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Remaking Foster Care: After A Number Of Crises, Redesign Takes Root In Fort Worth

Doualy Xaykaothao

About 45,000 young Texans can’t safely live with their parents. A third of them are in state custody. They’re trying to navigate a foster care system that’s faced crisis after crisis – from stories of child abuse and neglect-related deaths, to reports of over-medicated children, and others sent hundreds of miles from home.  

We are exploring these issues in a series called Remaking Foster Care. We'll hear from people across North Texas -- biological parents, foster parents and young adults who’ve “aged out” of the system. We start at a one-of-a-kind clinic in Dallas for kids in foster care.  

Toys and crayons dot small tables at Children’s Medical Center in Dallas. On a busy day, it can get a little loud in the clinic.

Dr. Anu Partap runs this facility, and she’s an assistant professor of pediatrics at the University of Texas Southwestern Medical Center. Her big brown eyes, and dimples make it easy for children to pay attention. In the last five years, she’s treated thousands of victims of abuse and neglect.

Credit Doualy Xaykaothao / KERA News
Dr. Anu Partap is an assistant professor at UT Southwestern Medical Center and runs a clinic for foster care children at Children's Medical Center.

“There’s something worse than death, and that’s not living your full potential,” Partap says. She'll never forget one Friday afternoon, when a young boy visited with his sister. 

“You have to picture this 7-year-old, he was so sweet with his younger sister,” she says. “When I was trying to take her shoes off, he took off her sandals for her. He buckled them back on. She couldn’t speak, she was covered in scars. She was really hungry. And his number one concern was her.”

"We have to see them as kids whose health has been harmed."

The 5-year-old girl was visibly tired, and shaking. She walked like a little old lady because of physical abuse, apparently at the hands of her mother. The boy was also covered in scars, and hungry. Dr. Partap says many children in foster care have experienced a degree of chaos comparable to surviving a tornado or a war.

“We have to see them as kids whose health has been harmed,” she says. “Their physical health, their emotional health, their developmental health, their educational health. And do everything else around that.”

A far-flung system

But the foster care system doesn’t work like that, yet. For years, foster care in Texas was based more on the structure of agencies and location of services. This left too many children being placed far from their families of origin. Siblings were separated. Some teens were moved 20, 30, 40 times.

“Every move is a loss,” says Madeline Reedy, assistant director ofDallas Transition Resource Action Center(TRAC). “Every move is significant. It is tragic for a young person to be removed from their biological home. And then to enter care, and then to be removed from your siblings. Or to be moved multiple times.”

Credit Molly Evans / KERA News

The system is broken, says Michael Redden, executive director of New Horizons. He's also a member of the Texas Public Private Partnership (PPP), a small group selected by the state’s health and human services commissioner in 2007 to improve the foster care system. 

“If we don’t take on the responsibility of taking care of our kids, and we move into the next generation, we know what happens with those kids that are ‘throw-away kids,’” Redden says. “They go out, and they marry, and they have other kids, and the system perpetuates itself.”

How the new system works

Under the redesign, Texas is divided into 16 regions. Instead of working with hundreds of contractors, the state works with only one in each region. Two years ago, a for-profit group called Providence Services Corporation began a redesign in a 60-county area that covered almost a third of Texas.  

The task turned out to be too much. Last fall, Providence pulled out.  

Credit Doualy Xaykaothao / KERA News
Wayne Carson is the head of ACH Child and Family Services in Fort Worth.

In Fort Worth, at a fund-raising luncheon, the audience celebrated foster parents, child advocates and community leaders.

"This is about helping kids," says Wayne Carson, CEO of Fort Worth’s ACH Child and Family Services. "So, telling horror stories is one option but you know there's another side of this story, and that side is what amazing kiddos can become if they get the right help at the right time." 

ACH is now the lead agency in foster care redesign, managing a much smaller region: only Tarrant and six neighboring counties.

“I think this is probably the most exciting opportunity to improve the care for kids in the state of Texas than I’ve seen in my 25 years of foster care,” says Carson.

Redesign is about creating a sense of normalcy, he says.  

"Quit thinking about these kids as the state's kids, and start thinking about these kids as our kids," he says.

With subcontractors, ACH essentially decides what’s best for a child entering foster care in its region. The state still has the final say, but ACH has more control. It’s helping re-write protocols with the Texas Department of Family and Protective Services , such as whether a kid needs to fill out a form to see a movie with a friend.

‘Why do we do this form this way? Why do we have two signatures on that form? The resources have shifted back and are allowing us to say with a voice, we need your help, families need your help, because they are your children,” says Gretchen Fehrm, the state’s administrator for foster care redesign. “The advantage to foster care redesign is it brings it back.”

Redesign stumbling blocks

Not so much, says Ashley Harris. She follows every foster care bill making its way through the state legislature for the Austin non-profit, Texans Care for Children.

Track every foster care bill going through the legislature this session. 

“Redesign is the legislature’s latest attempt to address foster care problems by taking a shortcut, rather than investing in Child Protective Services appropriately,” she says.

"It would be easier for advocates to be supportive of redesign if it was well-funded."

And after the Providence failure, Harris believes Texas shouldn’t be pushing redesign. Rather, it actually should be pausing privatization efforts.

“It would be easier for advocates to be supportive of redesign if it was well-funded, and had a strategic plan attached to it, and unfortunately that hasn’t been the plan,” says Harris.

ACH has a three-year contract with the state and annually gets $650,000 to manage its network of providers. A new report by the Fort Worth group shows it’s already in the red and needs $3 million more.

Coming up

Our Remaking Foster Care series continues with the voices of biological parents from Tarrant County, foster parents, and young adults who have “aged out.” Explore Part 2 here.

Explore KERA's Remaking Foster Care Series

Doualy Xaykaothao is a newscaster and reporter for NPR, based in Culver City. She returned to NPR for this role in 2018, and is responsible for writing, producing, and delivering national newscasts. She also reports on breaking news stories for NPR.