OFFICE OF THE COOK COUNTY PUBLIC GUARDIAN CHARLES P. GOLBERT JUVENILE DIVISION Pablic Guardian 245 DGDEN AVENUE “ah Fone ‘etcago, tL Lins esi2 Move) 000 TAR oa ADULY GUARDIANSHIP & ‘DOMESTIC RELATIONS DIVISIONS @ WINASHINGTON Te cuucage,LLivors sone May 28, 2019 hiowe-q13 eno lay 28, 20 FAX: (312) 603-9946 sewmpubiegntion rg |A HAND DELIVERY Honorable Jorge L. Alonso United States District Court Northern District of Hlinois 219 South Dearborn Street, Rm. 1908 Chicago, IL 60604 Re: B.H. v. Walker, No. 88 C 5599 -- Response to the Parties’ Agreement Concerning Placement of Youtl DCFS Custody with Significant Emotional and Behavioral Health Needs Into Aunt Martha’s Interim Care Center Dear Judge Alonso: [wish to comment on and offer some observations about the parties’ agreement concerning placement of youth in DCFS custody with significant emotional and behavioral health needs into Aunt Martha’s Interim Care Center, which the parties filed with the Court on May 24, 2019 (“ICC Agreement”). | offer these comments and observation as the Juvenile Court-appointed attorney and guardian ad litem for close to 6,000 of the B.H. plaintiff class members. In the introductory paragraph to the ICC Agreement, the parties state that, at the status hearing before Your Honor less than three weeks ago on May 8, 2019, the parties represented to ‘Your Honor that there was an “agreement limiting the admission of youth with high end ‘emotional and behavioral needs” to Aunt Martha's ICC. This is not entirely accurate. The parties did not represent that there was an agreement “limiting” such admissions. In fact, the parties represented that “there will be no planned admissions to the third floor, no admissions directly out of psychiatric hospitalization or because of significant emotional and behavioral need before there is agreement by the expert panel and the plaintiff as to the safety and 1 Gprwwomceaneesufficiency of programming for that purpose.” (May 8, 2019 Tr. p. 9 (emphasis added); see also id. pp. 9-10 (“there is in effect a standstill agreement on those kinds of admissions to this facility until there is further agreement by the plaintiffS and the expert panel”) (emphasis added), 23 (there is a “standstill agreement and order in place”). At the status hearing before Your Honor less than three weeks ago, multiple and serious concerns about the proposed ICC at Aunt Martha’s were delineated. (See generally Tr. pp.9 (the plaints and expert panel expressed serious concerns”), 10 (we have a lot of concerns about it)). The parties’ ICC Agreement offers no explanation as to how any of these concems have been alleviated, Some of the concerns include: * There is not continuity in planning about where kids come from and then what is ‘going to happen for them in the way of services and settings after they leave. (Tr. p. 11). * There needs to be extensive transition planning about where the child’s going to go next, what supports he needs, what does that home need to look like. (/d.). ‘+ The ICC is not connected to the Department's overall planning and thinking about what services and placement these children need. (Id) ‘© If Aunt Martha’s moves forward with admitting kids at this point, they will very quickly fill it up. (Tr. p. 12). * The ICC does not fit with an overall picture of how the Department is designing or is the Department designing, developing and managing community-based services for this group of kids. ‘That contrasted with other pilots that are included in the implementation plan. (Tr. pp. 12-13). The ICC is an example of the Department solving the wrong problem. We don’t need to manage two numbers. We're not trying to reduce the BMN population to get that number down. We need to be managing children. (Tr. p. 21), * No child coming out of a psychiatric hospital should be in a shelter. No one would ever recommend that as a setting for a child coming out of a psychiatric hospitalization.' (Tr. pp. 21-22.). * The ICC is not a model. This isn’t a known treatment method for people coming out of psychiatric hospitalization. This is a made-up thing, and it was operating as a shelter. (Tr. p. 28). ' Of course, discharging a child from a psychiatric hospital to a shelter violates DCFS’s own policies. See DCFS Procedures § 301.55(¢)(3).‘+ We havea resource problem. We have a placement problem. And we can’t afford to have a shelter becoming the final environment for some of these youth, and that’s what it’s looking like is going to happen. (Tr. p. 22). ‘It's not just to keep them physically safe. It’s to help improve their lives and put them in the most appropriate, least restrictive setting we can and setting them ona path so that they don’t face disaster when they age out of the system at 21. (Id). * Atone point, the Court observed that, “We're trying to get beyond reacting to these quasi-emergencies or emergencies, and that’s why we're here.” (Tr. p. 24). Most remarkably, the parties offer no explanation of how any of these serious concerns have changed over the past three weeks. ‘The parties state, in conclusory manner, that there will now be admissions to Aunt Martha's ICC “in light of recent developments.” “in light of recent events,” and “in light of additional information Aunt Martha’s has provided.” (ICC Agreement introductory paragraph and 1), However, these recent developments, recent events, and additional information are not explained. There is no explanation whatsoever as to what has changed since three weeks ago so that some of DCFS’s most challenging youth, in particularly youth being discharged from psychiatric hospitals weeks and months beyond medicai necessity, can now be admitted to Aunt Martha’s ICC without implicating the above serious concerns. The closest the parties come to an explanation is that the ICC is now “sufficiently staffed” so as to “safely” admit youth with high end behavioral and mental health needs. (ICC Agreement { 2). However, as made clear above, the issue is not, and has never been, about safety alone. See, e.g., Tr. pp. 22 (It's not just to keep them physically safe), 26 (there is a great deal of security on every floor), 29 (Ms. White did not see any safety concerns; that is, of course, the beginning of the discussion, certainly not the end. But for purposes of the safety of the youth there, she did not discern any safety concerns). The parties fail even to attempt to explain how any of the many, and serious, problems delineated just three weeks ago about the ICC have been resolved or mitigated. ‘The parties say that high needs youth “should only be admitted when no more appropriate placement can be located,” that there will be “immediate focus on transitioning youth to an appropriate placement,” and that DCFS may admit such youth to Aunt Martha’s ICC only “when ‘no more appropriate placement can be located.” (ICC Agreement 2). However, the parties offer no explanation as to how that will be effectuated in the face of DCFS’s severe shortage of placements, which is why it needs to resort to the ICCs in the first place. ‘The ICC Agreement is also completely devoid of any explanation of programming, recreational opportunities for the youth, step-down planning and priorities, and the like. Moreover, to the extent that the ICC Agreement leaves the impression that the transition to Aunt Martha’s ICC accepting DCFS youth was smooth or thoughtful, nothing could be further from the reality on the ground. The “transition,” such as it was, can only be described as chaotic