Broken System: Levels of Care

In 2003, the Department of Family and Protective Services streamlined the six-tier LOC system to four levels: basic, moderate, specialized and intense. Depending on the LOC, a child can be placed with a foster family, a group home or a residential treatment center. A foster child's per-diem rates to the family or institution housing him are based on the LOC; the higher the level, the higher the payment.

The levels are assigned by an Arlington-based nonprofit called Youth For Tomorrow. Based on YFT's most recent available tax forms, its sole client is DFPS. About half of the company's $1.4 million 2010 state contract goes to the services of 14 "clinical healthcare consultants." According to contract reports from 2008 and 2009, these consultants include licensed master social workers. The consultants conduct quarterly reviews for specialized/intense kids and annual reviews of kids at the basic level. (Caseworkers and others have the ability to appeal an assigned LOC.)

The rest of the contract money goes to Executive Director Ed Liebgott and his wife, Database Manager Margaret Liebgott, along with a records manager and two "program directors" for field services and intake and office services.

For a taxpayer-funded contractor that affects the lives of thousands of children in the state's care, YFT is a rather vague entity. Liebgott declined to answer any questions, referring the Houston Press to the department. But when the Press asked department spokesman Patrick Crimmins about certain statements on the company's annual reports, he referred us back to YFT for some questions and provided incomplete answers for others.

For example, the department's Public Private Partnership committee, charged with recommending changes for the foster system redesign, wrote in a January 2011 report that their recommendations were based in part on data culled from a Child Protective Services case management system called Impact.

But in the company's 2009 report, it noted that its staff "reported many situations in which CPS staff went into Impact and changed service authorizations and effective dates of YFT's data...In our judgment, this practice contributes to great confusion about the integrity of YFT's data."

The report also expresses concern that CPS supervisors and caseworkers in Travis County, apparently unsatisfied that the children in their charge were assigned lower levels of care, were "using the courts to obtain intense services [the highest level] for CPS children. In our judgment, this practice 'high-jacked' the Texas Service System."

In an e-mail to Crimmins, the Press cited the 2009 report and asked about these concerns. Crimmins replied that, "...we don't know exactly where this quote appears. It appears to be the opinion of the Executive Director of YFT, not an independent audit. If a court issues an order, whether that pertains to a service level or any other type of order, DFPS is obligated to comply. We don't have any evidence that Travis County caseworkers and supervisors were utilizing the court system to order a specific service level."

Crimmins also dismissed the company's allegation that CPS staff were altering data, writing that "caseworkers do not have the security access to be able to change or edit any service level authorization."

But if that's the case — that YFT is so delusional as to think certain caseworkers are altering service levels without authorization — why does the department repeatedly renew the company's contract? And why would the department not be familiar with its contractor's annual report?

One reason kids in the Permanent Managing Conservatorship are moved so often is that levels of care, while necessary, are extremely fluid. And because YFT staff rarely meet the children they label, what might look on paper like an appropriate LOC may not actually align with the reality of a given situation.

Take 21-year-old Daniel McGary, who first entered the system when he was five, was reunited with his mother when he was nine and then went back into the state's care at age 11. (He entered with two half-brothers and a sister; the brothers were placed in their biological father's home. He and his sister stayed in an emergency shelter until they were assigned different LOCs and sent to different foster homes.) He left his last foster home at age 17 — technically a runaway — to move in with a friend. Less than a year later, he aged out of the system.

Born in the small town of Quanah, McGary got to see a lot of Texas in his six years in PMC: Abilene, Lubbock, Houston, Dallas-Fort Worth, Midland-Odessa, Vernon, Witchita Falls, Waco.

When he was around 15, he wound up in a Houston foster home that he says was able to accommodate 12 foster children because the parents and three biological daughters all shared a bedroom.

The fridge and pantry were chain-locked, and the fosters ate ramen noodles while the family ate steak. He says the foster mom paid him to help her write the required daily logs, making sure to fudge them enough so that kids who were actually well-behaved appeared to be half-delinquent, so that LOCs remained moderate instead of dropping to basic. A kid got caught smoking, say, or two got into an ugly fight. In 2005, the per-diem for moderates and basics was $35 and $20 respectively. Multiply that by 12 kids, and that's a $5,400 monthly difference between service levels.