HSE and Tusla ‘failing children with disabilities’

HSE and Tusla ‘failing children with disabilities’

Both the HSE and Tusla are still falling short when it comes to ensuring adequate services and supports for children with disabilities in the care of the State — a year after a critical report highlighted inadequacies in one particular case.

Last year, the Children’s Ombudsman looked at the case of Molly, a girl born with Down syndrome and severe autism and abandoned at birth by her biological parents.

Her foster family, who have cared for her since she was four months old, complained to the Ombudsman about the level of supports and services being provided by Tusla and the HSE to meet Molly’s needs and support her placement.

The report had outlined a series of deficiencies, including a lack of co-ordination between Tusla and the HSE which meant services and supports provided by both organisations were insufficient.

In a new report on the case, the Office of the Ombudsman for Children (OCO) said there had been some progress but claimed there was “still a long way to go” before both agencies could be said to have delivered on the commitments they made a year ago at the time of the initial report, with the OCO highlighting the still-faltering working relationship between Tusla and the HSE as being “of concern”.

In 2015, there were 472 children with a diagnosed moderate to severe disability in foster care placements in Ireland. The latest OCO report shows that Tusla data from last November showed there were 483 children in care with a diagnosis of moderate or severe disability, of which 407 had their Child in Care Reviews within the statutory time frame. Of the 76 who had not, dates were set for 69 reviews.

Tusla said there is now a central national database but the HSE could not confirm that each of the local areas have identified these children.

The OCO report is based on quarterly updates since the initial report and input from Molly’s carers, as well as meetings with the Tusla and HSE national and local teams responsible for the implementation of the recommendations.

There were signs of progress in some areas and continuing deficiencies in others.

It found Tusla has not made any business case to government as regards enhanced support payments for foster carers of children with a moderate or severe disability and, as in Molly’s case, extra financial payments are at the discretion of area managers and approved through the care-planning process.

While the HSE had successfully obtained an extra €10m to develop respite services, opening 10 new purpose designed respite centres last year, it was still unsure of how much of this budget was allocated to expand children’s respite services, offering an estimate of €2m.

“Both HSE and Tusla told us that they could not make joint submissions together for additional respite services for these children,” the report said.

For Molly, the social work department had made “significant progress in re-assessing Molly’s needs and working with the HSE in order to put in place the therapeutic supports and services which might enable her to reach her full potential”. Among other improvements was the assigning of a dietician to her school.

“However, Molly’s foster carers continue to face financial challenges,” it said. “For example, when Molly was placed in a residential centre for two weeks for an assessment her carers’ Foster Care Allowance was deducted for these two weeks.

“This was despite the fact that they transported her to and from the residential unit, and visited her there. There are also still issues in relation to funding for child-minding services.

“Tusla reduced funding for child-minding services from €150 to €100 on the basis that six hours Home Support hours and additional respite had been assigned by the HSE although the family were not receiving these supports as the HSE were unable to identify a service provider.”

The Ombudsman for Children, Dr Niall Muldoon said issues still persisted. “While some positive progress has been made further change is needed,” he said. “As a result I will continue to monitor these issues for the next 12 months, engaging with both the HSE and Tusla.”

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