St. Catherine's Center For Children

St. Catherine's Center For Children

April 13, 2015

It started 127 years ago when the Daughters of Charity, an order of Roman Catholic nuns, purchased the Schuyler Mansion in Albany to create an orphanage for sick children. St. Catherine’s Center for Children evolved and now operates a child welfare program that includes a 25-bed group residence, a group home for eight additional children and a therapeutic foster boarding home program that provides care for 50 children. It has a series of prevention programs in Albany County and operates an “853” school for children with special needs. About half of the 68 students come from St. Catherine’s group programs and the rest are referred from school districts in the Capital Region and beyond.

However, St. Catherine’s evolution did not stop there.

“We are not just a child welfare agency,” emphasizes William T. Gettman Jr., who was named executive director in late 2011. “We are a multifaceted human services agency. We try to respond to the needs we see in the community. And we are very community-based. We believe that bricks and mortar don’t work long term for the children and families we serve.”

For more than 15 years, St. Catherine’s has run homeless services programs.

“We operate Albany County’s Marillac shelter for homeless families as well as community-based homeless prevention and supportive housing programs designed to stabilize families and help them stay in their own apartments,” says Gettman.

Late last year, the state Department of Health named St. Catherine's the Capital Region recipient for the Medicaid Redesign Team Supportive Housing Health Home Pilot Project. This innovative program is designed to engage Medicaid recipients whose homelessness or lack of stable housing prevents them from effectively managing their health care conditions and makes them among the most expensive users of Medicaid because of their high reliance on hospital emergency rooms.

The award, one of only 10 across the entire state, not only recognized the quality of St. Catherine’s ability to reach out, engage and support the most vulnerable people in the community, but also placed the agency squarely at the center of the state’s effort to redesign its health care system—including the provision of community-based social services— based on managed care principles.

RENEWAL

When Gettman arrived in 2011, St. Catherine’s was facing a host of serious challenges. Some were purely financial, some were cultural. Agencies with more than a century of service history face the risk of getting set in their ways and have to work at building on their traditions rather than being constrained by them. St. Catherine’s, it seemed, had become removed from the surrounding community and found it difficult to try new ways of delivering services and engaging children and families. 

“We were on the verge of a serious financial cliff,” says Gettman, who arrived after having served as executive deputy commissioner at the state Office of Children and Family Services. This sudden realization by both the board and staff helped him put together a recovery plan that included some strong medicine.

“We restructured, did layoffs and furloughs; there were no raises for a year. We cut expenses and sold a couple of pieces of property to bring in some badly needed revenue.”

Gettman and his leadership team went out and started talking to customers, finding out what was working and what wasn’t—and what kinds of services they needed but weren’t getting. St. Catherine’s began getting its kids out into the community.

“Community activities are a good way to motivate kids,” says Gettman. “If the kids are busy and engaged and the staff are engaged, we are having a good day.”

The Capital District YMCA in East Greenbush began giving St. Catherine’s kids a seven-week program of swimming lessons. When Albany County Executive Daniel McCoy was looking to reactivate Lawson Lake as a community resource, St. Catherine’s was right at the head of the line, agreeing to send staff to supervise its children during a weeklong camping opportunity. “We took kids from our residential and community-based programs and our homeless shelter to camp,” says Gettman. “This is not the kind of opportunity they were able to get before.”

The agency also opened up its programs so that the community could come in. “We tried to engage our donors and volunteers in a more active way,” says Gettman. St. Catherine’s began a “room makeover” program in which outside groups—scouts, church groups, etc.— could redecorate rooms in the commu- nity residence and group home based on themes that matched a child’s interests. There is a “SpongeBob” room, a sports room with autographed football jerseys, a very pink Cindrella Room, a NASCAR room, etc.

Particularly interesting is St. Catherine’s Volunteer Reader program. “Every night, we have to put 25 kids, ages 6 to 12, to bed,” says Gettman. “It’s hard. They need a transition time.” In response, the agency began a program in which a dozen adult volunteers are trained to come in one night a week and read bedtime stories to the children. “We ask for an eight-week commitment,” says Gettman. “We think that this has improved behavior and helped the children. It certainly has helped our staff. We are arranging for Si- ena College to do a formal evaluation of the impacts.”

The new outlook has helped St. Cather- ine’s financial situation, through a num- ber of significant new contract awards, and improved the working environment for its staff. Last year, the agency was se- lected by the Albany Times Union as one of the top 25 places to work in the Capital Region.

CHILD WELFARE

St. Catherine’s has its roots in child welfare programming and it continues to offer a full continuum of services. Its in-home prevention programs help families avoid the removal and placement of children into care. At the other end, its 25-bed Community Residence offers intensive treatment for children facing severe behavioral health challenges. What makes St. Catherine’s relatively unusual, however, is its focus on younger children—even in its congregate programs.

“We serve children aged 6 to 12,” says Gettman. “These are not the traditional children who have been placed in care because of parental neglect. These kids have experienced severe abuse—often sexual abuse—and are suffering from significant trauma.” Generally speaking, he explains, St. Catherine’s is a final opportunity for these children to find services close to home.

“If we don’t take them, they are going out of state. These are just little kids; it tears your heart out.”

In response, the agency has strengthened its clinical resources. Its 853 Special Education School also houses a licensed Day Treatment Clinic with a variety of on-staff therapists to assist children with mental and behavioral health problems. St. Catherine’s has also added new clinical supports, including sex abuse and trauma-informed therapists.

Children typically stay with the agency's Community Residence for a little less than a year, although some required more extended services. The goal is to step children down gradually from the community residence to an eight-bed group home, and then to a therapeutic foster boarding home with specially-trained foster parents and enhanced staff supports.

For the past several years, St. Catherine’s has been running at close to its maximum capacity in most programs and is now looking to expand.

“We would like to reopen a group home that we had closed about 10 years ago and utilize it as a short-term diagnostic program,” says Gettman. “Counties don’t really know what to do with many of the children they are sending us. No other foster care programs will accept them. This program would do a complete 60- 90-day assessment and provide them with specific treatment recommendations.”

HOMELESS SERVICES

St. Catherine’s began providing homeless services for Albany County in 1988 with the opening of its Marillac Homeless Shelter. Funding for the new shelter came through HELP, or Housing Enterprise for the Less Privileged, a program founded by Andrew Cuomo at a time when his father was governor. The shelter accommodates 24 families with swing units that can be adjusted to handle larger families. “The largest family I’ve seen here was one parent with 10 kids,” says David Healy, homeless manager.

St. Catherine’s staff work to help families address a range of issues and then find a stable apartment of their own. “We have some HUD vouchers that we can use but it is also possible to find apartments in Albany that are affordable using their shelter component of the public assistance grant,” says Gettman.

The agency’s role and relationships working with landlords can also be a critical factor. “We tell the landlord that the family has a case manager and that if there are any problems, they only need to call us,” says Gettman.

St. Catherine’s also provides community-based homelessness prevention services designed to keep families from losing the apartments they have. Once again, the supportive services help clients address a range of issues that may place their housing at risk.

SPREADING OUT

In 2013, St. Catherine’s entered into an agreement with the Columbia County Department of Social Services to help homeless families find their way out of motels and support them in individual apartments. “Within seven months, we were able to get all of the homeless families out of the motels. Now we are talking to the county about expanding the program to work with single adults,” says Gettman.

Now, the agency is in discussions with a number of other counties about the possibility of contracting to provide similar services for them.

Similarly, St. Catherine’s offers other community-based services to individual counties on an as-needed basis. For example, Schoharie County Department of Social Services makes use of the agency’s supervised visitation programs.

And St. Catherine’s will soon be opening satellite offices in both Hudson and Kingston to strengthen its service offerings in Columbia, Greene and other nearby counties.

LOOKING AHEAD

Going forward, St. Catherine’s plans to continue building on its core services— child welfare programming for younger children facing significant behavioral challenges, community-based programs, homelessness prevention services, and expanding opportunities in the new world of managed care.

“We want to know what our customers—county governments, local school districts and state agencies—need and how we can work with them to meet those needs,” says Gettman.

OPPORTUNITIES IN MANAGED CARE 

St. Catherine's selection by the state Office of Mental Health to operate the Capital Region’s Medicaid Redesign Team Supportive Housing Health Home Pilot—Project HOST—was a major win for the agency. 

Project HOST caseworkers will help identify eligible individuals, or those with multiple chronic health and/or behavioral health conditions which make them particularly costly users of Medicaid services through hospital emergency departments.

“We identified an individual who had been in the Albany Medical Center ER 32 times since the beginning of the year,” says Gettman. “Our workers will engage this individual, stabilize him, and get him into an apartment. If we can reduce his use of the ER by only 50 percent, we will be saving an enormous amount on his health care costs—far more than the cost of our services.”

Project Host will serve up to 50 individuals in Albany and Rennselaer counties.

Project Host is not the only way in which St. Catherine’s has been testing the managed care waters.

“A lot of this is going to be building relationships and finding ways in which providers can meet each other’s needs,” says Gettman. “We reached out to the Whitney M. Young Health Center. They just got a new mobile health van and we have 100 children and adults in our homeless shelter. This helps us to get health care for our people and it helps them to get Medicaid eligible clients.”

In another venture, Gettman identifies incoming homeless families that may be Capital District Physicians' Health Plan enrollees. “They reach out to engage them and in the process they are becoming more engaged with us.” Fidelis, another managed care organization, even sends its staff out with St. Catherine’s caseworkers to engage with families who are enrolled in the program who may be receiving in-home preventive services.

“The real question is whether they will write contracts and pay us for these kinds of engagement services,” says Gettman. “I am cautiously optimistic.”  

Fred Scaglione
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