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DR. ANTHONY D’URSO,
PsyD.
A professor at Montclair State University’s Department
of Psychology, Anthony V. D'Urso is a leading expert on
child welfare who headed up a task force investigating DYFS.
He also serves as Chair of the Child Fatality and Near Fatality
Review Board.
- Has been teaching at Montclair State University since
1994
- Teaches Child and Adolescent psychopathology and consultation
methods in school settings
- First got involved in child welfare in 1982. Was at
Morristown Hospital which had a child abuse program and
saw that kids were not being served well and cases were
poorly prepared
- Interests include the forensic assessments of child
abuse and how they are communicated to the courts
- Has been working in this field for 21 years
Frequently Asked Questions for Dr. D'Urso:
What are some of the biggest issues facing children these
days?
- Division in society between the “ haves”
and the “have nots” is becoming greater
- Kids living in poverty are 18 times more likely to
be physically assaulted, and 55 more times to be educationally
neglected
What is the state of the child welfare system in New Jersey?
- Positives:
- Have regional diagnostic centers, Child Advocacy Centers
(CACs) for investigations
- New Jersey is one of three states to have a forensic
interviewing academy to train people to interview kids
from the law enforcement perspective
- Negatives:
- Need for more governmental responsibility
- Need for standardized inter-governmental regulations
- System lacks the appropriate resources
- Need to keep the issue in front of the state at all
times
How do you make sure that cases don’t fall through
the cracks?
- Focus on a case by case basis
- Deal with the vicarious emotional trauma of the professional
- Need more training for social workers, psychologists.
- "Psychic numbing" of workers having 40, 50,
60 cases at once
Why is it that kids can get lost in the system? What can
we do to improve the system?
- Case load ratios
- No guideline for investigations in terms of time limits
- Governmental agencies need to establish uniform protocols
- What kind of care you get depends on where you live
How did the NJ task force deal with DYFS and the recent
death of the Williams boy?
- The Fatality Board reinforced recommendations it made
in annual reports
- Called for greater accountability, review of decision
making, need for ownership
- Task force is part of transformation process.
- Dr. D’Urso believes that the transformation process
has not been open enough, and has excluded the people
who provide the services.
- Government is not great at policing itself.
Is the state government unable to sustain itself in child
welfare and is there a need for a child advocate in the
state? What would this child advocate do?
- There should be a child advocate who is free to present
children’s issues. The position would not function
as a complaint bureau, and should have little to do with
the day-to-day running of any agency.
- The advocate would continuously present the Legislature
and the Governor with the needs that kids have.
Why is the system not changing in light of repeated problems
and tragic events?
- The system is too politicized and does advance the cause
of the people they represent.
DENNIS C. MILLER
President and Chief Executive Officer
Somerset Medical Center, Somerville, NJ
For more information about Somerset Medical Center, visit:
http://www.smchealthwise.com/
Key Points:
Independent Hospital Versus a Hospital System
- More advantages to having an independent hospital.
- Makes decisions a lot quicker.
- Closer to the community;. Creates value for the community.
- Hospitals like Somerset have done remarkably well because
they’re focused on one regional community.
- The public does not perceive any benefits of being part
of a hospital system. People just want good care.
Challenges Facing Independent Hospitals
- Need for physician and hospital collaboration.
- Important to create an atmosphere in which a physician
likes practicing medicine; need to cultivate relationships
with physicians
- Money issues.
- Ensuring that health is a social right or good available
to everyone with no limits.
- Many hospitals that take care of predominantly blue
collar, working class patients are struggling.
The Charity Care Issue
- No one wants to address it, although there is law that
says everyone is required to have healthcare.
- Who will pay for charity care? He believes that it's
a state obligation. Currently, it is funded through an
unemployment fund, but Somerset gets $0.13 on the dollar.
Malpractice Issue for Doctors
- Part of the problem has to do with a culture of greed.
- Need to find a balance—a victim of gross negligence
needs to be compensated for pain and suffering. The question
becomes how much?
- “A weatherman is wrong once, no big deal. A doctor
is wrong once, he’s sued for all he’s worth.”
- The more knowledge the people or “consumer”
has, the better. Patients aren’t coming into office
with a sense of fear anymore. They ask questions, find
facts about the procedures.
Labor shortage in healthcare:
- Patients who stay in hospitals these days do so because
they are VERY sick.
- As a manager of a healthcare facility, need to remind
ourselves that our employees are very valuable.
- Make things efficient for them, take the paper work
out of the job.
Final thoughts:
- Dennis thinks it’s a very difficult time for
someone to be a physician. “The perception is that
doctors make a lot of money. I know a lot of them who
don’t make a lot of money and live off their savings.
I don’t think we want doctors to struggle. I don’t
want those people who are taking care of us to struggle
to stay in business. Being a physician is a noble cause,
but it’s a struggle.”
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