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When Your Children Are Taken Away, How Do You Get Them Back?

It was a cold January day when Jennifer Jones’s two youngest daughters, Mary and Allissa, were taken from her and placed into foster care.

At the time, the mother of five was caught in a deep spiral of depression, rarely leaving her house.

“My kids were dressed and fed, but we never went anywhere,” she said. “I kept them indoors so that I wouldn’t have to leave the house. I missed their doctor and dentist appointments. It wasn’t a good home environment.”

An older daughter had also accused Jennifer’s then-boyfriend of abuse, an accusation she later recanted. But when Jennifer let the boyfriend back into her house, DHS placed Mary and Allissa in a foster home. For eight months, her only contact with them was through weekly one-hour meetings at a DHS office.

While her children were in foster care, Jennifer completed counseling, began taking medication for her depression, and took parenting and domestic violence prevention classes. Yet, she was still very isolated. Her caseworker also felt she needed more parenting guidance and told her about a new program with Volunteers of America Oregon called Families Uniting Now.

Launched as a pilot project in July 2011, Families Uniting Now (FUN) is designed to help parents, like Jennifer, cultivate their parenting skills and rebuild relationships with their children before they regain custody of them. Instead of a supervised one-hour meeting in a DHS office, parents spend three hours, two times per week, with their children in community settings, under the supervision of parenting educators.

“The parent-child relationship really deteriorates when you only see your child once a week,” said Rachael Poling, program manager for Families Uniting Now. “These parents also don’t get the real-life exposure of how children behave in the community and what to do when children act out.”

FUN focuses on helping parents find the skills they already have, then builds upon these, offering individual guidance and tips to help parents succeed. “We also model how to speak to children appropriately, like getting down on the child’s level, making eye contact, and setting clear expectations about how to behave when we go out in the community,” Poling said.

Still, Jennifer wasn’t sure the program could help her. At age 43, Jennifer was the oldest parent participating – older than even the parent educators leading the program. “It was hard to admit that I needed parenting help, because I had raised three older daughters,” she said. “But after a while, I realized that I talked to my younger kids the way I talked to my older kids. I was strict, impatient, and expected way too much from my younger girls.”

FUN also showed her the many family-friendly activities that Portland has to offer and demonstrated fun, low-cost activities that parents and children can do together, like making homemade Play-Doh. Mary and Allissa greatly enjoyed getting out of the house and visiting fun places like OMSI, the Zoo, and local parks, which was something they craved.

The program requires parents to be motivated and hands-on. “They don’t just let you sit and do nothing,” Jennifer said. “You have you be serious about changing your life and see what an opportunity this is.”

At the end of the pilot, Jennifer was one of five parents in the program to be reunited with her children. What’s more, she was able to connect to other parents facing struggles and experiences similar to hers and begin building a support system, which is crucial during the often difficult transition time when children return home. She and her daughters continue to spend time together with another mother and her children, playing, hanging out, and sharing parenting support.

Today, Jennifer’s goal is to make sure her kids feel safe and secure every day. “I want a healthy successful family, and I want my girls to grow up to have healthy, successful families,” she said. “VOA helped me find that I have the power to have a good life. I look forward to every day.”

The Long Road to Recovery

Ronnie Ford, graduate of Volunteers of America Oregon’s Day Treatment Program (DTX), lives in a hotel in Old Town run by Central City Concern. The neighborhood is full of bars and clubs. Ronald is a soft spoken man with thoughtful eyes. He’s broad shouldered and calm – a positive presence.

Ronnie’s grandparents were preachers, both of them. The family was strong and nuclear – two upright grandparents, two parents and three boys. Dad was a police officer. “My grandmother was the moral backbone of the family,” Ronnie says. “But she died young.” As his grandfather aged and failed, “the drugs came in. Everything fell apart.”

There wasn’t much support for an African American family in 1970s Portland. Even when Ronnie got the chance to go to school, he didn’t get the chance to learn. “Back then, they just passed people. I got left behind – didn’t get the basics, the reading and writing. Eventually I got the feeling that I was on the outside. Nothing more was expected of me.”

Social scientists use mass statistics to measure outcomes and identify trends. The statistics that make up a single life can tell us a lot too. One father gone to Texas. One mother gone to prison. One family broken. Ronnie at nine years old, smoking marijuana. Ronnie at twelve years old, out of school now: the man of the house, supporting his brothers, committing crimes to put food on the table.

From marijuana he went on to cocaine, then heroin. Moving out of an indifferent foster home at eighteen, Ronnie never moved inside again, except to be incarcerated. He estimates he’s been arrested over one hundred times. He ended up in prison nine times, all for drug offenses. He has spent twenty-five of his forty-eight years behind bars. It was the most stable residence he knew, but it didn’t give him the tools to stay drug-free on the outside. “The drug programs in prison don’t work. They’re forced on you – you have to be there,” he says. Ronnie yearned for something more.

“My youngest brother had graduated from the Day Treatment Program. He became my advocate. He told me to ask my parole officer about the program.” Ronnie was accepted. When he was released, he went into housing provided by VOAOR’s Residential Support Program (RSP). The treatment through the Day Treatment program was comprehensive. It included intensive therapy, where Ronnie learned to understand the role his parents played in his addiction; daily Narcotics Anonymous meetings, vocational training – “hands on training in a variety of jobs” - and educational opportunities.

“I struggled a lot at first. I worried that my reading and writing would hold me back. There were times I wasn’t sure I’d make it. But people like my Aunt Helen – she’s a counselor – and Rhybon Mayfield, who seems to know everyone in the African American community – mentored me. They gave me special attention because they knew I’d never been in a program before. Rhybon was always threatening to turn me in to Helen if I didn’t behave.” Ronald chuckles. “I’ve heard him make the same threat to other people – ‘I’m going to tell your mom, I’m going to tell your cousin,’ things like that.”

“What I really liked about the program was that it was highly personalized, not generic like so many programs,” he says. “They really look at your individual situation. For example: Alex, the head of RSP, seeing that I had a reading problem, sat down and put the NA literature on disk for me. I thought that was exceptional. Every aspect of the program is like that: they tailor it to your needs. I think that’s why it’s successful. True, some people don’t get it – but a lot do.”

“I can’t say enough about it,” he adds.

Ronnie’s youngest brother now works for Central City Concern. His other brother is in college. “After forty years, everybody is finally clean.” But, “four people in my extended family have overdosed. One of my aunts recently walked in front of a car and was killed. She drank and smoked crack. I can’t help but wonder if it wasn’t for that…well, these are the things I think about. I’m the oldest now. There are a lot of young people in the family who look up to me. I want to be a help, not a problem.”

With VOAOR’s help, Ronnie studies for his GED. He wants to continue the DTX program’s work, counseling others, taking responsibility the way he started to do when he was twelve. The moral backbone of the Ford family stands, upright and unbowed.

Sarah Wilson studies the case file and takes mental notes as she prepares to make her first visit to the Ramirez family. Five children under the age of 10, including a one-year-old. Mother speaks limited English. Father works long hours and is rarely at home.

As the Outreach Specialist with Family Relief Nursery, Sarah is the first point of contact for families entering the program. Sarah’s initial goal is to establish a connection with the family and begin to understand their situation. To enroll in the program, families must be experiencing multiple stress factors that place them at risk of abusing or neglecting their children. Home visits are a key part of the Nursery’s efforts to bring families back from the edge, offering a crucial window into the family’s world. Sarah listens to their stories, their challenges, their hopes.

“A lot more sharing happens because the parent is comfortable in their home,” she says. “We can see and feel what it’s like in their home environment.”

Mrs. Ramirez meets Sarah, who is bilingual, at the front door, and immediately, Sarah discovers something that wasn’t in the case file -- Mrs. Ramirez is several months pregnant. Sitting down together at the kitchen table of the small apartment that houses seven (and soon, eight) people, they begin to talk about the family’s circumstances. Mrs. Ramirez reveals that they are very isolated, with no family or friends living in the area. She tells Sarah that she rarely leaves the house, and with her husband’s demanding work schedule, she essentially functions as a single parent to her four school-age children and one-year-old son.

In the first few visits with families, Sarah addresses crisis situations and helps families meet their basic needs. If they’re not getting enough food or don’t have warm clothing for the winter, she’ll refer them to available resources and help them navigate community support systems. Still, she tries to avoid doing everything for the family. “We want to empower parents to seek out those things themselves,” Sarah says. “We encourage them to solve problems on their own.”

For the Ramirez family, the top priority is securing respite care for Mrs. Ramirez. When Sarah returns to the Nursery, she meets with FRN’s infant teacher interventionists to find out if there is space in the infant classroom for Mrs. Ramirez’s one-year-old. On her next visit to the family, Sarah is able to offer the classroom space for her son. The connection she established with the family makes it easier for Mrs. Ramirez to place her child in the capable hands of FRN’s infant classroom teachers.

In subsequent home visits, Sarah helps Mrs. Ramirez identify her own goals, which include improving her English. The respite time she received from Family Relief Nursery gave her time to rest, take care of herself, and ensure she carried her pregnancy to term. Her baby is now three months old. When she’s ready, she will be able to enroll her baby in Family Relief Nursery so that she can continue to make progress on her goals. Her confidence in her parenting abilities continues to grow. She understands that taking good care of herself will help her take good care of her children.

“Some people want to assign blame when families have issues,” Sarah says. “We see parents who love their children and want them to succeed.”

“Standing Up” for Seniors

“Stand-Up” for the Volunteers of America team at the Marie Smith Day Care Center isn’t a laughing matter. Standing together in a tight circle the daily “Stand-Up” meeting is an opportunity for center manager, Alison Bookman-Skidmore, and her team of eight certified nursing assistants and an activity coordinator, to share concerns and specifics of caring for each of the elderly clients enrolled at the center.

Jenny, a twenty-something registered nurse, tells the group about a new medication prescribed for one of their elderly clients. She reminds the group of the importance of keeping the man’s food moist, and to ensure he receives small amounts of liquid during the day. The group listens carefully, pitching in with suggestions for care.

At the back of the single story building in North Portland, another team is also preparing for their day. This group employed by Providence ElderPlace provides on-site medical services for the center’s Providence ElderPlace clients, and includes nurses, doctors, social workers, therapists and even an acupuncturist.

(Providence ElderPlace is a Program of All-inclusive Care for the Elderly (PACE), a federally recognized initiative that offers care for fragile, elderly people, aimed at enhancing the quality of life for seniors.)

The two teams have partnered for the last eight years to provide a unique and successful approach to adult day care. The partnership marries two areas of expertise--clients from Providence ElderPlace are seen frequently by the onsite medical team, while VOA staff provide daytime care and social interaction. The shared objective is to help fragile and elderly people remain in their homes and community as active individuals, for as long as possible.

The model was replicated last year at VOA’s Lambert House Adult Day Center in outer southeast Portland. Both centers include staff from each organization, distinguishable to clients and visitors for the most part only by the color of their name badges. The centers share two managers; Alison Bookman-Skidmore from VOA, and Sheryl Bruno from Providence ElderPlace.

Two organizations, one philosophy

Alison and Sheryl work in name (and paycheck) for two different organizations, but in approach and execution, they share a common goal to provide the best care for their clients. As two ex-social workers Alison and Sheryl’s organizations’ philosophies focus on meeting the needs of PACE, and in doing so, benefit VOA clients as well.

“Our joint approach is a win-win for both care providers,” said Sheryl. “It helps that our organizational philosophies for care are very similar. At a systems level there are differences, but our differences tend to complement each other, rather than compete. This partnership grows where many others dissolve. We are now at a point of shared values and trust, and we work well together.”

Prevention based care

Care at the centers is prevention-based and participant-centered. Staff work with clients to understand what is important to them. Each client has a care plan for the center staff to follow. In interdisciplinary meetings held four to six times a week, medical and direct care staff meet to develop the plan, and to talk about a client’s needs.

“The saying ‘it takes a village’ is translated here to ‘it takes a team’ to care for a client,” said Sheryl. “VOA staff see things during the day that our clinic specialists may not normally see. Clients behave differently in a social setting compared to their time spent with physicians and therapists.”

Alison echoes Sheryl’s comment, calling the VOA staff an extra set of eyes. “Our clients are at the center for six to seven hours a day, so we notice the changes in behavior that ElderPlace staff may not see in shorter medical appointments,” Alison said. “We notice how much our clients are eating, how they are sitting, if they are exercising.”

For example, if the VOA staff notice that a client is losing weight, they monitor what the client is eating and pass this information to an ElderPlace dietician, who can monitor and adapt the client’s diet both at the center and at home.

Clients are also invited to participate in a range of social and health focused activities, including art projects, gardening, music, movies, pet therapy, bingo, and book club.

Saying yes more often

Two providers, working closely in one center, hasn’t been without its tensions and struggles. Over the years the kinks in the partnership have been work out to find a common ground that benefits both client and provider. For both organizations the partnership has encouraged them to rethink how they work.

For Volunteers of America the partnership has required the agency to increase its staff’s skills to accept more fragile and elderly clients. The center was originally socially focused--a safe place to drop off an elderly relative for a game of cards or bingo. Today, social activities still structure the day, but VOA staff are now trained to meet their clients’ medical needs as well. The hiring process in turn has become more demanding, and CNAs now receive regular training on topics such as assistive eating practices, how to safely lift heavier patients, noticing flu symptoms, or caring for clients with severe dementia.

“The thing that makes me most excited about this shared program and a partnership like this, is that we open windows of saying ‘yes’ more often than saying ‘no’,” said Alison. “When people call us and say ‘I don’t know if you can handle my Mom, she has dementia’, we know that for us this is what we do well. This is what we train our staff for. This is what we have evolved our care to be.”

Alison smiles and adds, “And I am able to say, ‘Of course we can handle your Mom. Why don’t you come in and visit us’.”