Cardinal McCloskey Community Services was founded in 1946 to establish a “Home and School” for neglected and abandoned children. Today, that single orphanage in White Plains – which closed in 1980 -- has evolved into a multi-faceted $65 million per year agency which provides comprehensive child welfare, early childhood and developmental disabilities services for over 7,000 children, families and individuals every year.
Over the years, the agency changed its name, dropping the “Home and School” and adding its long-standing and well-established emphasis on community-focused services. Despite the change, President/CEO Beth Finnerty believes that Cardinal McCloskey continues to be a warm and welcoming “home” for people in need – whether as foster boarding homes and residences for individuals with disabilities, or as community office-based “homes” for a wide array of family-focused services in the Bronx and Westchester.
Cardinal McCloskey began the evolution of its child welfare services twenty years after its founding, when it moved beyond the original orphanage and developed a family foster care program. In 1966, Social Worker Marge McLoughlin, who would later become the agency’s Executive Director, placed its very first child in a Westchester foster boarding home. Cardinal McCloskey’s community focus began early with the establishment of a storefront office on Courtlandt Avenue in the Bronx where staff recruited foster families and provided counseling and supports for the birth families of children in its care. The agency now has more than 200 foster boarding homes providing safety and care for over 450 New York City children who are unable to live safely with their own families due to abuse and neglect.
In the 1972, Cardinal McCloskey opened its first community group home for children who were leaving its campus-based program in White Plains. The new programs provided an opportunity for older children who were not yet ready to return to their families – or did not have a home to return to -- to “step down” from institutional care and re-enter the community in a less restrictive but still appropriately structured setting. Over the next several years, the agency’s group home program would increase substantially, eventually providing care for over 125 children at 15 homes throughout Westchester, Rockland and the Bronx.
However, recognizing the benefits of family-based care, even for older and more troubled children, Cardinal McCloskey launched a Treatment Family Foster Care program in 1991. The TFFC program is designed to meet the needs of children who require specialized services due to serious emotional challenges, often as the result of physical and sexual abuse, extreme neglect and multiple prior failed foster care placements. Treatment Family Foster Parents receive specialized training, and children in the program have the opportunity to work with both a caseworker and a behavioral health specialist. At present, the agency provides Treatment Family Foster Care for a total of 41 children.
Following the development of TFFC, Cardinal McCloskey began to wind down its group home program, transferring many of its properties for use in serving individuals with developmental disabilities
Cardinal McCloskey continues to operate. two child welfare congregate care programs.
Hayden House Emergency Residence and School provides short-term diagnostic services for up to 12 children referred by the Westchester County Department of Social Services.
“These are children who need a good diagnostic evaluation so we can give the County a sense of what type of placement would be most appropriate,” says Audrey Erazo-Trivino, Vice President of Health and Clinical Services. “Most of the kids coming to Hayden have Serious Emotional Disturbance (SED).”
While Hayden is designed as a 90-day diagnostic program, children tend to stay longer on average in order to find an appropriate placement. “The County is pretty good about taking our recommendations,” says Program Director Priscilla Augustin. But, sometimes placements can be hard to find. The majority of children leaving Hayden are referred to Treatment Family Foster Care.
The Hayden staff work hard to ensure that a recommended placement is right for that particular child. “It is a six-week process,” says Erazo-Trivino. Prospective placement agencies come to Hayden to meet the child; then the child will meet the potential foster parents. “It is a structured process. They will go for visits; then spend an overnight. If the child is not comfortable, we will not force them to leave. We take a little more time than a lot of places. But if you move a child too quickly, they are only coming back the next week anyway.”
In order to increase placement options for these and other children, Cardinal McCloskey is now expanding its TFFC program to serve Westchester County as well. “It will be such a natural extension of the program at Hayden,” says Erazo-Trivino.
Cardinal McCloskey also operates the Tappan Group Home, a program for girls ages 12-21, in Rockland County. The Tappan Group Home operates using a house parent model in which a married couple, Karen and Ron, Prescha, invite the girls to live in their own home.
In addition to these residential child welfare programs, Cardinal McCloskey also operates several child abuse and neglect prevention programs under contract with New York City’s Administration for Children’s Services. These include a regular prevention program and two Family Treatment and Rehabilitation Programs, as well as a Special medical and Developmental Preventive Services Program.
Cardinal McCloskey has taken significant steps over the years to ensure that children in its child welfare programs receive the highest quality educational support.
The Cardinal McCloskey School, which serves children at Hayden, is a case in point. “This is a fantastic model,” says Erazo-Trivino. “Children live here and they go to school here.”
Despite the relatively short-term length of stay in the diagnostically oriented program, education is a high priority for the facility. Children who may have struggled in their home schools – if they attended at all – suddenly find themselves the focus of intensive academic attention and support. Because of the age range in the programs, children may find themselves in classes with only one or two other students – or even one-on-one with their teacher. “The census is only 12, so they are practically getting individualized instruction,” says Jennifer Fedele, the school’s Principal. “We have four classrooms including a fully-functional science lab.”
As a result, kids can make up a lot of ground. “Kids typically come here several years behind in reading and math,” says Fedele. “If a child stays here for a minimum of six months, they gain an average of a year-and-a-half to two years in reading and six months to a year in math. We have had a number of children who have earned enough credits here to go back to their own schools and graduate.”
Cardinal McCloskey has also implemented a broad based series of educational supports to ensure that all of the children in its foster care programs succeed academically. In 2008, Cardinal McCloskey developed and implemented its Strategies for Success program (SFS) which provides academic support and assistance to middle and high school students from the Bronx and Manhattan who are in the foster care system. (See “Strategies for Success”)
Cardinal McCloskey also ensures that children, families and adults in its programs receive high quality clinical services.
“Our clinical focus has always been on having a strong in-house medical and behavioral health component,” says Beth Finnerty. “Registered Nurses, Licensed Practical Nurses, Master’s Level Psychologists, Licensed Psychologists, and Psychiatrists maintain a steady presence in all programs and are available on a 24-hour basis to respond immediately to the medical and mental health needs of individuals in our care.”
Bridges 2 Health
As an outgrowth of this commitment to high quality medical and behavioral health services, Cardinal McCloskey was one of the first child welfare agencies in New York State to implement a Bridges 2 Health (B2H) program – and, with almost 300 children enrolled, it now is one of the largest.
B2H allows children in foster care who have one or more mental health disorders and at least one chronic medical condition to receive supplemental medical and behavioral health support services. “While we have a strong medical and clinical program, we knew our youngsters still needed additional services,” says Finnerty.
The B2H menu of 14 “additional services” include family caregiver supports and services, skill building, day habilitation, pre-vocational services, supported employment, immediate crisis response, planned respite, and more. Key among these services is Health Care Integration, which Cardinal McCloskey provides as a B2H contract agency.
“Our Health Care Integrators make sure that children and families receive the full array of supports they need to be successful,” says Audrey Erazo-Trivino. “They coordinate with the actual Waiver Service Providers who go into the home to provide services. The service providers are a unique group who work all hours of the day and night. For example, we might have someone who goes to a family at 6:00 in the morning to help the mother get a child with developmental disabilities ready for school. In the process, they will teach that mother how to multi-task and build her own routine so that in the future she will be able to get all of her kids ready for school at the same time.”
Respite is an important B2H additional service. It enables foster parents and caregivers – as well as children with severe disabilities -- to get a critical break that can avoid a more serious household crisis. Respite can range from a few hours so a family can go shopping or go to church, to overnights and weekends. Cardinal McCloskey itself provides B2H respite services at the Hayden Residence.
“We have seen very positive results,” says Erazo-Trivino. “There are fewer hospitalizations, fewer failed foster boarding home placements, and more children have been able to return home successfully.” One of the most important advantages of B2H is that eligibility continues, up to the age of 21, even after a child is discharged from foster care.
Developmental Disabilities Services
In 1995, Cardinal McCloskey responded to a rapidly increasing need for residential programs for adults with developmental disabilities. The Susan Lane Individual Residential Alternative (IRA) in Peekskill, serving six mildly-to-moderately developmentally disabled women, opened in February of that year. The building had previously been a group home for teenage boys in foster care. Before the year was out, Cardinal McCloskey opened five more IRAs, serving 22 consumers. Four of these were established in Co-op City Apartments. The fifth was a house in White Plains.
Since then, the agency has continued to develop new programs and is now home for 90 individuals with developmental disabilities who live in a total of 15 residential settings, all licensed by the NYS Office for People with Developmental Disabilities (OPWDD). Many of these residences were created by converting housing previously used for foster care group homes.
Locust Road in Ossining, Cardinal McCloskey’s newest IRA, opened in October of 2011 and serves four individuals with severe disabilities, two of whom had previously been forced to find care in out-of-state facilities.
During 2011, the agency also expanded through acquisition of St. Theresa’s Intermediate Care Facility (ICF) in Mt. Vernon. The 12-bed program, previously operated by ArchCare, provides more intensive services for medically frail individuals with developmental disabilities. “Having both IRAs and an ICF in our continuum of residential care allows us to serve a greater number of individuals with more complex needs,” says William Ursillo, Ph.D., Cardinal McCloskey’s Chief Operating Officer.
In addition to these residential programs, Cardinal McCloskey also opened a Day Habilitation program in 1995, serving many of the same individuals with disabilities living in its IRAs. Today, the program serves 23 consumers, helping them to develop life and vocational skills. “Our individuals volunteer at local community programs,” says Lidia Pena, Director of the Day Hab program. “They work at the local food pantry and in the day care center. The weekly schedule is packed with lots of volunteer opportunities.” Several individuals in the Day Hab program also work at paid jobs in the community. “One works in the DA’s Office in White Plains as a messenger and two individuals work here in our main offices,” says Pena.
In 2011, when Cardinal McCloskey relocated its headquarters to Valhalla, the Day Hab program moved into the same building. “Now the administrative staff get to see the work we are doing with consumers on a daily basis,” says Audrey Erazo-Trivino. “It has brought about a great empathy for the people we serve. The IT staff, the Finance staff… they all get it.”
Over the past several years, as an increasing number of its consumers have diagnoses on the Autism Spectrum, Cardinal McCloskey has begun utilizing Applied Behavior Analysis (ABA). ABA monitors detailed data about consumer behaviors, thereby allowing clinicians to assess their progress and fine-tune their individual treatment plans.
“It is all about being able to know that you are continually making progress, and when the progress stops, the program needs to be redesigned,” says Craig DeVincenzo, Assistant Director of Medical/Clinical Services.
So far, Cardinal McCloskey has rolled out ABA in Day Hab and in the Locust Road IRA, with another IRA just beginning implementation. The agency believes this approach is innovative. “It is fairly common to see ABA used in Day Hab programs,” says Dan Kenny, Program Support Psychologist. “It is uncommon to see it used in a residence and with adults.”
Early Childhood Services
The third major sector of Cardinal McCloskey’s services – Early Childhood Services – began way back in 1973 when the agency launched a small Family Day Care Program at its 149th Street office in the Bronx. The program both provides essential child care services to poor and working families in the Bronx, while also offering opportunities for individuals in these communities – often low income women – to establish their own family day care businesses.
Over time, the agency also established center-based child care programs in the Bronx.
In 2009, Cardinal McCloskey expanded its child care programming substantially when it merged with Little Angels Head Start.
As a result, the agency is one of the larger providers of early childhood programming in New York City. Following ACS’ recent implementation of the EarlyLearnNYC program, Cardinal McCloskey was awarded contracts for 600 Family Day Care slots, four center-based programs serving 217, and eight Little Angels Head Start programs with a total capacity of 860.
The challenges associated with providing services under the new EarlyLearn contract structure are formidable, however. Providers are required to provide a 6% private share match to City funding and there are serious questions about whether the full-enrollment reimbursement model will generate revenues to cover the actual cost of services. “You can’t fire 1/20th of a teacher if a child doesn’t show up,” says Finnerty. “There are things that will have to be fixed.”
The future for Cardinal McCloskey, like many other human service provider agencies, is filled with challenges. Medicaid redesign and the upcoming move into managed care for many of the agency’s clients and consumers – children in foster care and individuals with developmental disabilities – has the potential to significantly impact many of Cardinal McCloskey’s services. Will there still be a role for B2H Health Care Integrators in a new managed care world? How will clinical behavioral and medical health services be authorized, coordinated and delivered for children in foster care and individuals with developmental disabilities?
And, if that isn’t enough, how will the new EarlyLearnNYC contracts actually function in practice?
“We have three different lines of business, so we are diversified,” says Finnerty. Normally that is supposed to be a good thing. Now, it just adds to the challenges. “Every single side of our business is undergoing fundamental changes. It is different than any time I can remember,” says Finnerty.
Nevertheless, Finnerty is confident that Cardinal McCloskey will overcome these challenges. Success in the future will come the same way it has come in the past, she believes, by assessing and identifying community needs and then developing innovative programs and services to meet those needs.