‘There is noquick fix’
The following is an excerpt from the state-ordered review of the island’s children’s homes and places of safety.
THE recommendations contained in the report pointed to five main categories:
1. Improvement in the intake and evaluation process, from the Family Court to the Ministry of Health. Less emphasis should be placed on institutionalisation.
2. Introduction of a process whereby the physical, educational and psychological needs of the children are met, both for those considered normal children and those with disabilities.
3. Improvements in accommodations and all amenities in the homes.
4. Rationalisation, training and development of care-givers.
5. Improvements in organisational structures and standards in order to strengthen the monitoring of activities in homes.
Common thread
A common thread running through all the recommendations is the need to immediately begin improvements in the homes and places of safety. The Ministry of Health should now develop a plan of action geared at meeting the immediate needs of homes and places of safety, medium and long term, and to set verified objectives and standards against which outcomes will be measured. The UNICEF Report (1999) and the KPMG Report — “Modernisation of the Children’s Services Division” –should be factored into the implementation plan.
List of recommendations:
1. Extend the sentencing options to reflect the serious types of offences being committed by juveniles.
2. Introduce Community Service Orders.
3. Impose an adult sentence on the juvenile who commits a serious offence and is of an unruly or depraved character.
4. Increase the penalties, particularly as it relates to Child Abuse.
5. Where applicable, the juvenile should be referred to the Drug Court for rehabilitation.
6. Introduce new provisions whereby a Fit Person Order or a Supervision Order may be varied to substitute for another order as the changed circumstances warrant.
7. Amend the rules of evidence to admit the unsworn evidence of a victim, in sexual cases, notwithstanding being of tender age, without the need for corroboration. Safeguards, in the form of psychological tests, can be applied.
Parents/guardians who can afford to pay, should pay
8. Increase the quantum of the Contribution Order payable by a parent or guardian who has the ability to pay. Payment should not be restricted to the imposition of a Fit Person Order or a Correctional Order. All parents or guardians, who are able to pay for the support of their children whilst in care, should contribute. Their contribution should be regarded as part of their role as a parent.
9. Empower the social worker/children’s officer to send a juvenile for assessment where the assessment team so directs; the juvenile can be placed with a therapeutic foster parent for a temporary period of three months. The juvenile would not need to be sent to an institution, nor go before the courts as a prerequisite for payments to be made to the foster parents, as is now the case. The proposal would reap the triple benefit of reducing not only the numbers coming before the courts but those being placed in an institution and most importantly, be of benefit to the juvenile.
10. There should be a physical separation of:
a. Juveniles in need of care and protection
b. Those deemed to be uncontrollable
c. Those who have committed criminal offences.
11. A team of professionals (paediatricians, psychiatrists, psychologists, mental health officers, social workers, psycho-educational specialists) in each of the four health regions should be identified to carry out the evaluations.
12. The procedures relating to the intake of juveniles should be developed and documented within the Ministry of Justice (Family Court) and the Ministry of Health, from the point of entry to the childcare system to the placement in places of safety and children’s homes.
10:1 ratio between child and caregiver
13) The number of wards in the institution (places of safety and children’s homes) should be drastically reduced to manageable proportions to achieve a ratio of 10:1 caregiver. This ratio will facilitate the provision of a higher standard of care for each ward approximating internationally acceptable standards for juveniles in care. Accordingly, the available resources can be more efficiently applied.
14) Community-based care as compared to institutionalisation as a treatment-modality should be pursued.
15) An aggressive, unrelenting, public education campaign promoting family values and attitudes should be conducted nationwide. This should incorporate the Ministry of Education, corporate Jamaica, the churches, the family courts, the trade unions, NGOs, the universities, community colleges and service clubs should be urged/required to become involved in the programme.
16) Tax or other incentives could be offered to corporate Jamaica for its participation. Focus should be directed at the rural poor and to the inner-city communities from which most of the wards of the institutions come.
17) There should be recruitment of more foster parents to foster the juveniles presently in care and those potentially in need of care.
18) The Children (Adoption of) Act should be reconstructed to facilitate more adoptions of juveniles in care, particularly when they are small and can be moulded.
19) There should be cost-effective interventions to families by providing financial assistance in the home.
Assessment team to visit homes and monitor juveniles’ welfare
20) An assessment team should visit the institutions to monitor the welfare of the juvenile. When juveniles are utilised as a source of labour when a commercial venture is undertaken in the institution for its viability, not only should the juveniles acquire a skill, but also his/her welfare should be the paramount consideration.
21) Every child at present in a place of safety or children’s home should have a complete physical/psychological/educational evaluation. This should include:
viii) detailed information about the child’s family
ix) detailed history of the child’s birth, development and immunisation status
x) medical history, especially previous illnesses (especially asthma, sickle cell disease) and hospitalisations
xi) medical examination with laboratory tests as ordered by a physician
xii) psychiatric evaluation
xiii) school history
xiv) psycho-educational evaluation, if warranted.
22) An individual care plan should be developed for each child. The children’s officer, superintendent of the home and the child’s parents/family should be actively involved in the creation of this plan.
* Clear and achievable goals should be identified and monitored
* Quarterly meetings should be held. They should include family members, the identified child’s children’s officer, the superintendent of the home and the regional children’s officer supervisor. The child should also participate in these meetings
* An estimated date of discharge should be identified
* During the period of institutionalisation, every effort should be made for the child and family to keep in touch.
* The family should be prepared for the return of the child home
* An in-house medical record should be created for each child and updated when the child attends a medical facility.
* Repeated assessments should be done at appropriate intervals.
Long-term strategy to be implemented to reduce number of children entering homes
23) A long-term strategy must be implemented to minimise the entry of children into children’s homes and places of safety. This strategy will require collaboration with the Ministry of Labour and Social Security and the Ministry of Education, Youth and Culture. The community in which children with developmental and/or physical development and their families live and work also has a critical role to play.
24) Alternative strategies must be explored, which should include financial support to family units willing to care for their disabled child at home; build a community environment, providing information on opportunities, working with relevant ministries to create opportunities for these families.
25) Provide through its clinics ‘special needs extension workers’ to support families and do a level of monitoring of disabled children at home. The health clinics should provide scheduled community-based services for evaluation, development programme review in addition to health care needs.
26) The Ministry of Health, with the Ministry of Education, Youth and Culture, should explore the provision of ‘respite care’ and special day care facilities where parents can leave their child with a disability for brief periods to allow them the opportunity to work and nurture any other child who may be in the household.
27) Establish standards for homes that have been established for children with disabilities. There should be a time frame for compliance for existing homes.
28) Establish the actual cost of care and support for children depending on the level of disability, then enter into a clear agreement with each home regarding the level of Government funding or support it will receive and what is expected from the home to keep their accreditation.
29) That the Ministry of Health develops policies and guidelines which will enhance the process by which adequate governance of homes is monitored.
1:3 ratio for children with disabilities
30) That the ratio of staff to children be standardised as follows:
I. children with disabilities — 1:3
II. normal children — 1:10
31) That financial standards and procedures for private homes be developed.
32) The Ministry of Health should develop written policies and guidelines for separation from care
33) Implement tracer studies to determine how children are coping after separation
34) The Child Development Agency should establish a time-table to carry out inspections of the physical facilities of all homes
35) Establish operating standards for physical facilities such as number of bathrooms based on occupancy; special design of buildings to facilitate children with disabilities; allocation of sleeping space and minimum outdoor and indoor recreational facilities.
36) Establish operating standards against which performance may be monitored.
37) There should be annual revision of these performance standards to meet changing needs.
38) A Board of Visitors should be established, which will report to the responsible minister of health on the performance of each place of safety and children’s homes.
39) Annual strategic plans should be prepared for each place of safety and children’s home
Board of Visitors to hear opinions/complaints of wards of the state
40) Responsibility for hearing opinions/complaints of wards of the state be vested in the recommended Board of Visitors.
41) The organisation structure of the Child Development Agency (CDA) should be reviewed to reflect staffing which will meet the direct needs of wards of the state.
42) A monitoring structure and staffing should be introduced into the organisational structure of the head office of the CDA.
43) The organisational structure of the CDA should be reviewed to reflect the needs of all Jamaican children.
44) The training apparatus of the CDA should be strengthened.
45) A management information system be developed, which will be able to record and retrieve data relating to case files for each ward of the state and operational activities of each institution
46) That the CDA introduces a programme of community outreach through focus groups/town hall meetings with groups interested in the welfare of children in their communities.