DYFS considers health-care overhaul A draft proposal calls for HMO coverage for children, more nurses, and tripled funding for substance-abuse programs.

Posted: February 12, 2004

TRENTON — The overhaul of New Jersey's child-welfare system includes far-reaching improvements in health care, according to a draft of the state's plan.

Under part of the plan, obtained yesterday by The Inquirer, the number of families getting substance-abuse treatment would triple, the number of nurses on staff would more than double, and children living in adoptive and foster homes would be enrolled in HMOs.

Funding for programs dealing with substance abuse - suspected to play a role in as many as four of every five Division of Youth and Family Services cases - would triple to almost $90 million a year.

DYFS officials would not comment specifically on the plan. However, spokeswoman Laurie Facciarossa said medical care and substance-abuse treatment provided by the state desperately needed improvement.

"A major high-impact commitment to substance-abuse treatment for adults as well as children is absolutely critical for the success of the reform plan," she said.

The draft calls for the state to hire a DYFS medical director by July; the pediatrician would oversee health, mental-health and substance-abuse policies as well as medical programs.

The plan calls for hiring 32 nurses and four nurse practitioners by January. Currently, 27 nurses are on staff. Nurses would be on call around the clock.

"One of the more glaring deficiencies was the lack of attention paid to the medical needs of the children," Facciarossa said. "It's clear the plan needs to address those needs - needs to deliver mainstream medical care, needs to ensure children are accessing medical care.

"The fact that DYFS has not had a medical director for some time underscores the fact that the medical needs of the children have not been a priority."

Foster parents and caseworkers have complained for years about the current system of hunting for doctors who accept Medicaid. Under the proposal, the state would pay HMOs for enrollments, with the federal government reimbursing half the cost.

The plan, to be submitted Wednesday to a state child-welfare panel, calls for a nurse to be available in all DYFS offices (currently 32, but soon to grow to as many as 46). The nurses would review three-quarters of all new cases.

That would be part of a new program involving a so-called family team meeting, designed to offer a more comprehensive look at a case and use people familiar with the family to help.

The child-welfare panel reviewing the plan was established under a settlement of a lawsuit that the advocacy group Children's Rights Inc. filed in 1999. The expert panel - which can approve, reject, or ask for changes to the plan - is scheduled tomorrow to discuss what elements it would like included.

The plan, titled "A New Beginning: The Future of Child Welfare in New Jersey," was due to the panel last month. But the day before Gov. McGreevey appointed James Davy as acting commissioner of the Department of Human Services, officials acknowledged they would not make the deadline and got a month's extension.

Davy has been regularly announcing progress on a host of issues that were required to be addressed in the short term under the lawsuit settlement.

Yesterday, he said that about 2,000 of some 6,000 cases that had languished on desks waiting to be closed finally were closed after a marathon weekend session by supervisors. He also said DYFS had exceeded his goal of licensing 100 new foster homes.

Contact staff writer Mitch Lipka at 609-989-8990 or mlipka@phillynews.com.

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