S.J., APD wrote that child welfare administrators already were providing “a caregiver to tend to your activities of daily living, food and housing” and she was therefore not truly in crisis. The letter added: “You do not meet the agency’s criteria for crisis enrollment and your request for crisis enrollment is denied.”

Cleveland’s March 7 email led to more than just questions. In her 23-page ruling, Antonucci said S.J.’s condition had indeed become a “crisis” while APD and child welfare heads passed the buck between themselves. Disability administrators didn’t argue that they didn’t have the money, Antonucci wrote. Nor did they suggest they couldn’t find it if they had to. Rather, the agency said that, since APD is the state’s “payer of last resort” for disabled foster kids, they couldn’t be forced to help S.J. until all other means had been exhausted.

Antonucci also blasted APD for allowing high-ranking bosses to pressure subordinates into changing their positions, and for refusing to provide S.J. with the original paperwork.

“The agency was instructed that this manner of conducting reviews, and the … appearance of a deliberate attempt to conceal information from the hearing officer and [S.J.] was strictly unacceptable, and was not to occur again.”

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