Sunday, July 29, 2007

The children wronged by "Children's Rights"

The organization with the breathtaking arrogance to name itself “Children’s Rights,” as though the adults who run it and their wealthy benefactors (corporate raider Carl Icahn once chaired the Board of Directors) are the only ones who stand up for children, and the only ones who know what those rights should be, has struck again.

By children’s rights be assured that Children’s Rights does not mean the right of children to be free from unreasonable search and seizure. It does not mean the right to be with the parents who love and cherish them but may be too poor to keep them out of the hands of a child welfare agency. And it certainly doesn’t mean the right to be free from the racial and class bias that has permeated child welfare for more than 150 years. On the contrary, CR’s founder, Marcia Lowry, has dismissed all that as a “liberal agenda” for which she has no time.

That, no doubt, endears her to New York City’s large community of neoconservatives, who dominated public policy during the Giuliani administration. But the neocons have done no better for the children of New York that they have for the children of Baghdad. And CR’s latest analysis of child welfare in New York is about as useful as a lesson on military strategy from Donald Rumsfeld.

The analysis purports to show that reabuse of children worsened during recent reforms in New York City, when the city was taking away fewer children.

But two huge problems stand out immediately:

1. The starting line
2. The finish line.

The report begins with 2000 and ends with 2005. There is no logical reason for this. Data for most indicators are available back to 1993 and reabuse data are available back at least to 1998. Data also are available for 2006. Nothing in particular happened in 2000. There was no reorganization of the city child welfare agency, no change in leadership. And including 2006 data is crucial in order to measure the impact of the huge increase in removals of children that occurred that year in the wake of the death of Nixzmary Brown.

But including data before and after CR’s arbitrary choice immediately undercuts any connection between an alleged decline in safety and a decline in removals.

To see the real trend, including data for every year available, have a look at NCCPR’s report on New York City child welfare, Don’t Turn Back. The stats can be found on page 19.

The first thing anyone who has both this document and CR’s will notice is that, except for fatality data, all our numbers differ from CR's even though we’re both using city sources. That’s probably because, except for fatality numbers, our data are for fiscal years, and the CR report uses calendar year data.

But beyond that, the bigger picture is different from that portrayed in CR’s report.

For starters, consider reabuse of children left in their own homes. Yes, it went up from 2000 through 2005, when removals were declining. But in FY 2006, when removals soared, it went up again. Yet CR seeks to link the increase to the decline in entries into foster care. CR also omits data for 1998, when removals were at their height and reabuse was much greater – though that figure does not come directly from the city, it comes from The New York Times.

So what is the longer-term trend?

In all the years for which data are available, reabuse was at its worst when the city was taking the most children. Reabuse fell sharply, then has slowly increased, both when fewer children were taken and when more children were taken.

More significant is how CR has left out context concerning the second key safety indicator, foster care recidivism - the proportion of children sent home from foster care who must be placed again within 12 months.

For starters, CR fails to acknowledge that this is a safety indicator, providing data on this indicator only in the context of another important outcome, permanence. In fact, it’s a very important safety indicator, since a child is unlikely to have to be returned to foster care unless the child welfare agency thinks that child is unsafe. (Whether the agency is right or whether this was, in fact, a failure to provide support for the family after reunification is another story; indeed, there are indications that often it is the latter, something discussed further below.)

Data on this measure are available all the way back to 1993. And they show significant improvement starting when removals of children started to decline. And this time, the fact is, the improvement continued during the 2006 surge. That may be because, as a far better report just released from the Center for an Urban Future notes, the city has begun a program to provide intensive help to reunified families.

Overall, the rate of foster care recidivism in 2006 is more than 33 percent lower than it was in 1998, when the city was taking almost twice as many children.

At least as disturbing, however, is the way CR spins its own more limited data on this measure. A pullquote on page 102 cites a “25 percent increase” in this figure from 2004 to 2005 – with the percentage going from 8 percent to 10 percent.

Well, yes. But the chart on the previous page shows that for each of the three previous years, the figure was nine percent. So the 2004 figure may well have been a fluke. One unusually low year, followed by one unusually high year tells us nothing. Taking the two years in isolation suggests a trend that may not exist.

The one figure for which CR couldn’t avoid mentioning the year 2006 is deaths of children previously known to the city child welfare agency, since, at least within the child welfare community, that figure is well-known.

But that created a huge problem in PR for CR. Such deaths, in fact, soared in 2006, to their highest level since 1993. Not exactly a testament to the safety of taking away huge numbers of additional children – particularly since the previous record for such fatalities, 36, was set in 1998, during the height of the foster-care panic that gripped the city after the death of Elisa Izquierdo.

Back then, CR’s solution was to highlight the fatalities but simply ignore the increase in removals. This time, they decided to simply reverse their previous position and say that fatalities are a lousy measure of system performance after all. According to the report:

“…the number of fatalities in a given year, and even fluctuations in this number between years, are not particularly good indicators of how well a child welfare system is performing. The number of child fatalities is extremely small, compared to the overall number of children involved with the child welfare system. ACS investigates more than 50,000 reports of suspected abuse and neglect each year and more than 40,000 children are in contact with ACS at any given time in preventive services and foster care cases. During the last decade, an average of 26 children per year who were previously known to ACS died as a result of child abuse and neglect. Fluctuations in such a small number from year to year are likely to be random and not due to the nature or quality of particular policy or service approaches being utilized by the child welfare agency.”

Good point. It should be. It’s a point NCCPR has been making for years – though we always add that as long as fatalities are the measure of choice for the media, we will continue to point out the one consistent pattern all over the country: The deaths go up in the wake of a foster-care panic.

But while we’re glad to see CR realize the limits of fatalities as a measure, we’re puzzled by the fact that they never noticed this before. A report issued by CR in 1999 took the opposite view. And during late 2005 and early 2006, when a New York Times reporter used almost every story she wrote about a child abuse death to note that the death “comes at a time when” or “raises questions about” efforts to keep families together, CR never sought to correct her. Only when deaths soared after the city took far more children did CR decide there is no connection.

That would be the same Times reporter who described the deaths as a “series” of fatalities when, in fact, there had been no change in the rate of such deaths. (“It was a series,” the reporter would say later, “but not statistically.”) Then, when such deaths really did soar to their highest level since 1993, the Times declined to report it.

Needless to say, CR knew exactly where to leak its report ahead of its formal release in order to be sure there would be a news story with no real critical scrutiny. The Times reporter, who previously ignored data on reabuse suddenly found that they were important when spun CR’s way. And the Times reporter, who previously had used fatalities to measure system performance, now finds those data are not even worth mentioning.

And finally, there’s one more number that may be the most important of all, even though it doesn’t come from New York City: 15,000.

That’s the number of children whose cases were examined in the new, landmark study comparing children placed in foster care to comparably-maltreated children left in their own homes, discussed in the July 8 Blog entry. On average, the children left in their own homes did far better on measures such as teenage pregnancy, juvenile arrests and youth unemployment.

When things are at their worst in New York City, in 1998, the city took 12,000 children from their parents. Even with the upsurge in removals in 2006, the average in the eight years since has been 7,540. Had the city been taking children at the 1998 rate, 35,680 more children would have been taken from 1999 through 2006. That means 35,680 children have been spared the sometimes-unbearable emotional trauma of placement, and the risk of abuse in foster care itself. Indeed, using the results of this new study, it may even be possible to estimate how many of those 35,680 children have been spared from arrest, unemployment, and teenage pregnancy because of the reforms CR wants to reverse.

Whatever the number of children spared this harm, it probably is not as high as it should be. It probably would be higher if not for the efforts of CR to reverse reform. So there are plenty of children wronged by “Children’s Rights.”

Sunday, July 15, 2007

An Arizona newspaper's double standards are showing

Last May, I wrote about a reporter for the Arizona Daily Star who produced a front-page story condemning a tiny financial incentive to encourage caseworkers not to needlessly take children from their homes. The incentive was intended to balance the many huge incentives, financial and otherwise, to take children needlessly.

It didn’t work. Arizona is in a state of perennial foster-care panic. From October 2002 through September 2004, removals shot up 40 percent – and they’ve stayed at that high level ever since.

None of this mattered so the reporter. In explaining to me why he’d shut all dissent out of his story condemning the incentive, he wrote in an e-mail that:

“Those decisions should be made based strictly on the best interest of the children involved. Financial motivations, or even the perception someone could be swayed by financial motivations, are inappropriate.”

Unexplained was why the only “financial motivation” to interest him was the puny one favoring birth parents, not the huge ones favoring taking away children. But surely, if another story turned up where one of those other financial incentives was a key element, he’d raise just as much of a stink about it, right?

Not exactly.

The same reporter had another story on the front page of the Star Sunday. This one is something of an archetype: The adoptive parents who fill their home with lots and lots – and lots – of severely disabled children; they become the subject of any number of gooey feature stories at the local and sometimes national level – until it turns out all is not well behind the scenes.

The most notorious example recently is the case of the parents in Ohio who adopted 11 special needs children and then kept them in what prosecutors called cages.

Now it turns out that such a couple in Arizona also was the subject of one complaint after another alleging abuse, and that, at one point, all 16 of their foster and adoptive children had been removed from the home. The adoptive mother, who is separated from the adoptive father, says two since have been returned. (At one point, by the way, 19 children were living in the home.)

The children were not adopted from Arizona; the story doesn’t say where they came from.

But every state that placed a child in the home would have to have done a home study - which means they would have to know how many other children, all with severe disabilities, also were living there. So why didn’t anyone question whether it was a good idea to place a disabled child in a “home” with 15 other disabled children?

Probably because of the financial incentives.

States receive a bounty from the federal government for every finalized adoption of a foster child over a baseline number. The bounty can range from $4,000 to at least $8,000 per child, and the children in this house are likely to bring $8,000 bounties. If the adoption fails, states don’t have to give the bounties back; in fact, if they place the children again, they can collect another bounty for each one, as long as they exceed their baseline. This creates a huge incentive for quick-and-dirty, slipshod placements.

There’s also a non-financial incentive – the only time a child welfare agency gets good press is when it gets those adoption numbers up.

But apparently the Star reporter has decided that he can live with “financial motivations, or even the perception someone could be swayed by financial motivations” after all.

Because he never even raises the issue.

Sunday, July 8, 2007

The evidence is in

NCCPR long has argued that many children now trapped in foster care would be far better off if they had remained with their own families and those families had been given the right kinds of help.

Turns out that’s not quite right.

In fact, many children now trapped in foster care would be far better off if they remained with their own families even if those families got only the typical help (which tends to be little help, wrong help, or no help) commonly offered by child welfare agencies.

That’s the message from the largest study ever undertaken to compare the impact on children of foster care versus keeping comparably maltreated children with their own families. The study was the subject of a front-page story in USA Today. The full study is available here.

The study looks at outcomes for more than 15,000 children. It compares foster children not to the general population but to comparably maltreated children left in their own homes. The result: On measure after measure the children left in their own homes do better.

In fact, it’s not even close.

Children left in their own homes are far less likely to become pregnant as teenagers, far less likely to wind up in the juvenile justice system and far more likely to hold a job for at least three months than comparably maltreated children who were placed in foster care.


● The study examined cases in Illinois from 1990 through mid-2003. That means for most of the time, it was looking at the Illinois system before it reformed, when it was much like most of the rest of the country is today.

● The study uses the term “foster care” generically; it includes children placed in any form of substitute care. That’s important because whenever information like this comes out, people who want to warehouse children in orphanages try to use it to justify their schemes. But this study was not limited to family foster homes. And it takes three single-spaced pages just to list all the other studies documenting the harm of orphanages. (Those pages are available from NCCPR.)

● This does not mean that no child ever should be placed in foster care. But it means many fewer children should be placed in foster care.

The study excluded the most severe cases of maltreatment, a very small proportion of any child protective worker’s caseload, precisely because, horror stories that make the front page notwithstanding, these are cases where everyone with time to investigate would agree that removal from the home was the only alternative.

Rather, the study focused on, by far, the largest group of cases any worker sees, those that can best be called the “in-between cases” where the parent is neither all victim nor all villain; cases where there are real problems in the home, but wide disagreement over what should be done. As the study itself notes: “These are the cases most likely to be affected by policy changes that alter the threshold for placement.” They also, are, of course, the cases most likely to be affected by a foster-care panic – which also alters the threshold for placement.

Even among these cases, the figures are averages. Certainly there are some individual cases among the more than 15,000 studied in which foster care was the less harmful alternative. But what the data make clear is that foster care is vastly overused, damaging large numbers of children who would do better in life had they remained in their own homes, even with the minimal help most child welfare agencies offer to families.

This says less about how well child protection agencies do in helping families than it does about how enormously toxic a foster care intervention is. Anything that toxic must be used very sparingly and in very small doses.

● I expect that, from coast to coast, child welfare agencies will offer up a disingenuous response to this study along these lines: “Why yes, of course,” they’ll say. “This study just shows what we’ve always said ourselves: foster care only should be used as a last resort; of course we keep families together whenever possible.” But this study shows that agency actions belie their words. This study found thousands of children already in foster care who would have done better had child protection agencies not taken them away in the first place.

● The USA Today story quotes one deservedly well-respected expert as saying this is the first study to produce such results. But that is an error. Actually it’s at least the second in just the past year or so. A University of Minnesota study used a different methodology and measured different outcomes, but came to very similar conclusions. (Byron Egeland, et. al., “The impact of foster care on development” Development and Psychopathology, (Vol. 18, 2006, pp. 57–76)).

● Though the USA Today story says other “studies” go the other way, the one cited, with less than 1/100th the sample size of the new study, a shorter duration and at least one other serious flaw (omitting foster children in care for less than six months) is the only one we know of.

And of course that study also compared foster care only to typical “help” for families in their own homes, which generally is little or nothing. Providing the kinds of real help NCCPR recommends (See Eleven Ways to do Child Welfare Right) would likely change the result and, in the case of the two more recent and more rigorous studies, create an even wider gap in outcomes favoring keeping families together.

● Perhaps most intriguing, this study suggests it actually may be possible to quantify the harm of a foster-care panic, a huge, sudden upsurge in needless removals after the death of a child “known to the system” gets extensive news coverage.

Thanks to this study, we now have an estimate of how much worse foster children do on key outcomes compared with comparably maltreated children left in their own homes. It’s also usually possible to calculate how many more children are taken away during a foster-care panic. So it should be possible to estimate how many more children will wind up under arrest, how many more will become pregnant and how many more will be jobless as a result of a foster-care panic.

It also should be possible to estimate roughly how many children have been saved from these rotten outcomes in states and localities that have reformed their systems to emphasize safe, proven programs to keep families together.

This new study and the Minnesota study are in addition to the comprehensive study of foster care alumni showing that only one in five could be said to be doing well as a young adult – in other words, foster care churns out walking wounded four times out of five. (See NCCPR’s publication 80 Percent Failure for more on this study) and the mass of evidence showing that simply in terms of physical safety, real family preservation programs have a far better track record than foster care. (See NCCPR Issue Paper #1.)

The buzzword in child welfare lately is “evidence-based.” What that really means is: How dare proponents of any new, innovative approach to child welfare expect to get funding if they can’t dot every i and cross every t on evaluations proving the innovation’s efficacy beyond a shadow of a doubt? Old, non-innovative programs, however, are not held to this standard. If they were, child welfare would be turned upside down by the results of this new study.

Because now, more than ever, the evidence is in.