The2nd meeting of the Subcommittee on Families and Children of the Interim Joint Committee on Health and Welfare was held on Friday, September 5, 2008, at 10:00 a.m., in Salon D of Marriottís Griffin Gate Resort in Lexington, Kentucky . Senator Katie Stine, Chair, called the meeting to order, and the secretary called the roll.
Members:Senator Katie Stine, Co-Chair; Representative Tom Burch, Co-Chair; Senators Charlie Borders, Perry B. Clark, Alice Forgy Kerr, Joey Pendleton, and Johnny Ray Turner; Representatives James R. Comer Jr., and Joni L. Jenkins.
Guests:† Kathryn Vogelsarg for the 14th Circuit Family Court; Rice Leach for the Lexington Health Department; Susan Pollach for Kentucky Injury Prevention; Laura Ebert for Community Partners Protecting Children, Fayette County; Phyllis Millspaugh for the Cabinet for Health and Family Services, Department for Community Based Services; Marylee Underwood for the Kentucky Association of Sexual Assault Examiners; Jill Seyfred for Prevent Child Abuse Kentucky; Joe Farless for Family Preservation Pennryle Allied Community Services; Janice Johnston for the Department for Mental Health, Mental Retardations Services; Jim Kimbrough for AARP KY; Mike Grimes for the Cabinet for Health and Family Services, Department for Community Based Services; and David Cozant for the Lexington-Fayette Urban League.
LRC Staff:† Ben Payne, Jonathan Scott, and Cindy Smith.
The minutes of the August 20, 2008 meeting were approved without objection.
The first item on the agenda was an update on the Child Protective Services Complaint Report (07 HJR 137), by Sandra Brock, Executive Director, Office of the Ombudsman, Cabinet for Health and Family Services; and Patricia R. Wilson, Commissioner, Department for Community Based Services (DCBS), Cabinet for Health and Family Services.† Ms. Brock presented the findings of the report to the subcommittee.† She said that the Ombudsman office is required to investigate any county with 10 or more justified complaints within a six month period.† The counties with 10 or more justified complaints from the last report were Jefferson and Madison counties.† Data was also presented for the time period January, 2008 through June, 2008.† Ms. Brock stressed that the Office of the Ombudsman reports directly to the Secretary of the Cabinet and that this promotes independent investigations.† Ms. Brock also gave an overview of the structure of the Ombudsmanís Office detailing the divisions of Performance Enhancement, Institutional Review, and Complaint Review.
††††††††††† Patricia Wilson, the Commissioner of DCBS discussed the ways the cabinet responds to the Child Protective Services Complaint Report.† Commissioner Wilson described the process that DCBS follows after the report is received from the Ombudsmanís Office.† Commissioner Wilson also discussed a main issue that has arisen from the reports, the monthly home visits by DCBS to families.† She stressed that DCBS is working to ensure that regular contact is maintained with the families and the cabinet; and not just with the child and the cabinet.†
Representative Burch asked how much independence does the Ombudsmanís Office have.† Ms. Brock said that the Ombudsmanís Office reports directly to the Secretary of the Cabinet and that makes its job easier.† The Ombudsmanís Office has been given the ability to make recommendations and then even more can be done from that point.
Representative Burch asked if the Ombudsman Office has the power to override, or just the power to make recommendations.† Ms. Brock said the office has a lot of power because she works directly for the Secretary and Ms. Brock can speak on her behalf and take issues directly to Secretary Miller.†
Representative Jenkins asked how the Cabinet is doing in terms of field positions for Child Protective Services.† Commissioner Wilson said the Cabinet is moving forward and filling the positions more rapidly.† The number in the field changes often.† Currently there are 1,500 front-line service workers and they are looking at staffing patterns and caseloads in each county.
Representative Jenkins asked if there had been many retirements in the Department for Community Based Services.† Commissioner Wilson said there had been a significant number, with many being from management and supervisory ranks.
Representative Jenkins asked if the Department for Community Based Services has lost a lot of expertise with the retirements.† Commissioner Wilson said expertise has been lost, but the Cabinet has been expecting and preparing for that.† Also, the retirements are providing others the ability to move up in the ranks.
Representative Burch asked how many social workers have been lost this year. Commissioner Wilson said she did not have that information with her, but she could get that information to the committee.††
Representative Burch asked what services are offered to families.† Commissioner Wilson said there is an array of services that are offered.† When and investigation is done, there is a check for mental health and substance abuse issues and a check for basic food, clothing and shelter needs.† The family is looked at as a whole to see what is needed so better parenting can be taught to the family.
The second item on the agenda was an update on the Child Fatality Review Report by Dr. Ruth Ann Shepherd, Division Director, Division of Maternal and Child Health, Department for Public Health, Cabinet for Health and Family Services.† Dr. Shepherd discussed the origins, purpose, and function of the Review System.† Dr. Shepherd also discussed the local and state Child Fatality Review (CFR) Teams and how they operate to help coronersí investigations for persons younger than 18 years-of-age.† It was reported that 67 Kentucky counties have CFR Teams, 45 counties have no CFR Teams, and eight counties are developing CFR Teams.† Dr. Shepard highlighted and discussed the fact that there is a two-year lag time between the data and when it is reported.† Some of the leading causes for the deaths of children in Kentucky were reported to be unintentional injuries, congenital anomalies, SIDS, diseases, and suicide.† Dr. Shepard reported that specifically, transportation deaths are the leading cause of injury deaths to children in Kentucky, with half of these deaths, the children were not in child safety restraints.† The second leading cause of injury deaths of children in Kentucky is caused by child abuse.† It was reported that Kentucky is above the national average in childhood injury deaths.† Dr. Shepard said that the cabinet strives to implement the findings from report data into other programs such as HANDS, Healthy Start, Safe Routes to Schools, and others.
Representative Burch asked if the Graduated Driverís License has reduced teen deaths.† Dr. Shepherd said it is too early to tell, but she expects to see those types of results in the 2007-2008 data when it is released.
††††††††††† Representative Burch asked if the importance of booster seats is being stressed. Dr. Shepherd said it is being stressed across Kentucky and that all health departments are stressing that as well.†
The last item on the agenda was an update on the First Steps Program by Dr. Ruth Ann Shepherd, Division Director, Division of Maternal and Child Health, Department for Public Health, Cabinet for Health and Family Services.† Dr. Shepherd said the program serves children from birth to three years-of-age.† Any child with developmental disabilities can be referred into the program by anyone; a family member, a child care provider, or anyone else who has contact with the child.† First Steps operates by adhering to three guiding principles; Children will get the services they need, Families will get the support services they need, and First Steps will stay within budget.† Dr. Shepard described to the members the process of finding children who need the program and the referral process for services.† Dr. Shepard also detailed improvements that have been occurring within the program.† Three improvements were highlighted; Improvements for Children and Families, Improvements for Providers, and Improvements for Efficiency.
Representative Burch wanted to impress on people that First Steps is a payor of last resort and the families choose whether or not their insurance is billed.
The meeting was adjourned at 11:22 a.m.