PRACTICE AND POLICY LECTURE SERIES, OCTOBER 2012 - FOSTERING HOPE

Deborah Shropshire:  So, my name is Deb Shropshire, it's so good to be with you guys.  As I was, you know, thinking about being here with you, it was just... I just got excited over the last week or so. Just the fact that I knew I was going to see friends, I was going to make some new acquaintances and just at the opportunity to really share with you kind of my heart around foster kids and the story of foster kids.  

It's really my favorite thing that I do, so I do a lot of different kinds of things over the course of the week, but this is my favorite. And so, it's good to be with you, thank you for having me. I just want to figure out kind of who we have in the audience.  Some folks I know, and some folks I don't, but if you're like with child welfare, something to do with child welfare, caseworker, supervisor, whatever, would you guys just kind of wave at me?

I've got some child welfare people, good.  If you're with like some other division in DHS, who have I got?  Have I got anybody from other divisions in DHS? Okay, good. If you're like a service provider for foster kids, or those kinds of things, maybe mental health, or other kinds of service providers. Who have I got there in service providers? 

Okay, how about foster parents? Have we got some foster parents? Got some foster parents in the room.  Some of you are the same, some of you raised your hands like three times, like you're doing all those jobs. 

(laughter)  

Mrs. Shropshire (continues): How about like organizations, maybe community organizations that are doing work with foster kids. Good, got some of that as well. So, it is like in thinking through, you know, what to talk to you about today, it was actually easy in some ways, because I only talk really about one thing.  If you heard me talk, I really talk about one thing.  

On the other hand I've had just kind of a burden for you for the past week or so. Just to bring to you, I think, the right message. So that hopefully when you walk away at the end of an hour of being here together with us, that you're going to walk away with a fresh sense of purpose and of hope for what we're doing right now in foster care. 

So we're going to talk about foster kids and about what that looks like.  We're going to talk about, sort of who comes into foster care just a little bit, where they sort of land, I just want to make sure everybody is on a level playing field.  And then we're going to talk about their health issues, we're going to talk about their outcomes.

And I got to tell you it's going to be ugly for a while, okay?  It's going to be a pretty ugly picture for a while. But, I want you to hang in there with me because we'll get to a place where we can really talk about what hope we have for these kids and what the outcome could look like if we'll all engage in what we're doing here.  And so, let's talk about kids in foster care. 

No Audio: Kids in Foster Care - 60,000 reports annually (Oklahoma).  80-85% neglect.  Around 8,500 kids in foster care.  DHS job is to investigate maltreatment, and to protect and provide for basic needs while working toward resolution of family issues and reunification of children with birth parents.

Just in Oklahoma we have about 60,000 reports every year of child abuse or neglect.  The majority of those, and one of the things I had to learn, when I started working with foster kids, was that most of the stuff I learned about in terms of child abuse as a physician in physician training, was physical abuse, it was the kid that sort of comes to Children's Hospital, that maybe made the news, those kinds of things.  

But the truth is about 12 years ago when I started taking care of children at the shelter, at the Oklahoma County DHS foster shelter, the Pauline Meyer shelter, where many children come to stay for a short period of time while we're trying to find them a foster placement.  

When I started taking care of those children what I realized was, all that training as a physician on child abuse that I had gotten, really for many of these children, that wasn't their story.  Their story was one of neglect and that is not what hits the news but the truth is that 60% or 70% or 80% of the kids who come into our system come in because of issues like their mom's on drugs or their parents have domestic violence or they don't have adequate housing or food or supervision. 

Those kinds of issues and those are not necessarily the ones that make the news, unless something really, really bad happens. And so, we have to understand that, that the majority of the children that are bumping into our foster care system are not the one sensational news story.  They are the kids that every single day they are struggling to have enough to eat, or struggling to have a warm house to sleep in, okay? 

That's the kind of kids that we're mostly dealing with.  There is about 80-85% neglect as I mentioned.  Around when I made this and it said 8,500, the numbers.... like I need to update it because like every six months the numbers are changing, right?  We went down as low as maybe 8,000 kids in foster care. We were as high as a few years ago as maybe 13,000 kids in foster care, 12,000 and we're maybe in the nines now, 9,000 - 9,500. 

Now, you'll hear this is a soap box, I get on one of those every once in a while so you're welcome to just sort of tune that out when I get there. But, the truth is what you need to understand is sometimes we'll hear about how we're going to keep more kids at home, and philosophically we're going to make sure that we're not picking up too many kids. 

And you get sometimes the idea that dropping the number of children in foster care is always a good thing. But, the reality is there are some number of children in our state who are not safe in their homes. And that's really the purpose for right now at this point in time for the child welfare system.  

If the idea is to figure out who is not safe and to protect them and to get them into a place where they are safe and work with the family to be able to see if maybe we can, make that situation better so that family can re-unify. That's the purpose of the system.  I would argue with you that our goal, my goal, my career goal is that we get to a place where we don't have kids in foster care, because there's no more child abuse.  

That ought to be what we work for.  But it's not where we live right now. We have to understand that there is going to be some number of children in foster care and right now that's 9,000, 9,500 something along those lines, okay? DHS's job is not to steal children away from their families, okay? And it's not to take them away from their families so that we can put them with other good families. 

Their job is to figure out if a child is safe or not, to protect that child. And to work like crazy to get that child back home with their family if they can.  We have to understand that.  Sometimes it doesn't happen, in fact I'm going to show you some statistics on that.

Kids come into foster care through this mechanism, there is some sort of report of child abuse or neglect.  DHS is involved in trying to figure out if the child is safe or not.  And then if the child is unsafe it is placed into foster care system. And DHS, the Court, the family, a variety of other groups work together on some sort of treatment plan so to say, "Okay what do we need to make sure that this home, this family is able to be safe for their children to be healthy for their children, going forward?"  

And at some point if that plan is not working out very well, the Court system and the District Attorney's office and DHS will agree to move on and say, "Hey, this child has got to have permanent placement even if that means living with someone else for the rest of their life." Okay? 

Kids come into foster care and they live in a lot of different places.  I... one of the places that I serve is the shelter as I mentioned.  I've been there twelve years, I've seen almost 20,000 kids. In twelve years, that's a lot of kids coming through the shelter setting.  That's only one shelter, and we have other shelters around the state. Oklahoma City and the Tulsa shelters are the largest, but thereÆs lots of smaller shelters around the state where children are passing through.  

And sometimes they are going into the homes of relatives, grandmas, aunts, or teachers, people who maybe are not related, blood related to them, but connected to them in some way. Sometimes they are going into the homes of strangers who have somehow gotten this idea that it would be a great idea to have a few more kids in their house.  I don't know, I tell you traditional foster parents are a mystery to me, they really are.  And I think it's because I don't really like children all that much...

(laughter) 

Mrs. Shropshire (continues): ...and so I... look... I don't, I don't.  I wasn't going to be a pediatrician. I was going to be an emergency medicine doctor, I wanted to be a doctor all my life.  I loved like blood and guts and I would always watch all the emergency medicine shows on television, you know? 

And so when I came into medical school that was the direction I was whole-heartedly going. And really what happened to me is, during the clinical years of training, I ran into an elective in child abuse and neglect, I thought, ôThis would be great training for me. 

I'm going to be an E.R. doctor, and I'm going to see this stuff.ö And in the course of that elective, most of it was not medical. Most of it was actually more sort of about the system of child welfare.  It was going out with case workers, into the field, seeing what a caseworker has to do when they're concerned about a child.  It was going to court and watching the court process.  

It was those kinds of activities.  And in doing that, man, I just fell in love with foster kids.  I didn't just fall in love with foster kids, I fell in love with these crazy people, who are like strangers to them, and who say, "Yeah I got an extra bedroom, you can come stay at my house."  

And who go through a lot of hurdles and hoops and red tape to make that happen.  That blew me away.  But I tell you the other group I fell in love with when I was going through that rotation - birth families.  Because I saw moms and dads who were bumping into the system, who I looked at and went, ôWow, I thought you would be like green with horns, or something like that.ö  

You imagine what a family is going to look like when they've abused or neglected their child.  But, the truth of the matter is they look like me.  And they look very similar to many people that I went to school with.  

I grew up in western Oklahoma, Erick Oklahoma.  Does anybody know where Erick Oklahoma is?  One person, yeah.  Or two people. (chuckles)  It's a big place right? It's on I-40 and probably most of you have seen the signs for it, but you've like, as you've gone to Colorado or New Mexico to go skiing or whatever.  But you've never stopped there because there's not much out there.  

I grew up in Erick, Oklahoma and the truth of the matter is it was a real small rural town, small high school, that kind of stuff.  But in my high school there were 28 kids that graduated at the time that I did.  I think it is even smaller now.  

But, the salutatorian in my class, who was a smart guy, okay, very smart guy, went to college, got hooked on drugs and six weeks after he started college wound up back in our home town, basically dealing meth and has, you know, really I mean heÆs not doing much.  HeÆs not really doing much. 

And I looked at these families and I went, "Wow, that could happen to any of us." There's not so much difference from me and one or two decisions that I might have made in my life that would put me in a spot that a mom who's addicted to drugs, or a mom who's depressed or, a set of parents who have domestic violence issues or whatever those issues are.  

One or two different decisions and any single one of us could have been in this situation, okay? One or two different decisions.  And the truth is I was born into a family where, it wasn't a perfect family by any stretch but it was a family where we didn't have to deal with those issues.  

Like mom was a good mom, my dad was, kind of little, you know, he was little nuts and whatever. (chuckles)  I mean it wasn't perfect, but they knew how to raise me, they knew how to parent me, you know I never went without.  I never was neglected.  They took care of us.  My mom was a teacher and so we always had help with our homework.  

We always had, you know, the motivation that we could sort of do whatever we wanted to do. The families that I ran into when I started interacting with foster kids and they didn't even have anything close to that in their family. They'd never been told they could do something, they'd never been told they could be a good mom, they had no idea how to communicate with their little kid. 

And you start saying to mom, you know, ôHey sit down and talk to your baby.ö  And they are like, "I don't, why would I do that?  The baby can't talk back." They have no idea that the way you get your child to learn languages is by speaking to them. They don't understand. And that is something I didn't have to overcome, didn't have to deal with. 

And so I really fell in love with all the different parties in the system, that's where I wound up here.  But it's amazing to me.  That there are people who will step out and say, "I'm going to go through a bunch of red tape, I will go to a bunch of training classes that are booorrring."  

I don't know if I have any trainers in here, but I'm sorry, I'm not trying to offend you, I'm just saying it's boring to sit around and learn policy and you know, procedure and all kinds of stuff.  I don't care who you are it's boring. Okay, go through all that, so that I can take a kid, and it's not ever just one kid.  

Like they'll tell you, "Oh yeah, thereÆs this one kid." But they always have four siblings, youÆre just not going to learn them until about a couple of weeks from now, when you like that kid.  And then they are going to be like, ôBy the way there is another one.ö  And after a while you will have about five more kids in your house.  

I, listen, when I was training I could barely keep the dog alive.  There is no way I needed children in my house.  I have two kids now and they are alive and they are healthy.  And thank God they are old enough that they get themselves out of bed, get dressed, and fix their own breakfast in the morning.  I'm happy about this because, I don't have to really, I've got them trained properly where they can do that for themselves, and I like that.  

And so I could never have done this, but some of you have done that.  You've done it in the past or you are doing it right now. And my hatÆs off to you because I think it is a very, very difficult job.  Some of these kids are wind up staying in group home settings.  Okay?  Settings where maybe there's more supervision, or maybe they're just an older kid and there's just not a home for them.  

My heart breaks for kids that are sort of those junior high or senior high age kids.  It's very, very difficult to find them a home.  You can have a good kid.  We had a good kid recently, really good kid that we ran across.  Straight A student.  Very sharp kid.  Doing well in school. Doing well in sports.  All this kind of stuff.  Couldn't find a home anywhere across the state for a kid that age.  

I mean, we're not talking about a kid that's going to set fire to your garage, okay? We're talking about a good kid, and we couldn't even find a home for that kid, much less a kid who may have more struggles.  And so some of these children wind up in group home settings. Some of the kids, older kids especially, wind up in special programs, like maybe, we have settings where you can be a teen mom who has a little baby in foster care.  

Sometimes you wind up in a setting like Jobcorps where you're learning trade skills and getting ready to be out on your own. Then unfortunately we have not a small number of kids that are in inpatient psychiatric facilities.  And that's probably, there are some of those kids who need that much assistance, but there are some of those kids who they just desperately need a family.  

And that's what they need more than anything else, and they just haven't ever had it.  And what they've seen and experienced has caused them to really struggle with life and that's our default, because we don't always have good places for those kids to go. So that's where kids kind of land. Now here's sort of general outcomes. And these are sort of really national outcomes but they are similar to what we see in our state.

No Audio: Outcomes - 52% will be reunited with birth family.  30% will be adopted.  Others will age out of foster care, run away, or move into other systems.
  
About half of kids are going to be reunited.  Remember I told you the goal of DHS? In almost every case the goal of Child Welfare is going to be to put that family back together again.  Protect those kids, put that family back together again.  The reality is, it doesn't always happen, because man there is a lot of brokenness in these families and a lot of struggles that folks are going through, sometimes can't, just doesn't or can't get remedied in a timeframe that's reasonable for that kid, and so some of these kids are going to wind up going other places.  

Well, that bothers me.  Both these groups bother me for different reasons. If you go home, and we think that everything about your life is fixed, because somehow you managed to work through the plan and get your kid back, that worries me, because some of those families are really struggling. 

And the issues they struggled with have gotten remedied a little bit better, but boy life is still hard man.  If you're poor, it's just hard to be poor. If you are having difficulty maintaining a job, you might be able to do that for a while, but you may struggle in the long run. If you are undereducated, whatever the issues and the challenges.  If you have mental health issues. 

Whatever those challenges are, they don't magically go away, because you worked a treatment plan successfully and got your kids back. And in fact, honestly, sometimes if I have my kids gone, I have much better mental health than when I have them home, right? (chuckles)And so, I know that's nervous laughter, like you don't want to admit that you feel that way sometimes... 

(laughter) 

Mrs. Shropshire (continues): ...but we all do. It's struggle. It's difficult.  Thirty percent of the kids who don't wind up going home are going to be adopted, and this last group really breaks my heart.  Another 20% or so are going to go somewhere else - out into the abyss or whatever. They're going to age out, they might run away, they might move into other systems.  

A lot of the kids who are in the OJA system, the juvenile justice system, they're kids in foster care, or they used to be in foster care.  Guess what? If you start looking at human trafficking, at kids who are 13, 14, 15, 16, a whole bunch of those kids have been in foster care.  These systems overlap.  These kids do not just magically get better because we identify their family struggle and we picked them up.  

They don't magically get better, they often wind up in other systems, with some of the same struggles they had in ours. Well, one of the things I've learned about kids, when I started taking care of the kids at the shelter, was that these are kids that are sick, and I thought, "Well, this is good news, because I'm a doctor, (chuckles) I know how to take care of sick kids, so this is good.  They're sick, I can fix this, okay?"  

The USGAO says that as a group, foster kids are sicker than homeless children and children living in the poorest sections of our inner cities.  This is an unusually ill population.  And they are ill with a lot of different things for a lot of different reasons, okay? Sometimes it's physical illness.  Sometimes it's an issue with having been premature, and having complications related to that, okay? Sometimes it's an issue with what your prenatal experience was. You were prenatally exposed to drugs and alcohol. 

Or what we're really starting to understand a little bit better as we learn more about trauma in kids is that how trauma, even in pregnancy, whether that's trauma the mom experiences, not physical trauma, even emotional trauma, or whether that's a pregnancy that was unwanted by a mom, how much that actually affects a growing fetus.  And we're starting to see the effects of that. Sometimes kids are have medical issues, because they had health issues, regular old kid health issues that weren't treated very well before the child came into foster care.  

I mean, if you're barely able to get food on the table and a roof put over somebody's head, you are not making it to all your well child check appointments, okay?  You're not making it to every health visit you need, and especially if you're a parent who has a child that has a lot of health issues, it's difficult, okay?  

I have a couple little boys, a friend that is a foster mom that takes care of a couple of little boys who have special needs.  In the last year she went to 200 medical appointments. In a year. In a year.  

How many people who are just trying to survive could pull that off?  How many of us could pull that off?  I couldn't pull that off, okay? One thing we have to understand about the children with families who are engaged in the system is they are challenged well beyond what most of us could ever accomplish.  

I don't know that I could pull off 200 visits.  Now, thank God for this lady and her husband who are amazing foster parents and they have pulled it off.  They've enlisted the grandparents and the friends and everybody and the dog to be able to do it, but I tell you what, I look at that situation and I go "What birth family could pull it off? What person in this audience could pull that off?" 

Two hundred visits, I mean that's a lot, that's a lot.  And so sometimes these kids have health issues that are just bigger than what their family is able to deal with.  Sometimes these are kids who are exposed to genetically to a family history of stuff, okay?  And sometimes that's medical stuff and sometimes it's stuff like asthma or diabetes and things that we're used to inheriting. 

But sometimes it's stuff like mental health issues, or substance abuse issues and you start looking at the family story and gosh, mom has problems and dad has problems and grandma has problems and you look back three or four generations and everybody's got some kind of problem, okay?  Those kids are carrying the burden of that.  

Sometimes they have acquired problems.  Maybe because of the surroundings they were in, we certainly see lots of kids that come into the shelter, especially in the emergency setting, who have been exposed to environments that aren't very safe.  We keep lice treatment and scabies treatment things like that, you know, by the gallon because a lot of kids live in environments that are not very healthy and so, as a result, they come into our care with medical problems that need to be treated. 

They also acquire as they go, either through life outside the system and sometimes life in the system an awful lot of baggage.  Some of that is emotional, a lot of that is emotional baggage, a lot of issues of abandonment, of neglect, of "I don't know how to have normal, healthy relationships because no one ever had that with me." Of just all different kinds of just weights that the kids carry around.  

And when you carry that kind of stuff around it affects your health and we'll talk about that just a little bit more as we go forward.  Practically the way that looks like to me in my practice in the shelter, is an inordinate number of kids who have things like stomach problems.  I mean, you see a four year old with an ulcer and you're like, "Dude! What do you have an ulcer for? Like a 30 year old who has, you know, lost their job and trying to make ends meet I understand - you're like four."  

Well, let me tell you, they're carrying around enough stress that a lot of adults have never even experienced, what that child has experienced. And so ulcers, headaches, chronic pain... I mean the diseases really of adults in these children because of the stress that they experience, okay?  

And then high-risk behaviors, it's uncommon for me to have a shelter full of kids where I don't have at least one teen who is pregnant, or a teen who has fathered a child, or something along those lines.  That really freaks the staff out whenever someone goes into labor.  We've had it happen a few times, and they do not like it. Let me just tell you. 

There's this guy named Jerome, he's great. He works at the shelter and he like the most chill, calm, kind of slow speaking person. He's just a nice guy. But one day he called me because I take phone calls from the staff of the shelter if they have questions.  He called me and he was talking so fast I could barely make out what he was saying. 

But what we had was a teenage girl who was at term, who had gone into labor.  And he'd actually managed to count like how long in between her contractions, but he was talking so fast, and I was like "Jerome, why don't you take her to the hospital? Why don't you call the ambulance and let them take her to the hospital?"  And he was like "Yes ma'am, yes ma'am". Click.  

(laughter)

Mrs. Shropshire (continues): I mean that was it. He just needed some reassurance that it was time, he did not want that kid delivering a baby at the shelter.  And so we get that kind of stuff.  We get kids who acquire their own behaviors.  And I've had a kid that came in, a child that came in, who's a 14 year old who had been smoking since she was seven.  

I keep nicotine patches at the shelter, because I have so many kids who are nicotine addicted.  I've had kids that detoxed from alcohol and detoxed from meth and all manner of things at the shelter, because they had acquired some of the behaviors of the people around them and it was causing them health problems. Not only are these kids sick kids though, what I came to understand pretty quickly after I began working with children at the shelter, in the settings in the hospital, and in the clinic setting, was that the outcome in terms of health for these children doesn't look so good either.  

So I had, when I first started working with kids, I thought to myself, "Okay, if we can work on improving communication, which needs to be done and is being done. If we can work on improving communication so that whatever health information I gather up, make sure we get it from the shelter to the foster parents, and from this foster parent to that one or whatever, we make sure that information flows good.  

If we make sure these kids get put on insurance, they get put on Medicaid as soon as possible so we can get access to health care. And if we make sure we update their shots and if we make sure they get their well child checks and they do all of that kind of preventive health care and we treat whatever we find, and we get them plugged into a counselor if they have mental health issues.  

And if we do all that stuff, we are going to fix everything." And that's the idea that I had. And it's right for us to do those things.  I don't want you to misunderstand, those things are important. They need to be done. But the reality of it is, that for many of these kids, the adult outcome is really, really... maybe the track for that is already set in motion. It's already set in motion. 

And so what I've learned about adults who have been abused and neglected is that they don't look very good.  So, I'm going to show you some data.  Many of you have probably seen this data from the Average Childhood Experience Study.  This is not a study of children who grew up in foster care.  This was a study of adults who had bad health, okay, health issues.  

And it was having them look back on their childhood and trying to figure out, how much of our adult health choices, health behaviors that contribute to bad adult health are related to things that we had happen to us in childhood, okay? And so the researcher who was looking at that suggested that the more adverse childhood experiences you had the worse off your adult health would be.  

And here's the list of adverse childhood experiences that they determined play a role.  So there's emotional or physical neglect, there's contact sexual abuse, repeated physical abuse, repeated emotional abuse, parental imprisonment.  So to a child, parental imprisonment feels like abandonment. My dad was here and now he's gone. I don't have a dad anymore, I don't have a mom any more.  Maybe I don't have either one anymore, because now I have to live with grandma or aunt or somebody because my parents are in jail.  

Divorce, and particularly divorce where one parent disappears off the scene, again to the child it feels like abandonment.  Domestic violence against the mom, untreated parental mental illness and parental substance abuse.  There's nine of these okay? 

And so what the researchers did is they said, "First of all, how many of those do you have?  Check the box. Out of these nine things, how many have you got? And second of all, what does your adult health look like?" And we wanted to see, how does childhood correlate with adult decisions, okay? How does it correlate? 

And so what I'm going to show you is a series of slides and I don't want you to, like if you're like a data nerd or whatever, you can look at the data, I don't care.  You can look online, it's got more data than I have here.

No Audio: Childhood Experience vs. Adult Alcoholism - a bar graph showing that persons with higher numbers of adverse conditions also have a higher percentage of alcohol abuse per group.
 
But what I want you to really get a feel for is the story behind the data, okay? It's the story here.  And so what I want you to see, that across the top what you see is some kind of a health behavior or a health outcome.  And across one side, the left side here, you'll see some measure of that and across the bottom, the number of those nine adverse childhood experiences that the respondent indicated they had, okay? 

And so we see with alcoholism, if you are, you know, you don't have any of those adverse childhood experiences, that the rate of alcoholism in the general population is maybe, you know, 2 1/2% or 3%, but that in fact as you add adverse childhood experiences to your history, look what happens to the rate of alcoholism, okay?

No Audio: Childhood Experiences Underlie Chronic Depression - a bar graph showing that higher instances of chronic depression are correlated to higher number of adverse childhood conditions. 
 
Here's what depression looks like.  Here's what suicide attempt looks like.
 
No Audio: Childhood Experiences Underlie Suicide - a bar graph showing that higher instances of suicide attempts are correlated to higher number of adverse childhood conditions.
 
Here's what they defined as high-risk sexual behavior looks like. 

No Audio: Adverse Childhood Experiences vs. Likelihood of >50 Sexual Partners - a bar graph showing that higher numbers of adverse childhood conditions are correlated to higher likelihood of having 50 or more sexual partners. 

And this was sort of an arbitrary setting that they used to try to figure out what is your risk of catching like HIV, or Hepatitis or some kind of chronic health problem. I think 49 would have been a lot, too. 

(laughter) 

Mrs. Shropshire (continues): I'm just saying.  I'm just saying.  I don't know what the right number was, I didn't do the study, but I'm just saying. 

(laughter) 

Mrs. Shropshire (continues): Your health risk cannot go down that much at 49, I'm just saying.  These were not people, like these were not the kinds of people who are in front of me at the shelter.  These were for the most part, working class, often white collar, not even blue collar folks, but white collar, educated people that we would run into at Walmart or we would run into in our business ventures and we would say, "That person's successful." This is what their life looked like.  

And I go back to the shelter the next day and I'm looking at a group of kids that I know the outcome data on, and I know the odds are that this kid is going to wind up dead before they're old enough to answer this survey, or they're going to wind up in prison, or they're going to wind up being trafficked or something along those lines. 

So the kids I'm looking at - you and I are working with in foster care - they're not even in this population and this is what it looks like, okay?

No Audio: The Influence of Adverse Childhood Experiences Throughout Life.  A pyramid diagram showing ôAdverse Childhood Experiencesö at the base, ôSocial, Emotional, & Cognitive Impairmentö on the next level, ôAdoption of Health Risk Behaviorsö on the next level, ôDisease, Disabilityö on the next level, and ôEarly Deathö at the top.
 
Here's the model. The model, the idea is, that what happens to you in childhood, it can be difficult.  Now we all face adversity right? And sometimes adversity is good for you.  It actually makes you stronger. You know, your family goes through maybe some lean years.  

My family was not, we didn't have a lot of money, and so we learned how, I mean, I learned how to be kind of a penny pincher.  Not in a crazy, weird way, but in like a just a like we just learned how to do stuff.  I learned how to repair clothes, like put a button on.  I hate it.  I don't want to do it, but I learned how to do it.  I learned how to sew.  My mom knew how to sew.  I learned how to can things.  

I am not ever canning anything again in my life, but my husband wants to and so I bought him a bunch of crap and I said, "Have a good time, you know, canning that stuff." 

(laughter) 

Mrs. Shropshire (continues): A whole bunch of jars and all this kind of stuff.  The point is I learned some skills, some really good life skills.  About how to go without and how to say no and my kids, I try really hard not to spoil them, but they are so rotten compared to how we were.  

Like growing up, I didn't, it wasn't an automatic that when I said to my parents that "I want that for Christmas" that I was going to get it.  I mean, I learned some really great skills going through adversity, but the truth is that the kind of adversity that this study was looking at, remember that list, that was the kind of adversity that breaks you.  It wasn't the kind of adversity that always makes you stronger unless someone is able to sneak into your life and help you with that.  

That's the kind of adversity that breaks you.  And so, when you suffer adverse childhood experiences the model was that it messes you up somehow.  This is not rocket science.  Like they did a study, and I looked at it and I went, "Of course, this is not rocket science."  When stuff happens to you, and you don't trust anybody because no one took care of you when you were a little kid, or you're a baby and you cry and no one feeds you, pretty soon you learn that people aren't going to respond to your needs.  

Whatever it is and that sense of relationship, that brokenness doesn't just go away because now you're in foster care, now you're in a shelter, or now you're in a new foster home or even in an adoptive home, that brokenness stays with you.  And what we have to figure out is, what do we do about it?  

Okay, so the model is adverse childhood experiences leads to some kind of impairment, adoption of high-risk or health risk behaviors, and that ultimately leads to disease and disability.  And so, I told you, this isn't even our population, but I went back to the shelter the first time after I saw this data, and I looked at the first little group of kids that came in to see me, and there were several little kids in this family, and just from basically what I knew of their, the little bit that the case worker sort of gives us, the little bit of information and what the kids were telling me, because I always ask kids, "How'd you get here? What's going on?" And half the time it's the back of the police car is the answer, right? 

(laughter) 

Mrs. Shropshire (continues): So we have to work through that, you know. But I'm interested in what kids perceive as what they're doing here and I'm talking through with them what this place is and what it's for and what's going to happen next, because a lot of times they don't quite understand.  And so, I'm talking to these children about, "What is your family like?"  

And I start counting in my head, looking at these beautiful little kids who really looked fine, and they had seven adverse childhood experiences. Seven, not one or two or three or four like the graph showed. They had seven. And I'm looking at these kids going, you know, on my piece of paper, on my little medical note, I'm putting I don't have any concerns, because that is sort of doctor lingo for "There's nothing wrong for today." 

But the reality is I have huge concerns about where these kids are going to go and what they're going to look like, okay?  I told you it was depressing, right?  It's depressing, but hang in there with me, okay?  We'll get there.  Now before we get to the good stuff, you've got to know the social outcomes aren't any better. 

At some point I realized, somewhere along the way, that me doing the best medical stuff I could do was not necessarily going to fix everything.  I'll give you an example.  If we take a family, and this is true, we deal within the larger clinic I work in at Children's, there's a ton of families that have, that are just poor or under-resourced, you know, they are undereducated and things like that.  

If I take some family that comes in, that brings in their kid because their kid is sick, and I diagnose them and I give them the best medical treatment I can, but they don't have the ability to go to the pharmacy and get the prescription, or they don't have the transportation to go to the specialist appointment or the speech therapy appointment or whatever, it does not matter how smart I was in diagnosing this child and in prescribing a treatment plan.  They can't pull it off. They can't pull it off.  

And if I vaccinate some kids that are in front of me, who are in foster care, or I make sure they, you know, get plugged in for their well child care, their mental health provider, whatever, and they don't get through school, their life still isn't going to look that great, okay?  I'm going to show you some of that data in terms of social outcomes.  

And so, basically, I guess I didn't put my data slide, so I'll just tell you what that looks like.  Basically, if we look at kids who age out of foster care, okay, and we say, "Okay, you've been in foster care, we've had you," - and here's the way I think about kids in foster care:  I think of that as an opportunity for us to get around the kid and figure out what they need and really provide that and shove them in a different direction.  

At least give them a picture of what something different could look like then maybe where they came from.  Whether they are going to go back to home and be reunified, whether they're going to go to adoption, whether they're going to go age out, whether they're going to go to a group home, I don't care so much. I'm not so fixated on the individual outcome as I am that, while you're with me, that we are doing everything we can to come around you and give you hope for a future.  That's what we should be doing.  

But the reality is, of kids who age out of foster care, what the data says is that only about half of those kids graduate from high school. We had them.  Like we had ahold of these kids.  

How can they not graduate from high school or get a GED, that includes GED programs, okay? How can they not get out of high school? We had them.  Only about 2% of the kids graduate from college.  We've actually got, our independent living folks have done a really good job, we've got a pretty good number of kids over the last couple of years that have graduated from college.  

And one kid in fact that recently graduated from med school, which is pretty dang exciting, but I'm going to tell you what, for every one of those, there's 100 kids out there, they're not going anywhere. They're not going anywhere. Our prison is full of them. 

Our stripper streets, 10th street and all of the different areas of town where you go where you drive down the street with your doors locked because it's all the bars everywhere.  They're full of young adults who grew up in foster care. That's where they are.  They're not in college.  

I heard a guy, had a conversation with a guy recently who grew up in foster care.  He's out of foster care, well he didn't grow up, but he aged out of foster care.  And I heard him talking about, he went to work for a prison as a prison guard.  He'd gotten a little bit of education.  

Went to work as a prison guard in the local community where he had aged out of foster care in the group home, and he said every one of his foster brothers that he remembers from the group home, came through the prison as a prisoner. Every one of them. 

Two percent of kids go through college and successfully graduate, okay? If you look at these folks at 25, so you get a few years out, you look at kids that age out of foster care, you look at them at 25, 50% of them have mental health issues. We should not be surprised by that. Now that's sort of depressing and you kind of go well that's sort of a lost cause.  

But the reality is the mental health issues they have are fixable issues.  They are things like depression, anxiety, PTSD.  Those are diagnoses that we have really good treatments for.  These are not the hard ones, okay? These are the ones that man, we can fix, we have good evidence based therapy for, but they can't access it because they don't have health insurance. 

Why don't they have health insurance? Because they don't have a job that pays for health insurance, because they don't have an education.  Guess where their children are going to be. In foster care. In foster care. And so we just see this cycle, and we had them.  We had them for some period of time.  Maybe six months or a year or two or three or five years, we had them.  

Sometimes the kids that age out of our system, they've been in our system for 10 or 12 years.  We had our hands around them, and yet somehow the outcome for those children isn't very good.  That's what we have to figure out how to do something about. That's more than just me giving them vaccines and saying, "You're up to date on vaccines" guys.  

It takes a lot, a lot more than that, okay? There's some reasons why it's so difficult, even in foster care, to get around these kids and to give them what they need.  There's a lot of difficulty with mobility. Mobility remains an issue and any time if you're around child welfare at all, you'll hear people talking about placement moves and placement disruptions and moving and that's a huge focus of data. 

Like we're constantly paying attention to what is our rate of mobility of kids because it matters.  If you move around, you do worse.  If you move from school to school to school, guess what? Your chances of finishing high school are not very good. And in fact what we see among these kids is that because they've been often very mobile before they ever even came into foster care, often their families have been kind of unstable, that a lot of kids are behind educationally when they hit the door.  

And they stay that way because they move around, they move around, they move around in foster care and so we want we wind up with kids by the age of about sixth grade that most the children we are encountering, are one full grade level behind, and by the time they hit ninth or tenth grade, they may be turning 18, but they're a tenth grader.  
We shouldn't be surprised that our 18 year olds aren't graduating high school because they're not even eligible to graduate.  

They're not even in the right grade year.  I've got kids that I take care of that have never finished their freshman year that are fixing to age out of foster care.  They never finished it.  We got to figure out how to put the kinds of resources and people around them to help those kids understand that they can do it.  

I tell you, one of the things I commonly run into is kids who don't believe that they're smart enough to do anything else.  They just don't believe it.  And so, and again, some of that is really their family, it's what their family has spoken into them or not spoken into them.  

I mean, my parents, you know, they were kind of like, "You can do whatever you want to do, you're a smart kid, you make good grades, you can go to college, you can do whatever you want to do."  Now I will say, my family is not medical and they were always, I think, I won't say "distressed," but they were always like rolling their eyes when I'd say I was going to be a doctor.  That's what they did.  

And I can remember my mom when I was in college and I was applying for medical school and all this kind of stuff, she says, "You know, why don't you just be a nurse? It just doesn't take as long as this whole doctor thing."  That was the encouragement I got. 

(laughter) 

Mrs. Shropshire (continues): "And so, why don't you be a nurse?" And I said, "Because I want to be the one giving the orders not receiving them." And she said "Oh yeah, you're right there, you need to probably go to medical school." 

(laughter) 

Mrs. Shropshire (continues): So I did. But then she came - I will never forget - she came to medical school, like when I called her and I said I had got accepted, she said, "I knew you would." (chuckles) Which again, is not maybe the right answer for parents, you know, if you got little kids, don't just say, "I knew you would." 

Be proud of them and encourage them or whatever.  But the truth is, in my family, there was a sense that I could sort of do whatever I wanted to do.  There was.  Many of the families these children come from, that's not on the table. That's not even on the table.  And so one of the things that we have to figure out is how to take a kid who may be a year or two behind in school, and honestly to the school teacher, may look like a disaster, may show up in the middle of the year, you know, in my class, they're 1/2 a semester behind in algebra, or whatever class we're in right now... they're speech delayed.  Many, many of these kids are language delayed.  

Sometimes it's actually what they are able to say and articulation. Many times it's they donÆt have the development in their head to figure out how to communicate what they need, because, you know what? 

When they were little, and were supposed to learn that, nobody answered them anyway.  And so they don't have the processing, it's not that they can't learn it, but they don't have it in their head to communicate, "Here's what I need," or "Here's what - I don't know how to do this teacher. I need some extra help." They don't know how to do that, okay? 

And so you have a teacher who receives some kid in the middle of the year who's disruptive, often has behavioral issues, and is a mess and disruptive, and they have no concept of what that child has gone through to get to this place.  And they look at that kid and say, "Gosh," you know? Honestly I think probably they hope that the kid will get moved pretty soon, because they'll get at least out of their class.  

And they look at this kid and say, "Well if he's behind, she's behind, they must be slow.ö  And we do an IP, which we need to do because these kids need IP, but sometimes you get that and if a child doesn't understand, that's not because you're dumb, that's because you're behind.  If they don't understand that, they feel dumb. You're the oldest kid in the class by like two years, you're like a foot taller than everybody else because you're like 14 and you're in sixth grade. 

And they look around and they go "I must be dumb." And I'll have kids that I take care of in the shelter, and I'll say, "What do you want to do when you get, you know, older?  What's your dream? Are you going to go to college? Are you going to go to Vo-Tech? Do you want to work? What do you want to do?" And they'll say, "I'm not smart enough to do anything.  I'll just go back to the streets.  I'll go back to my neighborhood.  I'll go back to my family." And that's the answer.  

And it's not because they're not smart enough, it's because nobody has ever told them they could do it. They don't understand. And sometimes in fact people have told them the opposite: that they're dumb.  That they're not able to do this.  That their best bet is maybe to be a good athlete so you can get an athletic scholarship or something like that, because you're not smart enough to really achieve.  

And that's ridiculous, because the majority of the kids that I interact with, they're sharp, I'll tell you.  They have street skills that would put us to shame. I'm... listen, listen, if you can run... I have 14 year old boys who can run a gang.  If you can run a gang. 

(laughter) 

Mrs. Shropshire (continues): If you can run a gang, you can run a business.  I would say it's harder to run a gang because people might be shooting at you. 

(laughter) 

Mrs. Shropshire (continues): In a business, you don't have that model.  I have girls who literally are incredibly good at prostitution.  Alright, that's a service industry.  

(laughter) 

Mrs. Shropshire (continues): There are lots of other legal good ones that you can be a part of, okay? They don't understand.  I have a 13 year old kid that came to the shelter one time, he was a little like gang banger, had his pants all hanging down and all this kind of stuff, and it's funny - little gang kids are funny because they're tough until they walk into my office and then they're afraid of needles, which makes me laugh. I'm like, "You will stab your friend, but you are afraid of getting a shot." 

(laughter)  

Mrs. Shropshire (continues): So he comes in, he's like this tall anyway, he's all tough then he comes in and sits down and he's like this, and I said, "You know man you're 13. I know you've still got the teenage years to go and we'll see how that goes, but when you get out, what do you want to do with your life? Like, what do you like about school?  What do you enjoy?  Because if we can figure out something you enjoy, maybe we can tap into that. We could push you forward in a different direction than you are going." 

And he says "I don't like anything about school." I'm like, "Come on, do you like, you know, math, science, whatever, sports?  What do you like about school?"  And finally after three or four times of asking him, he finally says, kind of grins a little and says, "Well I like art."  And I said "You do? Do you like to paint or draw or sculpt or what?" He's like, "I like to paint," and then I got an even bigger smile. (chuckles) 

And I said, "You know what, are you good?" And he said "I'm really good." And I said, "If you're good enough, that can be a career, like people pay for that. Did you know that?" He said "What do you mean they pay for that?" I said "They pay, people to paint murals on the side of their buildings, to paint murals on their house, there's all different kinds of opportunities for artists.  

You have to be good, and you probably have to do good enough in school so that you can get on to maybe some secondary schooling, so you can get really, really skilled in this field that you want to go into, but you could be an artist if you wanted to be." And he said, "I had no idea you could actually work doing that.  I had no idea." I said, "The challenge for you is going to be painting where people ask you to and not where they don't." (chuckles) And he smiled real big and he said "Yes ma'am. That is going to be a challenge." 

I said, "Here's the thing: you've got it in you."  We've got to be able to tell these kids what they have in them, but when they're moving around, moving around, moving around, it's very difficult because they run behind in education, they move from health care provider to health care provider, they move from mental health provider to mental health provider.  

Honestly, I don't have any illusions about how great pediatricians job pediatricians do, because the truth of the matter is any monkey can vaccinate your kids, okay?  You don't even need a pediatrician, you can go to the health department and get that done, okay? 

But mental health providers, for a kid to tell their story and to really form a relationship that causes that child to be interested in being introspective in thinking about where they are and tell their trauma story and work through the stress and the struggle of that.  That is a very important thing, and yet we take a kid and we move them, we move them, we move them.  

Different health provider, different mental health provider, different mental health provider, we don't have a very good continuum.  You go to therapy in foster care because you're a disaster, you got this counselor, you got to bond with this counselor, and guess what happens? You get better and you move.  And now you got to have a new counselor.  

Why is it we think that will work? Why is it we think, would we do that?  How many times are you going to tell your crap, whether it's on your marriage, or whether it's on your kids, or it's on your past, or whatever it is?  How many times are you going to confide in somebody? Most of us have a hard time thinking about doing that one time, much less over and over and over again. 

We have to figure out how to get these kids stable, and sometimes stability is in a home where they stay put, sometimes that stability might be services, it might be a kid that has to move for whatever reasons, but they stay in the same geographic area.  

I had a girl, a lady not a girl, a lady that came in my office one day.  I was interviewing her for residency, okay?  So it's like she's graduated from med school and she is interviewing for pediatric residency and one of my partners had interviewed her and she's like, "Hey you got to meet this lady."  So she comes in and she starts to tell me her story, and she had spent 12 years in California in foster care.  

Not only had she spent 12 years in California foster care, she was in at a time sort of in foster care history when we thought that bonding with foster parents was a bad idea if we were probably going to reunify.  And so, she was in a system where she had to move every three months, even if she was doing well in the placement she was in, okay? Every three months, because they didn't want her to connect too much.  

So 12 years, back and forth between home and foster care, moving at the maximum every three months, okay?  And this kid is like a graduate from an ivy league college of medicine. And I went "This doesn't go together, like, you know, where, what, I'm missing something in here?  What am I missing between this part of the story and this part of the story?" 

And she said, "Well, I had a case worker who I hated, but she was really good. Like I look back now and I think, ôOkay. she really did a good job with me.ö And I had a judge that I hated even more, but really that judge did a good job too, and they just decided that you know that I needed a chance, you know? That I was a pretty smart kid and that I needed somebody to really, really get ahold of my case. 

And so they got me a scholarship, they applied for and got me a scholarship, in a local prep school, like a private school." Kind of a Cassidy-style private school or whatever, okay? They got her in there when she was in eighth grade.  

Now she had been in foster care off and on her whole life. She got in there at eighth grade, and in that setting she met a teacher, who kicked her butt and was like, "You can do this. You don't need to be whining about how you can't do eighth grade work, you know if you can't do eighth grade work, then we'll work with you until you can. 

And then you're going to do ninth grade work, and then you're going to do tenth grade work and then we're going to keep going because you're a smart kid and you can do it and I'll get you tutors or weÆll do whatever." 

And what happened was, the case worker and the judge, even though she was moving because of the way their policy was at the time, they kept her in a geographic area around that school. So for five years of that moving, she stayed in the same school with this one teacher who just kept setting the bar and saying jump over it and setting the bar, jump over it, what resources you need I'll put them around you, but you're going to have to do it, jump over it and here's the expectation.  And that kid went to an ivy league college. She went to an ivy league college of medicine, and now she's on faculty in an ivy league college of medicine.  

Because we kept something stable in her life.  I'm not saying that every single kid should stay, go to one home day one and never leave, there are some good reasons why these kids need to move. What I'm saying is we have to, as a system and as a community, we have to figure out some ways to keep kids connected to what services are working for them. 

Whether that's the mental health provider, whether that's their school, whether it's their mentor, whatever it is, we have to figure out how to do that.  Otherwise, we're just chasing our tails, because what's happening is, the kids grow up, we spend a ton of money, a ton of time, we spend half our career working on it and then guess what happens? They get to be 18 or 19 or 20 and they pop out a kid who winds up back at the shelter. That's what happens.  

I have a lady, well she's retired now, but there was a lady who worked at the shelter, who worked there for 40 years, which I personally think causes you to be certifiable and you should be in Fort Supply. (chuckles) That's a long time to work in that setting.  That's a long time.  

She was a great lady though, but I remember a baby coming in that had a real kind of unusual last name. And so we looked up the mom's name of this baby and this lady who's worked at the shelter 40 years says, "I know this family." Which is always bad when you're talking to social work people, if they know the family.  She said, "I know this family. The baby's mama was in the shelter at some point when she was a baby and the baby's grandma was a baby here in the shelter." She saw, she could see that. 

We've only had foster systems really for, you know, that long.  I mean the truth is, if you went back another generation or two you'd probably find the same issues in the family.  If we don't do something different with how we're doing work and life with these kids right now, well, you know, ten years from now when you're ready to retire, change jobs, whatever, we'll just have a shelter full of the children of the children who are in the shelter right now.  

And that's not okay with me.  That's just not okay with me. I didn't get into this deal to chase my tail for 20 years or 30 years and just struggle through the next round of kids who are coming into the shelter. I just didn't do that, okay? Obviously placement disruption can cause a lot of problems.  We've talked about this a little bit, but it's difficulties with attachment to families, to people, not attachment disorder. Don't get that confused. 

That Reactive Attachment Disorder is a very specific thing, but just issues with trusting people.  Like I met a girl who's 14 who had moved around a lot. She'd actually been in multiple states and just kind of craziness in her life.  And she had a diagnosis of Reactive Attachment Disorder, but she was a real articulate kid. 

And I was asking her, and she seems pretty good, like you know pretty socially appropriate.  So I said, "Hey, you have this diagnosis, what do you think about it?  Do you know much about it?  What do you think about it?" And she said, "Oh they gave me that because they don't know what else to call me but I don't have that, I just don't like to attach to adults because they don't tell you the truth, they lie to you, and I just don't want to.  Yeah I can attach to other people. 

I have friends on Facebook that are my old friends from this other state I lived in. We connect. And when I get done with this whole foster care deal I'll go back to this other state where I have friends, but I don't want to attach to adults, because they don't tell the truth."  Attachment problems.  

Lost continuity as I mentioned, more behavior problems, and decreased educational success.  So, here's the deal: like we're in a really interesting time.  I think right now in child welfare, child welfare history in our state, but I think across the nation we're in a very interesting time.  There's a lot of racket, a lot of noise around this issue of foster care.  Not just in our state, but in many states, okay? 

And some of that's legal noise, some of it's public noise, like in the public press, some of it is systems that are trying to figure out ways to improve, some of it is communities that are finally starting to hear about foster kids and go, "Hey what's this issue with foster kids?" 

But there, I tell you, I started working with foster kids 12 or 14 years ago, and no one was talking about it.  No one was talking about it.  And now everywhere I go, or whatever I watch on Twitter or Facebook or whatever, everybody is talking about foster kids.  

There's a lot of noise around this issue right now, and certainly in our state, one big piece of that is The Pinnacle Plan and what child welfare is trying to do in terms of improving its systems.  And let me just tell you something.  I'm a fan of system improvement.  I think we have some very tangible things that could be improved.  I'm excited about the grant awards that were announced on the news yesterday and today that you heard about.  

I think there's some really cool stuff going on and there are some cool people leading right now and I'm a fan of that.  But I tell you, when I started this deal, back years ago when I was a resident, before I ever even really quite knew what it was looking like, and I was making the decision to spend my career on these kids, okay? 

When I was wrestling with that, trying to figure out what that looked like, I got to a place where I said, "You know what?  I am not going to spend 30 or 40 years unless I think I can actually make this better."  Not just sustain it, not just see the same families over and over and over, but really see "pie in the sky" - an end to child abuse.  

That 20 or 30 or 40 years from now, that we wouldn't have to even have a child welfare system the way we have right now.  Because there's not kids in foster care.  I'm not saying... there's going to be some mean person out there who does something stupid, okay?  I'm not saying that. 

But I'm saying the vast majority of children that I take care of - their life could look completely different, if we figured out how to interrupt the generational cycle that they're stuck in the middle of, okay? So, I ran into this at a talk that I was at some years ago and it's really haunted me and I want to haunt you with it (laughs), too.  I'm just going to haunt you all...

(laughter)

Mrs. Shropshire (continues): ...so that you can't even sleep tonight about this, okay?  Here's the question I have. Like I'm a fan of system change but if all the systems and the policies and the programs and the plans that we lay, if they all worked, would we even achieve the outcome that we desire? The outcome that I desire is for us to not have child abuse.  That's the outcome I want to see.  

If the Pinnacle Plan worked at 100% efficiency, it won't do that.  You have to understand what it's going to take to make that happen is the community deciding that these are our kids. That they're our families and whether that kid goes to adoption or whether they goes to reunification, or whether they age out - it doesn't matter.  That's our kid.  That's our family.  

And we're going to come around them and we're going to figure out how to give that kid a shot.  A kid will have to... at some point that child is going to have to set their own course.  I understand that.  But if you don't know that you're smart enough to go to school, if you don't know that you're smart enough to get a job and be successful, if you don't know that it's possible for you to learn how to do relationships well enough that you could actually someday get married, have children, and not abuse or neglect your children, stay married and have a reasonable family life, if you don't know that about yourself, we're not going to see these kids go anywhere and we shouldn't be surprised that we just see the, you know, same thing going on over and over and over again.  That's not something DHS can fix.  

Dude, it takes every single bit of us to figure out how to impact a generation of foster kids, okay?  Would it even matter?  And I had to answer honestly - all the medical care I'm delivering in the droves, all the complaining I'm doing, all the sitting on committees I'm doing, all that stuff put together - it's not really going to come up with the outcome I want unless I'm willing to spend my life working with these kids, okay?  

What do we know about how to interrupt destiny?  Like, I've presented to you, I think, a pretty bleak picture of the outcomes of these kids.  But what do we know about how to reverse that?  Well you got a clue to that in the story I told you about the lady who went to medical school.  

She had someone in her life that pointed her in a different direction, that said to her, "You can do this," that gave her some tools, some tutoring and some access to some tools to catch her up, okay?  She had someone in her life that held her to a standard.  That teacher didn't just say, "Oh, poor you," you know, "We're just going to make sure you're a victim.  We'll just pass you through from grade to grade."  

That teacher said to her, "You know, no - you can do this.  If I need to provide you tools; extra teaching, extra counseling, extra whatever it is, I'll help you.  But you're smart enough, here's the bar. Jump over it.  Here's the bar.  I'm going to raise it.  You can do it, you can get into an ivy league school.  Not just any school, you can get into an ivy league school."  And that kid did it.  

We've got to have people who are willing to engage children and youth that are in foster care or in situations where they're bumping into a lot of the kinds of people that are bumping into our system.  We got to figure out how to engage them in a way that spurs them onward and doesn't just keep a child a victim.  

These kids need family.  They need families.  You're hearing that, you know, all the time as part of the Pinnacle Plan but also we were hearing it before that.  That "we need foster families, we need foster families, we need foster families." Okay?  We need them in the droves.  We need a thousand of them in Oklahoma County, which sounds crazy but it's the truth because you know what?  

The case worker who has a kid who lands at the shelter needs to be able to look at that kid and say, "what do you need?  And, "I've got five options."  And, "What's the best one?"  And it might be with your grandma, it might be with your aunt but it also might be with this other foster home who can provide for your special needs.  

Or maybe it's with the home that can take you and your four siblings all at one time so that you're not scattered to the four winds, only two months later to be court ordered back together.  Which we don't have a home for because if we'd had that home in the first place, we would have put them in that home.  

We need people who say, "I don't just have one extra bedroom, I got two or three.  And I'm not going to take a kid, I'm going to wait for five or six."  We need that kind of family, okay?  Or we need families who'll say, "I'm going to take a teenager." 

I'm telling you what: I don't have teenagers in my house yet. I'm dreading the day my husband says he is going to go to Colorado into the mountains and return when my daughter turns 18.  And I hope he doesn't, he might, I don't know.  He really might.  

I don't love teenagers, but there's got to be some people out there who love teenagers, even with all the drama. There's got to be people out there who love little babies, who want to take care of little babies.  There's people out there who love special needs kids, who loves kids that are going to have 200 doctor appointments a year, okay?  We need families.  

We need lots of them, and we need our case workers to have the option not to shove a kid into an available bed but to set a kid into a family that's waiting for that kid.  That's what we have to have, okay?  We need people who'll come alongside and be role-models.  Sometimes that's service providers.  

It can be service providers who are bumping into these kids.  It can be people in the community who are mentoring, it can be a neighbor next door who's hauling that kid to church, it can be all different kinds of people.  But I'll tell you, a lot of times that role-model may not necessarily be their home family, their foster family, may not necessarily be their case worker, may not necessarily be their judge.  

And you have to understand, I think if you're in those categories, obviously you're going to offer that kid the opportunity to learn from you and to be connected to you.  But the truth is a lot of times kids are going to be like that lady I told you about.  They're going to look at their case worker and see them as the policeman that keeps me away from my family. 

They're going to look at the judge and see that judge as the barrier between me and my family.  Or they're going to look at a foster mom, even if they love her, and they're going to see her as in direct competition with their birth family.  And it's hard.  It's hard sometimes for a kid to let that person be their mentor.  

But then we got to figure out how to put a rich collection of community around where those kids are.  I don't care if they're in a group home or in a foster home or in a biologic, you know, home that we're trying to reunify.  I don't care where they are.  We've got to put rich community around them so those kids have opportunities to meet role-models to see something that's different in their life.  

We need people who'll tutor.  We need people who will coach.  We need people who will take a kid to practice and make sure they have their sports equipment they need and pick them up from practice and take them to the games and cheer for them in the stands.  

We need a lot of those kinds of people.  We need people who love biologic families.  You say, "Man, you know, you're not in a space where you can take care of your kids right now.  But man, I care about you and I'm going to come alongside you and help you in whatever ways I can.  Not enable, but help."  Mentor, tutor, tell you - you can succeed.  Because I'm going to tell you something.  

A lot of the biologic families - they look like those kids do in foster care.  They're just a 25-year-old version of that with probably even more baggage, because they're older.  We need people who will fall in love with biologic families.  We need people who care about case workers.  Can I get an amen...

Audience: Amen.

Mrs. Shropshire: ...from the case workers in the room?  Okay?  Man, the racket around case workers is often so negative even from foster parents or other people who are in the system.  You know, if I go and talk to foster parents or I listen to health care providers or things like that, you know what comes up?  

"That case worker didn't do this, that case worker..."  And believe me, I had that thought this morning, okay?  Because I had a situation where a case worker didn't do something they were supposed to do.  And they didn't do it and it frustrated me.  But the reality is I don't have that job.  It's an incredibly difficult job.  I think they're crazy as foster parents are.  I don't know why in the world people do it but I am thankful that they do. 

And they need help.  They need help.  And I'm not saying that there's not accountability too.  What I'm saying is, my primary position ought to be of one of, "How can I serve you?  How can I serve you?  What can I do that will help you? Can I provide..."  So in terms of health care, what I do is, "Can I help you hook a kid up with services.  Can I provide you a report so you can take it to court so you're not having to, you know, go through 27 layers of administrative crap at OU to get your records?  

Can I help you?  Can I write a letter?  Can I help you understand what the health issues are of that kid that I'm seeing that may impact where you're going to place them?  How can I come alongside and help you?"  And for every single one of you that are bumping into these kids, there may be a different way.  But, "How can I help you?"  

And not, "How can I judge you and give you a hard time for what you didn't get done?" Okay?  We've got to have people who fall in love with case workers, okay?  And then if you're a kind of faith sort of person, then we need you on your knees because I'm going to tell you something.  

If I've learned anything over the last 10, 12, 13, 14 years, it's that this is a battle.  It is a battle for these kids.  There is so much... like you just, sometimes you just feel like you're running in mud.  Do you guys feel that way?  Like you're just running as hard and fast as you can and you're just in quick sand.  And you take, you know, one step forward and three steps backwards with the kid.  

And maybe you feel like things are going pretty well in a case or maybe this child seems to be responding to whatever interventions we're putting in place.  And then, you know, you blink and you're back before where you started.  And it's so difficult.  It's so difficult.  We need people who say, "Man, I don't know what else to do, but I'm going to pray like crazy." Okay?
 
No Audio: Service Opportunities - Pauline Meyer emergency shelter.  Citizens Caring for Children; mentoring program, Back to school.  OK Foster Wishes; Christmas and birthday wishes, FLUX graduation party.  AnnaÆs House Foundation.  Lilyfield or Angels Foster Care.

I brought you this non-exhaustive list. So if you're not on this list please do not give me a hard time or send me a crap email or whatever.  I'm just suggesting that here are some places that I know about locally, that if you're not plugged in helping foster kids, this is where you need to be, okay?  

Some of these kinds of places - lots of other places as well - but every single person in this room needs to be serving in some way.  For some of you, that's in your job description.  For some of you, it's your choice, your career choice like for me.  For some of you it's a service opportunity to come alongside, being a mentor, whatever it is.  But we need everybody.  

We need you, we need your friends, we need your family.  We need everybody that you touch that you think is not crazy.  Do not bring us crazy people, okay? 

(laughter)

Mrs. Shropshire (continues): We do not need that. We lots of that.  Do not bring crazy people with you, but bring your friends.  Your healthy friends and that kind of thing and come and serve, okay?  And I just want to close with this idea, this thought.  This has really been on my mind for the last couple of weeks I've been thinking about you guys. 

And I tell you, I've been just thinking especially about those of you who are already in the trenches - your case workers or supervisors.  And, man, a lot of case workers and supervisors, especially in these metro areas, they're looking for another job.  If you don't believe that, then you are just deluding yourself. Because this is a hard job.  

It is difficult every day to go in to know that you are going to get to the end of the day and you're not going to have gotten everything done that was on your To-Do list. And that the stuff that fell off the bottom was very important. It wasn't just like take the trash out, okay?  It was important stuff.  And you're not going to get done.  

And not only are you not going to get done today, you're not going to get done tomorrow either.  And you're going to do the best you can for some kid and it's going to be a disaster.  And to live every day knowing that, it's hard.  And so people are, you know, they're looking for other stuff to do. Maybe you're not led well.  And the truth is, in some areas... I mean I have in my place, in our place I'm right now, we have some leadership that's not leading well.  And it's hard.  

It's hard for them to get up and go to work every day because I... I sat at OU in the clinic with the clinic manager recently talking about a situation involving an employee where the leadership over that employee was doing a very bad job.  And some of you live with that.  You're living with that today, okay?  And you're like, "Man, I don't want to go to work tomorrow."  And some of you here are foster parents and you're in the trenches with this kid and you just don't know if you can do one more day of it.  

I mean you just don't know if you can do one more day of it or one more week of it.  And you're not even sure the direction the case is going the way you think it ought to go.  You think nobody's listening to you, the court's not listening to you, and you're looking ahead going, "Is it even worth the time and the effort and the energy I'm spending right now?" Okay?  

But here's the thought that I want to leave you with: I think sometimes we look at things that we're doing in terms of "What do they cost me? What does it cost me?  What's the amount of the check I've have to write? What's the amount of time that I have to invest here?  What's the amount of heartache or emotion... whatever it is that I have to do?  What's the amount of sacrifice from my family, maybe, that I have to do today?"  

But I think we have to shift our thinking. If we're going to change a generation, what we have to do is we have to shift our thinking and quit thinking about "What is it going to cost me today?" and think about "What is the value tomorrow of what I'm doing today?"

No Audio: Fostering Hope - www.fosteringhopeproject.org.  Twitter - @DebShropshire.  Facebook - Deborah Shropshire.