Contractors in charge of handling foster care in Kansas have been investigated dozens of times during the past three years, in some cases leading to changes to protect children they serve.
Records obtained by The Star show that in multiple situations foster children’s mental health needs were not met and contractors fell short in ensuring some kids were placed in appropriate homes or facilities.
The records, which detail complaints investigated by the Department for Children and Families’ licensing unit, offer a rare glimpse into reported problems at the state’s four contractors. And they provide insight into Kansas’ troubled system, which was the first to be fully privatized in the mid 1990s.
Among the incidents investigated:
-- A foster care manager didn’t respond to requests that a child be psychologically evaluated. In the meantime, the boy laid down on a busy highway “attempting to get run over.”
-- Two foster kids were placed in the home of a caregiver who was on the state’s Child Abuse Registry, and even after the contractor was notified about the error they remained there for a month.
-- A fourth Kansas child in care was able to grab “unsecured” prescription medication and run off. Later, he allegedly crushed and snorted some of it.
-- And, early last year, a supervisor with Saint Francis Ministries was investigated for dragging a foster child by her ankles.
Some incidents, described in detail throughout the records, are proof, experts and child advocates say, that DCF must do more to hold contractors accountable and protect the state’s most vulnerable children.
“There’s such a culture of allowing the contract agencies to just run rampant,” said Lori Burns-Bucklew, a Kansas City attorney and accredited child welfare law specialist who was involved in a class action lawsuit filed against DCF in 2018. “That’s the only thing that could allow this kind of situation to take place.
“It’s such bad practice. Some of these things sound unconscionable.”
Under the Kansas Open Records Act, The Star requested all complaints against the four contractors reported to the state since 2020. DCF released roughly three dozen complaints and the survey findings in those cases.
All four foster care contractors were found noncompliant in various areas and were required to complete a “compliance action plan,” records show. One was issued a civil fine.
For as long as privatization has existed in Kansas there’s been concern that private contractors often aren’t subjected to public scrutiny and that the state isn’t cracking down on their performance enough.
When Laura Howard took over as DCF secretary more than four years ago, she said accountability of contractors would be a critical focus for her administration. While detailed examples laid out in the licensing complaints and surveys do “cause great concern,” Howard said she’s confident that the contractor oversight in place finds shortcomings and works to correct them.
“Yes, of course, I’m very concerned about specific situations that happened that could put a child at risk,” she said. “But I’m glad that we have a robust regulatory process to pursue that, to remedy that and to try to avert something similar happening in the future.”
Teresa Woody, litigation director for the Kansas Appleseed Center for Law and Justice, which was part of the team of attorneys filing the class action lawsuit five years ago, said it’s encouraging to see DCF has investigated dozens of complaints in recent years.
“One of the biggest concerns that we’ve had is that DCF have appropriate oversight of the contractors,” Woody said. “I think it’s a good sign that DCF is trying to see what (contractors) are doing and getting the complaints and trying to deal with them.”
One contractor faces a third of complaints
The boy who laid down on a busy highway also stabbed himself in the leg with scissors, “which resulted in an emergency trip to the hospital and an acute psychological screen,” according to records obtained from DCF.
Before those incidents, multiple emails were sent regarding the need to get the child evaluated. The manager with Saint Francis Ministries said he “forgot to get to the emails,” records show.
“That’s horrifying,” Woody said. “Absolutely horrifying, that a child is under such stress, such mental and emotional needs that aren’t being addressed, because somebody is just ignoring them.”
When asked, Saint Francis did not answer what the specific outcome of the case investigation was. The nonprofit also could not provide specific information about the child’s age or medical services received, said Cristian Garcia, the nonprofit’s chief advancement officer.
“Saint Francis followed all reporting processes as required both internally and externally,” Garcia said in an email. “Saint Francis worked collaboratively with DCF to ensure the safety and well-being of this youth.”
One-third of the complaints investigated since January 2020 involved Saint Francis Ministries, which has been engulfed in controversy since 2020 when former CEO Robert Nelson Smith, an episcopal priest from Salina, was accused of misusing funds.
Last year, Smith was one of two people indicted on federal charges related to allegations they participated in a conspiracy to defraud the faith-based nonprofit.
Garcia said in an email that St. Francis is “committed to the safety and well-being of the children and families we serve.”
“At Saint Francis, we have the privilege of serving 46% of children in the foster care system in Kansas,” he said. “Based on serving almost half of the state of Kansas, the rate of complaints is proportional to complaints to our partners.”
Garcia went on to say in the email that Saint Francis Ministries “works collaboratively and transparently with DCF to identify and work through any challenges regarding complaints and has a robust process using a data tracking system that ensures visibility for our organization.”
Other complaints involving St. Francis
The focus of a second complaint involving Saint Francis also centered on a lack of mental health treatment for a 17-year-old foster child. Records show that in 2020, the teen had a “bucket filled with urine, feces and feminine products” in her bedroom. Also in the room were dirty dishes, spoiled food and soiled clothing, the documents said.
DCF found Saint Francis noncompliant for failing to provide training or resources to the foster family “regarding the foster child’s isolation, theft and personal hygiene.” And noncompliant by failing to refer the teen into new mental health services and making sure the foster child attended regularly.
“The youth was exhibiting serious mental health needs and due to SFM (Saint Francis Ministries) missed mental health services from 12/2020 to 2/2021,” the survey of the complaint read. “Additionally, SFM failed to maintain communication with the mental health provider once services were set up. SFM failed to notify the mental health provider of any of the concerning behaviors the youth was exhibiting.”
“The 17-year-old foster child’s bedroom was in deplorable condition … yet SFM did not intervene or develop a plan with the family to resolve the safety hazard,” the survey findings from the complaint said. “During the monthly visits by the Case Manager and by the Foster Care Worker the youth was simply told to clean her room and no follow up or guidance was provided to the Foster Family or the youth.”
Saint Francis Ministries did not answer specific questions regarding the incident. Garcia said the nonprofit is “committed to the safety and well-being of the children and families we serve.”
Another complaint involving the contractor and a different child pertained to an incident on Jan. 31, 2022.
“The foster child was held in a bathroom and drug by her ankles by an SFM supervisor,” records show. This complaint had several “non compliance issues” identified in the investigation.
The nonprofit did not respond to The Star’s questions regarding the supervisor and what punishments, if any, were issued.
Lawmakers and child advocates say they continue to be concerned about Saint Francis amid these complaints and leadership controversy in recent years.
“I think any contractor who has the volume of issues that have been raised with St. Francis both with respect to children in their care and with respect to the way they were being run and the financial issues that have surfaced,” Woody said, “I would think that would be a concern to me.
“I personally would not want them as a contractor.”
Saint Francis has strengthened its training programs, Garcia said, “to ensure our team members are equipped to work through difficult conversations and monitor the safety environment of our children.”
“Furthermore, Saint Francis has established a Child Welfare Certification Program that trains our front-line team members to deliver optimal service.”
Issues from lawsuit persist
Many of the records The Star analyzed involved the alleged failure by contractors to conduct proper mental health assessments of foster children and concerns that kids weren’t put in appropriate placements. Both were critical issues in the 2018 class action lawsuit that was settled three years ago and approved by a judge months later.
The state is still under that settlement and is required to meet 14 benchmarks before it is released from the oversight. In September, DCF received its first progress report that showed it had met seven benchmarks and didn’t meet five. Of the remaining two, one was in progress and another couldn’t be measured because of “data issues.”
Burns-Bucklew said Kansas’ child welfare system is still not doing enough for those “hard-to-place” youth.
“They’ve done nothing to increase or improve their placement array,” she said. “They’re working on the front end to try to prevent kids from coming into care. … But they haven’t really done anything that I’ve seen to recruit foster homes for the population of youth they’re having trouble placing.”
State Sen. Molly Baumgardner, a Louisburg Republican, said that for several years too many foster children have not received the mental health assessments they need. And even though it’s mandated in the settlement, the state still fails to ensure children are properly assessed during their time in care.
“What is frustrating to me is that no one seems to be able to pinpoint why it isn’t occurring in a timely manner,” said Baumgardner, a member of the Joint Committee on Child Welfare System Oversight. “When they don’t receive that evaluation, the foster parents can’t move forward to help them. And essentially, that mental health issue is on hold.
“That puts the foster parent at risk, their foster family at risk and absolutely puts the child at risk. And so the expense of being in foster care continues.”
Jenny Kutz, a spokeswoman for foster care contractor KVC Kansas, said it’s important to remember that “the Kansas foster care system is safe, and in fact it is safer than most other U.S. states.”
“KVC Kansas and the state as a whole are not only meeting the federal standard for child safety in foster care but performing much better than the federal standard.”
Investigations lead to change
Complaints can come into the state hotline as possible child abuse and neglect and evolve into a licensing investigation. Or vice versa.
“I think one of the things that’s really robust about this system is that we can be doing things on the abuse and neglect side,” Howard said, “but then at the same time have something parallel happening related to the conditions of licensure.
“... We’re very much walking alongside them and overseeing them in lots of different facets.”
Several child welfare experts and lawmakers say they weren’t aware of the allegations detailed in the licensing investigations. Or that corrective steps have been taken to address those concerns at the state level or inside many of the contract agencies.
One case that prompted change was the incident where two children served by TFI Family Services were placed in a home where the caregiver was on the state’s Child Abuse Registry. According to the complaint and survey findings, once TFI learned of the problem, the children remained there for a month.
A TFI spokeswoman said the organization could not discuss specifics of the case “due to confidentiality.”
When asked, DCF said the case involved a “near kin” placement, meaning the caregiver was not a family member but known to the two kids.
“The licensing investigation found the agency to be in noncompliance and a civil penalty was assessed,” DCF said.
The state agency also stated that it had recently signed a “memorandum of understanding” with case management providers and child placement agencies regarding this issue. These agreements allow them to access background information when there is need for emergency placement with a relative or people known to the children.
This would “determine if they are a match to a confirmed, validated or substantiated case of child abuse on the Central Child Abuse Registry,” DCF said.
Keeping medication secured
Multiple licensing investigations involved medication and whether it was property secured.
Late last year, DCF investigated a complaint about contractor Cornerstones of Care and a 13-year-old foster child. The teen was being “transported” to a foster placement when the incident occurred.
Prescription medications “were in the front passenger seat of the transportation van and accessible to the 13-year-old foster child,” the survey findings said. The foster child ended up “taking his medications then proceeding to run off and then later was sitting on the top of the vehicle.”
“Reportedly the 13-year-old foster child pocketed some prescription medication and later crushed, snorted, and took the additional prescription medication,” the records said. The boy was not hospitalized.
In the investigation, DCF found Cornerstones to be non compliant in several areas including not providing the child with proper supervision during the transport and for the worker not notifying the child’s foster placements about the incident.
“A Compliance Action Plan was initiated,” DCF said in an email, “which included mandatory education and training for specific (Cornerstones of Care) staff on safety measures for transporting children with accompanying medication.
“... DCF’s priority is always the health and safety of children in our custody, including access to medication. This is why we work with our partners on training and provide technical assistance through licensing processes to ensure youth remain safe.”
Justin Horton, Cornerstones’ chief programs and innovation officer, said in a statement that his agency is bound by regulations to “not disclose information and respect the privacy rights of our children and families.”
“We take each inquiry made through Kansas DCF seriously and examine each situation on a case-by-case basis,” Horton said. “We follow internal procedures that reflect DCF’s policies in Kansas. In the complex world of foster care, we always look to celebrate our successes and steadfastly look for areas of improvement.”
Securing medicine also came up in a complaint involving KVC Behavioral HealthCare, which is also known as KVC Kansas. In that situation, a 15-year-old foster child had been released from the hospital after an overdose of non-prescription medication.
“The CPA (child placement agency) worker did not document … that the family foster home had violations of medications not being in locked storage,” DCF records said. “Since no documentation was noted … licensing requirements were not met and the safety of the foster child was not met.”
Kutz, of KVC Kansas, said that all foster families “are informed that prescription and over-the-counter medication must be locked up to ensure the safety of youth.”
“Medication safety is an important part of foster home safety and our licensing staff continue to train families about this on a daily basis,” she said. “... In this case, the worker who first went to the home documented the need to store medication safely before the youth was placed there. What was missing was the follow-up documentation to verify it had been secured.”
A delay in reporting
In another complaint related to KVC, a 15-year-old foster child reported in early December 2021 that a 16-year-old boy “put his hands up her top and down her pants” inside the “child room” at the nonprofit’s Olathe office. The girl told an “on call worker” what had happened.
According to the licensing investigation, the incident was not reported to the state hotline for about a week and following the incident the two teens were not separated after the worker initially spoke to the 15-year-old girl.
“The agency was found to be in non-compliance, and a mandatory Compliance Action Plan was put into place,” DCF said in response to questions from The Star. “The worker is no longer employed by KVC. KVC did not act immediately when it discovered the delayed mandated report.”
Kutz said her agency investigated the incident and notified law enforcement. Because of confidentiality and privacy laws she said she is limited in what she can say about any specific event.
“The safety of children is our priority, and indeed it is the purpose of providing foster care services,” Kutz said. “While we do not have the right to share state or law enforcement investigation results, we can tell you the state’s investigation is concluded.
“... The substantiation of non-compliance only concerns our delayed call to the DCF hotline as we did not make the call within 12 hours as required. It is not substantiation of the allegation itself. Several staff were in the room with the youth, and they were supervising them.”
Though an “internal review and DCF child abuse investigation of the incident did not result in any substantiations,” Kutz said that KVC did put in place corrective action “to ensure that reports of suspected or reported child abuse are submitted to the Kansas Reporting Center timely.”
KVC already had policies regarding staff supervision of children who are waiting inside child welfare offices. The contractor, though, did provide “reminders and additional training to staff,” Kutz said.
