By Sandy West
Originally appeared in the Texas Tribune
A Child Protective Services disability specialist says Texas’ foster care system isn’t preparing teens with cognitive disabilities and mental health challenges for adult life.
Recently, on her 18th birthday, a Texas foster youth with an IQ of 70, an inability to safely care for herself and an extensive history of hospitalizations for mental health issues was told by law enforcement to leave the unlicensed facility where the state’s child welfare agency had housed her.
Next, “client took her dolls and began walking down the road,” reads a letter Child Protective Services disability specialist Gina Magliolo sent to state officials on June 24.
Ultimately, Magliolo helped the teen find a bed in a homeless shelter for adults, and later a foster care placement for older youth. But for that work, she wrote, she was “admonished by my boss for doing extra work for this youth as she is 18 and ‘needs to learn.’”
In the letter, obtained by The Imprint from a third party, Magliolo states that the case is not unique: Texas foster youth with cognitive disabilities and mental health challenges housed in churches, hotels and other unlicensed facilities as “children without placement” are being cast out of the system when they turn 18, leaving them in potentially dire circumstances.
Although Texas and states across the country can serve young adults who’ve grown up in foster care until they turn 21, Magliolo stated that “there are many children aging out of care with serious developmental and/or mental health issues that have not been properly served by this organization.”
The development disability specialist said she feels hobbled in her efforts to properly care for these children by her agency’s management staff, whom she described as “extremely abusive.”
“I am constantly told to ‘stay in my lane,’” she wrote to Republican state Sen. Lois Kolkhorst of Brenham, Republican Gov. Greg Abbott, several judges and a staffer at the Texas Office of Mental Health Coordination, adding, “It is difficult to stay in my lane when I know that these children will be on the streets immediately facing life and death decisions that they can neither comprehend or absorb.”
In a follow-up interview Magliolo agreed to after she consulted with an attorney, she confirmed the letter’s concerns and its authenticity.
Kolkhorst declined to comment for this story. Emails to Abbott’s press office went unacknowledged.
After obtaining a copy of the letter, Marissa Gonzales, a spokesperson for the Department of Family and Protective Services — Magliolo’s employer — responded to questions about the allegations it contained. Gonzales highlighted the state’s efforts to improve care for older foster youth through privatization, its revamped reimbursement structure for service providers and “service packages” that will better match young adults with the appropriate programs. She did not directly respond to Magliolo’s allegations about “abusive” managers.
In an email, Gonzales stated that Texas foster youth receive a wide range of medical and mental health care services, and she credited her agency’s “dedicated staff” who equip teens with the skills and resources as they transition to adulthood.
“We take seriously our commitment to improving the lives of those we serve and protecting children from abuse and neglect,” she said.
Older foster youth face a multitude of hardships. Like other states, Texas has failed to provide enough foster homes for teenagers with behavioral and mental health challenges, instead providing makeshift housing in poorly supervised settings including hotels and offices. In May, an average of 100 teens per night had been sent to such unlicensed placements.
Gonzales said that “about 70% of youth awaiting placement in June had moderate, specialized or intense levels of care. Youth with those designations may require behavioral intervention or have intellectual or developmental delays, intensive therapeutic needs or specialized medical needs.”
An investigation by The Imprint published in February revealed that the state stands out for its poor performance providing youth ages 18-20 the housing and basic-needs services they are owed under the federal extended foster care program. Despite having one of the nation’s largest child welfare systems, Texas has far fewer young adults in foster care than states with comparably sized populations, including Illinois, Florida, Ohio and New York. Even states with smaller foster care populations enroll many more young adults in extended care.
One key shortcoming is access to supervised independent living placements, a preferred option among older foster youth because it allows them independence with minimal caseworker oversight. A state-run work group is exploring ways to improve access to the program, which continues to have unfilled beds because of what youth advocates describe as burdensome entrance requirements. The advisory group, which includes state agency staff, judges and legal advocates, has met about once a month since April.
Young people who are poorly housed by the state or lack support when they age out of the system have survived early childhood trauma, separation from family and the upheaval of life in foster care. They include young people in failed adoptions and those whose parents simply lacked the resources to care for them.
Magliolo described youth with developmental disabilities and serious mental health issues as among the most poorly served by the state.
She included two additional examples in her letter to state officials.
In one case, an older teen struggling with homicidal ideation came into the foster care system scared and pleading for help. He was placed in a state mental hospital. As he approached his 18th birthday, he was at high risk of aging out into homelessness because staffers did not know he was eligible for placement in an adult community-based treatment center.
Magliolo said she and another state employee ultimately were able to secure a placement for him, where “he is not in jail nor is he victimizing others.” But those efforts were viewed as outside the scope of her job, she said.
In another case, a 16-year-old who had suffered a psychotic break was placed first in a residential treatment center and then moved to a step-down facility until she turned 18. After entering extended foster care and living in what Magliolo described as an unhealthy and exploitative relationship with a teacher’s aide, she was abandoned at a hospital. Magliolo and the teen’s mother were eventually able to get her into a community-based program — but Magliolo again described her efforts as being discouraged by management. “I could not allow this wonderful young woman to be left out on the streets,” she said.
In her letter, Magliolo pleaded for additional funding for home- and community-based programs providing mental health care for vulnerable youth. According to the Texas Health and Human Services agency, adults are eligible for such services if they are over 18 and have a primary diagnosis of serious mental illness, multiple hospitalizations for psychiatric crises and/or a recent history of arrests.
In an interview with The Imprint, Magliolo expressed some optimism for improvement, after recently working with a CPS program specialist who connects children and young adults in foster care with mental health resources, including the state Home and Community Based Services program.
But she said too many young people leave the system without needed support — even when they meet the eligibility requirements for state-funded programs.
“There needs to be something for these kids when they age out,” she said. “It’s a huge problem.”
Situations Magliolo described in her letter are “so accurate it hurts,” said Meredith Parekh, supervising attorney for the foster care team at Disability Rights Texas.
Parekh said many youth with mental health issues and disabilities are shut out of the state’s extended foster care program because they can’t meet the requirements that include working or going to school. Additionally, she said, only those youth who are in a placement licensed by the Texas Department of Family Services on their 18th birthdays are eligible to enter extended foster care.
Advocates say the Department of Family and Protective Services needs to improve its coordination with other state agencies and better equip staff to transition foster youth into housing programs when they turn 18.
Kate Black, an attorney on the foster care team with Disability Rights Texas, said her clients with intellectual disabilities often don’t get access to Preparation for Adult Living classes — which are designed to help foster youth learn basic independent living skills — because there appears to be an assumption they can’t pass.
“This is a stereotype about kids with disabilities — that they can’t do things or learn things,” said Black. “This is the population that most needs these classes.”
Instead, she added, her clients end up being “kids who don’t know how to count money. They don’t know how to tell time. They don’t know what a bank account is or what a deposit on an apartment is.” That leaves youth with intellectual disabilities “with no resources.”
Parekh said in many cases, not enough is done in the critical years before foster youth turn 18 to find placements, teach life skills or apply for lifeline benefits such as Supplemental Security Income.
“And so the kids who have the most acute needs are the kids who struggle the most,” she said.
In her responses to The Imprint, Gonzales said agency staff “work to diligently help youth plan for an independent life” armed with “the skills and resources to transition into adulthood.”
Union leaders representing child welfare employees have said staffing woes continue to exacerbate the problem, including vacancies, high turnover and employee burnout — problems particularly acute among caseworkers assigned to supervise children in hotels and offices.
Gonzales said turnover for CPS investigators is 39%, down from 45% at the beginning of the fiscal year. This is a slightly higher rate than for other caseworkers in the agency, which she said is continuing to work on its recruitment and retention efforts.
Others are hopeful for some relief in the state budget passed earlier this year. As part of beefed-up mental health funding — roughly $4 billion over the next two years — about $15 million is set aside for grants to nonprofits and health care providers that provide mental health services. About $54 million is set aside for community mental health grant programs.
Most of those allocated funds are for adult services, which could benefit youth aging out of foster care. Some funds, albeit a smaller amount, are set aside to expand mental health programs for Texas youth.
The Department of Family and Protective Services “is not meant to be the mental health provider of last resort for children in crisis,” said Sarah Crockett, director of public policy at the Texas branch of CASA, the state’s Court Appointed Special Advocates group. But there may be other agencies better equipped to assist.
“The Legislature just invested millions of dollars to create more mental health beds for children and adults in crisis, and we are hopeful these new resources will keep children and families out of foster care altogether,” Crockett said.