After reading "Danger behind these doors," about adult foster care homes, I found myself needing to respond to defend the providers who take proper measures to effectively manage their adult foster care organizations.
To begin, I sympathize with local law enforcement agencies that continue to receive calls requiring them to do the work of adult foster care organizations. When an adult foster care provider elects to accept a resident with a violent past, it should work to ensure it has hired individuals with professional training in defensive tactics. Furthermore, the resident should have a provision for the use of hand restraints in his or her placement plan to ensure the safety of the resident and others. Individuals with violent behaviors typically are well-funded clients; however, many providers continue to hire naïve staff, lacking any of the above training, in an effort to create greater profit margins.
St. Louis County Public Health and Human Services Director Anne Busche is correct in stating these types of incidents are not unique to Stepping Stones for Living. It is also important to recognize these types of incidents are often non-existent within many organizations, as they can generally be avoided.
Currently, one of the greatest issues we face within St. Louis County is that the county has placed a moratorium on the expansion of adult foster care homes. The moratorium has, in effect, eliminated the need for healthy competition between providers. Competition between providers would lead to more professional programs, which in turn would result in better services to residents and fewer calls for emergency services. Case workers have come to me with their concerns that they're often stuck placing residents with providers that meet only the bare minimums of licensing or with whom they've have bad experiences, due to a lack of better options.
Other issues stem from the number of restrictions providers often place upon their residents. Many providers have several dozen house rules in effect but have little to no means of enforcing them. I have found great success by following individual placement plans and not blanketing the residents with restrictions. This in turn allows staff to pick their battles and avoid verbal and violent confrontations while still ensuring the safety of the resident and housemates.
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Absentee owners and lack of oversight also tend to account for the situations of abuse and neglect that may go on for some time before being resolved.
I utilize behavioral interviewing techniques in an attempt to determine how my candidates would respond to difficult or even potentially dangerous situations. I also have worked to train my staff in verbal judo, which is a form of communication that uses persuasion to resolve tense, difficult or even dangerous situations. Many of my staff members also hold college degrees and bring with them a tool box of skills learned through their studies.
Working with individuals who suffer from mental illness, chemical dependency or traumatic brain injury can be incredibly challenging. Proper training and well-thought-out program plans can help reduce the number of dangerous incidents as well as the number of calls made to emergency services. There will always be challenges and unexpected outcomes that cannot be planned for when working with people. Providers must learn from mistakes and work to eliminate future similar situations. Proper reform is needed to ensure the safety of residents, staff and the communities in which they reside.
DALE R. PORTER is president of Moving Forward AFC (Adult Foster Care) in Duluth (movingforwardafc.com).
