Category Archives: Social services

Past Time for Serious Sanctions for the Commonwealth’s Worst Nursing Homes

Posted on June 19, 2023 by | 11 comments

by James C. Sherlock

Effective May 1 of this year, Karen Shelton M.D. became Virginia’s Health Commissioner. Dr. Shelton is now the licensor and regulator of Virginia’s nursing homes.

By law, state-licensed nursing homes must comply with federal and state laws and standards. By regulation, the Health Commissioner “may impose such administrative sanctions or take such actions as are appropriate for violation of any of the standards or statutes or for abuse or neglect of persons in care.”

It is time.

I hope that she will pose a challenge to her Office of Licensure and Certification (OLC), of which I am a public admirer, that goes something like this.

Too many Virginia nursing homes are measured objectively by CMS (the Centers for Medicare/Medicaid Services) to be dangerous to the health and welfare of their patients through a combination of:

  • inspections that we ourselves conduct;
  • staffing measures linked to payroll data; and
  • medical quality measures from federal records.

Many have been that way for a very long time.

Current staffing far below CMS requirements seems to indicate that too many have no apparent path to improvement.

Come and see me in a couple of weeks with a list of the absolute worst of them.

And tell me why I should not shut them down to let the rest know that there are minimum standards beneath which they will not be permitted to operate in Virginia.

And one more thing.

Please let me know if there are organizations or individuals, current or recent, whose facilities have appeared regularly enough with the lowest staffing rating to indicate that understaffing may constitute a business model rather than a local exigency.

That too will not be tolerated.

We will take on those challenges here as if they are our own.

This article will identify the absolute worst of the facilities, using government records. The next will look at understaffing trends among owners. Continue reading →

11 Comments

Posted in Consumer protection, Government Oversight, Health Care, Law enforcement, Leadership, Long Term Care and Nursing Homes, Public safety & health, Scandals, Social services

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School Boards, Model Policies and Parental Rights in the Raising of Children

Posted on June 11, 2023 by | 16 comments

by James C. Sherlock

The Virginia Beach School Board will vote tomorrow.

The announced subject will be transgender rights in schools.

It is couched by The Virginian-Pilot as the school board defending transgender students against “unnecessarily cruel policies.“  As opposed, one supposes, to necessarily cruel policies.

The local paper refers, of course, to the Youngkin administration’s “Model Policies” on the subject. Which, like their predecessors from the Northam administration, are not mandatory, so need not be debated at all.

The School Board debate is at its core constitutional.

You will note that the Youngkin Model Policies linked its constitutional interpretations to court decisions. The Northam version did not. Northam’s just asserted what the constitution meant. Must have been an oversight.

My take:

  • Families are responsible for shaping the values, beliefs, and personalities of children;
  • Government is required to protect children from abuse and neglect. But government schools are not allowed to substitute their judgements on values and beliefs for those of the families;
  • They are most certainly not permitted to define parental moral or political disagreements with school personnel as emotional abuse at home. Or as harassment of government schools or teachers;
  • And government schools, absent evidence of abuse or neglect, must never be allowed to substitute their own moral judgments for those of parents.

But that’s just me. Not a lawyer. Continue reading →

16 Comments

Posted in Children and families, Civil Rights, Culture wars, Education (K-12), Freedom, Governance, Individual liberties, Marxism, Parental Rights, Politics, Social services

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Arlington CPS Seizes Baby Girl Over Tylenol

Posted on March 23, 2023 by | 9 comments

by Asra Q. Nomani and Debra Tisler

Late Wednesday afternoon, in Courtroom 4B of Arlington County’s Juvenile and Domestic Relations Court, Sean Jackson beamed widely as a judge granted him and his parents, Carlos Makle and Kim Jackson-Makle, joint custody of Sean’s baby girl, Amoria, instead of relegating her to foster care or instability with a mother struggling with drug addiction.

Kim later said, “Hallelujah,” thinking the nightmare they had been living for over a year with the County’s inept Division of Child Protective Services was finally over. But it was just about to begin all over again. Arlington County’s Child Protective Services was about to dispatch a social worker to an apartment in Arlington to seize Amoria’s second cousin, London, also a cute baby girl, from her mother, Paris Adams.

Why?

Over an alleged missed dosage of Tylenol Wednesday morning that the baby wasn’t even required to get, per doctor’s orders, but was rather prescribed “as needed.” With so much written in the news about public policy, legislation and politics, this story is disturbing because of the sheer inhumanity of bureaucrats operating with complete disregard for actual child welfare or a mother’s heartache.

First, a rewind.
Continue reading →

9 Comments

Posted in Children and families, Courts and law, Demographics, Efficiency in government, Government Oversight, Individual liberties, Parental Rights, Race and race relations, Social services, Uncategorized, Virginia Law

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Feeding Petersburg

Posted on March 3, 2023 by | 34 comments

Garrison Coward oversees Gov. Youngkin’s Partnership for Petersburg initiative – photo contributed to the Progress-Index

by James C. Sherlock

I have written in this space many times about the struggles of Petersburg.

Petersburg is blessed in one way.

The Progress-Index’s Bill Atkinson and Joyce Chu may be the best pair of local news reporters working in Virginia.

Mr. Atkinson, in a series of reports, has detailed the continuing struggles of that city to get a grocery store downtown.

The big grocers surround the center of the city in more prosperous, safer areas but have not entered there.

Food Markets in Petersburg courtesy of Bing Maps

It is no secret why. Poverty and crime do not attract retailers vulnerable to shoplifting and worse. And Petersburg is among the poorest and most crime-ridden in Virginia.

A recent Petersburg solicitation for interest in building a grocery store downtown drew no bidders.

The Governor has a broad Partnership for Petersburg initiative to help Petersburg help itself  It is run by Garrison Coward, an external-affairs senior advisor to Gov. Youngkin.

He reports that the Governor is “hell-bent” on seeing a grocery store built there.

I will offer an idea. Continue reading →

34 Comments

Posted in Business and Economy, Charity and philanthropy, Children and families, Economic development, Governance, Hunger, Not-for-profits, Poverty & income gap, Social services

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Child and Adolescent Mental Health and Virginia Public Schools – Dangerous Children’s Services Act Changes Proposed

Posted on February 13, 2023 by | 13 comments

Credit JAMA Pediatrics, April 6, 2020

by James C. Sherlock

One of the key elements of state and local efforts to support children with behavioral health, educational disabilities, and other challenges is the Children’s Services Act (CSA) (the Act).

In education, its primary role has been paying for placement of children and youth with educational disabilities into private special education schools (PSES).

CSA funds support those students whose educations are judged by the public schools themselves to be too demanding for them to accommodate.

The local CSA Community Policy and Management Teams, appointed by the governing body of the participating local political subdivision, send their own children to those private schools.

I will describe Virginia’s network of PSESs in a follow-on article.

Changes proposed. In a 2020 report, the Joint Legislative Audit and Review Commission (JLARC) had found a long list of seemingly disqualifying flaws in public school special education that would prevent them from accepting students with more severe disabilities than the ones they already try to serve.

Yet there is a movement to remove some severely troubled kids from PSESs back into public schools that have already admitted that they cannot properly serve them.

JLARC, in a disturbingly superficial report in that same year, recommended CSA money be taken away from PSESs and made available to public schools, which is not currently permitted under law.

And that all of the then-fungible CSA school money be administered by the Department of Education, not the Department of Health and Human Resources.

This recommendation was made in the face of the fact that JLARC, in both 2020 reports, admitted the public schools are not equipped to handle these children, much less for the average of 271 days a year they attend PSESs.

So some combination of progressive ed-school dogma, as yet undefined fairy dust and widely non-existent qualified mental health providers and trained special ed teachers are apparently to be sprinkled on the public schools to transform them to be ready to accept children whom they have already referred out to PSESs.

Most of the proposed changes are dangerous, dogmatic and thinly researched nonsense. Continue reading →

13 Comments

Posted in Central planning, Children and families, Culture wars, Education (K-12), General Assembly, Governance, Health Care, Mental illness and substance abuse, Psychology, Social services

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Child and Adolescent Mental Health and Virginia Public Schools – Big Complications and Major Changes

Posted on February 9, 2023 by | 19 comments

Credit JAMA Pediatrics, April 6, 2020

by James C. Sherlock

Rebecca Aman, a member of the Newport News School Board, is frustrated. She told me in an interview that:

Without sufficient discipline and access to clinical mental health services, behavioral intervention does not work to make schools safer and healthier.

She believes that Newport News schools need to improve both discipline and the effectiveness of behavioral interventions.

She is absolutely right.

But school-based mental health services offer different, very complex and rapidly changing challenges.

The profession of psychology has recognized that the one-on-one clinical treatment model is permanently out of reach for the broad communities needing assistance because the supply of qualified professionals cannot now and will never meet the demand.

So the delivery model is in the midst of profound change.

Three key changes being pursued are

  • a far bigger emphasis on prevention, much of it to be delivered by school staff;
  • better diagnosis; and
  • “school based” (their term) group treatments.

Which raises at least three questions:

  • Are the pediatric mental health delivery models changing so much that the schools are “shooting behind the rabbit” in the hunt for more services?
  • What does the profession of psychology mean when it describes massively expanded “school-based” services? The schools and parents better find out.
  • Should schools even be in the hunt for more in-school services? I say no. They are already trying to do too much.

Continue reading →

19 Comments

Posted in Children and families, Culture wars, Discipline and disorder, Education - Early Childhood, Education (K-12), Efficiency in government, Finance (government), General Assembly, Governance, Government Oversight, Health Care, Mental illness and substance abuse, Psychology, Social services

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Virginia Community Schools Redefined – Part 2 – Stop Trying to Provide Mental Health Services in School

Posted on January 25, 2023 by | 14 comments

by James C. Sherlock

In Part 1 of this series I described the current Virginia Community School Framework (the Framework) and found it not only lacking, but counter-productive.

Its basic flaw is that it assumes all services to school children will be provided in the schools by school employees, including mental health services.

When you start there, you get nowhere very expensively, less competently, and with considerably more danger in the case of mental health than if the schools were to partner with other government and non-profit services.

This part of the series will deal with child and adolescent mental health services exclusively.

Public mental health, intellectual disability and substance abuse services for children and adolescents are funded by governments at every level. For the federal view of the system of care, see here.

In Virginia, those services are organized, overseen and funded through a state and local agency system.

  • The state agency is the Virginia Department of Behavioral Health and Developmental Services (DBHDS) in the Secretariat of Health and Human Resources. The Department of Medical Assistance Services (DMAS) (Medicaid) plays a funding and patient management role as well;
  • Local agencies funded and overseen by DBHDS are the Community Services Boards (CSB’s) throughout the state.

Some schools and school systems seem to operate on a different planet from their local CSB’s. Indeed, the Framework mentions them only reluctantly and in passing.

The ed school establishment clearly wants to handle child and adolescent mental health problems in-house, with tragic results. They need to stop it now.

There is absolutely no need to wait. Continue reading →

14 Comments

Posted in Children and families, Education - Early Childhood, Education (K-12), Efficiency in government, General Assembly, Health Care, Mental illness and substance abuse, Psychology, Public safety & health, Social services

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Virginia Community Schools Redefined – Hubs for Government and Not-for-Profit Services in Inner Cities – Part 1 – the Current Framework

Posted on January 24, 2023 by | 5 comments

by James C. Sherlock

I believe a major approach to address both education and health care in Virginia’s inner cities is available if we will define it right and use it right.

Community schools.

One issue. Virginia’s official version of community schools, the Virginia Community School Framework, (the Framework) is fatally flawed.

The approach successful elsewhere brings government professional healthcare and social services and not-for-profit healthcare assets simultaneously to the schools and to the surrounding communities at a location centered around existing schools.

That model is a government and private not-for-profit services hub centered around schools in communities that need a lot of both. Lots of other goals fall into place and efficiencies are realized for both the community and the service providers if that is the approach.

That is not what Virginia has done in its 2019 Framework.

The rest of government and the not-for-profit sector are ignored and Virginia public schools are designed there to be increasingly responsible for things that they are not competent to do.

To see why, we only need to review the lists of persons who made up both the Advisory Committee and the Additional Contributors. Full of Ed.Ds and Ph.D’s in education, there was not a single person on either list with a job or career outside the field of education. Continue reading →

5 Comments

Posted in Attendance, Charity and philanthropy, Children and families, Civil Rights, Courts and law, Crime , corrections and law enforcement, Culture wars, Discipline and disorder, Education (K-12), Efficiency in government, Entitlements, General Assembly, Health Care, Infrastructure, Law enforcement, Mental illness and substance abuse, Not-for-profits, Political Influence, Poverty & income gap, practice of, Psychology, Psychology, Public safety & health, Social services, Threat Assessment

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Democrats Want to Raise Youngkin-Proposed Mental Health Budget Increase

Posted on January 5, 2023 by | 33 comments

Health Resources and Services Administration Mental Health Care Health Professional Shortage Areas, by State, as of September 30, 2022, data.HRSA.go.                 Courtesy Governor Youngkin

by James C. Sherlock

There is fundamental agreement in Richmond over mental health services.

From the Richmond Times-Dispatch:

Virginia’s forecasts of long-term budget surpluses mean this year’s General Assembly has a chance to catch up with years of under-funding Virginia schools and the state’s behavioral health system, General Assembly Democrats say.

To govern is to choose. “Democrats” may wish they had used different words than “years of underfunding,” considering who had control in Richmond in 2020 and 2021.

But it is actually helpful that they now think even the governor’s proposal for a 20% increase in the mental health budget approved last year is not enough. If (a big if) more money can be spent efficiently and effectively.

The governor has proposed a $230 million increase in behavioral health program spending over what was approved last year.

So, as the old saying goes, they are just discussing price.

Let’s look at the behavioral health situation to see why. Continue reading →

33 Comments

Posted in Budgets, Children and families, Education (K-12), Efficiency in government, General Assembly, Governance, Health Care, Mental illness and substance abuse, Politics, Psychology, Social services

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Great Investigative Reporting of a Heartbreaking Story

Posted on December 6, 2022 by | 4 comments

Courtesy Asra Investigates

by James C. Sherlock

For a story that will simultaneously make you angry and break your heart, read “Fathering While Black,” by Asra Nomani and Debra Tisler.

It is the story of a guardian ad litem (GAL), Karen Keys-Gamarra, who is reported here to have systematically abused her position to pursue a Black father and his parents for the crime of loving and caring for his daughter while male.

The child’s mother was a junkie who exposed her baby to cocaine. The father is a gainfully employed paramedic in Stafford County with a clean record and clean drug tests. His own mother is a registered nurse and his father a retiree.

The GAL got an order from an Arlington J&D judge to take the child from the home of her father and grandparents last night.

The authors have practiced world-class investigative journalism in describing the case and the system — Arlington J&D judge, GAL and Child Protective Services — that worked together to seize the little girl. And put a gag order on her father and his parents.

If ethics violations were a crime, based on this reporting this case would be a Class 1 felony.

Now nobody in the system will comment.

Ms. Nomani and Ms. Tisler comment for them.  Thoroughly and compellingly.

4 Comments

Posted in Children and families, Civil Rights, Courts and law, Ethics, Government Oversight, Law enforcement, Parental Rights, Scandals, Social services

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Virginia Mental Health Services in Deep Trouble – A Survey

Posted on November 28, 2022 by | 42 comments

Eastern State Hospital. Courtesy Virginia Department of Behavioral Health and Development

by James C. Sherlock

Nov. 29 updates in blue.

Supply cannot begin to keep up with demand.

In this case, the consequences involve personal welfare and public safety. And they can be terrible in both cases.

Governor Youngkin will propose to the 2023 General Assembly additional funding and policy prescriptions for the state’s mental health system.

The state offers inpatient services, community-based government services, and Medicaid-funded services.  Medicare offers payments to participating hospitals. Private insurances offer coverage.

I say “offer,” because much of what policy prescribes has proven difficult to fill in practice.

Virginia’s mental health system is in deep trouble because of shortages of personnel and facilities to absorb the very steep rates of increases in persons needing assistance.

The personnel problems are twofold and affect both government and private services.

  1. Key personnel positions require trained specialists, the shortages of whom are manifest across the country; and
  2. Working conditions in mental health care are very stressful, physically demanding and dangerous, driving away badly needed low skilled workers who can easily find jobs elsewhere.

Medicaid programs offer services that private facilities and practitioners, facing the same labor shortages, have proven in some combination unable or unwilling to provide at Medicaid reimbursement rates. State-contracted Medicaid Managed Care Organizations (MMCOs) have not solved those problems.

So part of the answer is money, but we really don’t know how much. And in this case, money alone may not provide sufficient services to satisfy demand. Continue reading →

42 Comments

Posted in Budgets, Entitlements, General Assembly, Governance, Health Care, Insurance, Mental illness and substance abuse, Public safety & health, Social services

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Petersburg Resumes Important Actions Against City Code Violators — Homeless Needs Increase

Posted on November 22, 2022 by | 38 comments

Travel Inn was shut down by the ACE team in June. Courtesy Joyce Chu, Progress Index.

by James C. Sherlock

Sometimes absolutely necessary actions have more than one outcome.

Such is the case in Petersburg.

Joyce Chu of Petersburg’s indispensable Progress- Index last evening initiated a multi-part series on the impacts of the city’s closure due to safety violations of two motels used by otherwise homeless people.

Her first article makes a case for more government and charitable services for the people affected by the closures. Good for her. No one wants people living on the streets and everyone wants the kids in school.

She explains that the California Inn, OYO and Travel Inn motels, among a group of low cost motels right off of I-95, were

also hotbeds of crime, drug overdoses and prostitution mixed in with families with children, according to former residents and homeless advocates.

She points out that Petersburg has resumed (after a lengthy period when it did not) enforcing its zoning codes. A team called the ACE team — Abatement, Compliance, and Enforcement — is on task, run by the Fire Chief.

Code enforcement is an absolutely necessary step to revitalize the city.

So is helping those adversely affected.  -Hotel owners should be forced within the limits of the law to assist. Continue reading →

38 Comments

Posted in Attendance, Charity and philanthropy, Children and families, Crime , corrections and law enforcement, Health Care, Homelessness, Infrastructure, Law enforcement, Mental illness and substance abuse, Public safety & health, Regulation, Social services

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Afghan Immigrants and Their Children in Virginia – Part 1

Posted on November 16, 2022 by | 10 comments

Courtesy of Virginia Department of Social Services

by James C. Sherlock

The flow of Afghan refugees into Virginia has been at a much higher volume than is generally appreciated.

I have data on Virginia resettlements of Afghanis from 2016 through the middle of 2021, when the total was 8,560.

The current total is far higher as a result of the Kabul airlift. A government survey reports that 41,000 of that group admitted to the U.S. settled in Texas, California and Virginia.

A significant majority of the Afghanis admitted between 2016 and the middle of 2021 have been granted Special Immigrant Visas and are lawful permanent residents.

Special Immigrant Visas (SIV) have been issued to those who took significant risks to support our military and civilian personnel in Afghanistan, were employed by or on behalf of the U.S. government or our coalition forces in Afghanistan, or are a family member of someone who did.

I think I speak for all Virginians when I welcome them and thank them for their service.

I have embarked on an effort to understand the numbers and impact of those refugees on our institutions, especially our public schools.

And our impact on them. Continue reading →

10 Comments

Posted in Children and families, Education (K-12), Entitlements, Governance, Immigration, Labor & workforce, Social services

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Youngkin Champions Licensing Reforms, Loosens Regulatory Barriers

Posted on October 27, 2022 by | 11 comments

by Eric Burk

The Virginia Board of Social Work has changed licensing regulations, making it easier for social workers licensed in other states to get licensed in Virginia.

“There is a critical shortage in Virginia of mental health professionals, and this is a significant step by the Board of Social Work to help address this shortage,” Governor Glenn Youngkin said in a Wednesday press release. “A priority of my administration is to reduce state regulations and regulatory barriers, and this action shows how regulations can be streamlined to remove barriers to practice with the goal of bringing more mental health professionals to the Commonwealth.” Continue reading →

11 Comments

Posted in Social services

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Virginia Needs Better Information Sharing to Provide Mandated Public Services to Illegals Efficiently and Effectively

Posted on August 3, 2022 by | 15 comments

by James C. Sherlock

I am on record as a persistent advocate of improving the quality of both schools and medical services for poor and minority citizens. It has been the main focus of my work for years.

In a directly related matter, we read, with different reactions depending upon our politics, of the struggles with uncontrolled immigration on border states on the one hand and D.C, New York City and Los Angeles on the other.

We are treated to the public spectacle of the mayors of sanctuary cities deploring massive new influxes of illegal border-crossers and asking for federal assistance. It provides one of the best object lessons in being careful what you ask for in recent public life.

All of that is interesting, but Virginians know that the problem is increasing. They know Virginia can’t fix it, and they want to know how Virginia will deal with it.

By law we owe illegals services. And we need to provide them efficiently and effectively both for humanitarian reasons and to ensure that citizens are not unnecessarily negatively affected.

There is work to do. Continue reading →

15 Comments

Posted in Budgets, Charity and philanthropy, Children and families, Demographics, Education (K-12), Efficiency in government, Entitlements, Immigration, National Security, Planning, Social services, Virginia Law

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