NOTHING IN THIS POST WAS UNAVAILABLE TO THE MIAMI HERALD BEFORE THEY RAN THEIR STORY TODAY ABOUT FLORIDA'S CHILD ABUSE HOTLINE. THE NEWSPAPER CHOSE TO IGNORE IT.
Right after The New York Times
ran a story praising reforms by the Florida Department of Children and Families that emphasized keeping families together, I predicted a backlash. I wrote that:
You don't change the way child welfare has been done for 150 years without making enemies. There are plenty of people who think of the days when Kathleen Kearney ran DCF as the good old days. That was when she so terrified the agency into taking away more children that, as one administrator at the time put it: "I don't dare say the word 'reunification' in her presence." The fact that this endangered many more children, destroyed countless lives, and collapsed the entire system has not dampened this nostalgia.
I referred to those who want to see the reforms fail as a "Kearney DCF-in-exile."
Apparently, The Miami Herald has jumped on the nostalgia bandwagon. In a huge, front-page article today based almost entirely on horror stories, an article that distorts both the actual data and the context, the Herald charges that Florida is endangering children by doing what every state does: screening out some of the calls phoned to the state's child abuse hotline. The Herald is wrong.
What the Herald knew – but did not tell readers – is that:
● For most of the past decade, Florida screened out calls to the hotline at a lower rate than the national average.
● Right now, Florida is rejecting proportionately fewer calls than it turned away in 2005 and 2006, before it reformed to emphasize family preservation.
● Florida's former policy of failing to screen out enough calls so endangered children that even the nation's foremost advocate of a take-the-child-and-run approach, Richard Gelles of the University of Pennsylvania, said Florida needed to screen out more calls.
The story also ignores the big picture: Measure after measure, including an independent outside evaluation shows that children in Florida are safer in the years since DCF abandoned the take-the-child-and-run approach and started doing more to keep families together.
But you won't find any of that information in the Herald's account. Instead you'll find what the worst child welfare reporting always uses as the ultimate crutch: Horror stories. And out-of-context horror stories about things DCF actually has done were not enough for the Herald. The story went on to attack DCF for off-the-wall ideas that have been discussed but never implemented – with no plans to do so.
NO SCREENING = "RUSSIAN ROULETTE" WITH CHILDREN'S LIVES
The most absurd single comment in the article has to be the one from Howard Talenfeld who chairs a group that calls itself Florida's Children First, a group that typically takes positions that can best be described as "Kearney-lite." Said Talenfeld: `Hot-line calls are cries for help on behalf of a child. Any call that is screened out is a cry that falls on deaf ears.''
In fact, hotline calls can be all sorts of things. Sometimes they are, indeed, cries for help, sometimes they are well-meaning errors, sometimes they are mandated reporters covering their rears, and sometimes they are acts of harassment by vindictive ex-spouses, or neighbors, or anyone else with a grudge. That's why no child welfare system can operate effectively without screening calls to the hotline. Workers would be inundated with false allegations and trivial cases, leaving them no time to find children in real danger. And, of course, huge numbers of additional children would be traumatized by needless investigations and stripsearches.
But, of course a family preservation advocate like me would be expected to say something like that. You would not expect to hear that from America's foremost proponent of the take-the-child-and-run approach to child welfare, someone who has said only 20 to 30 percent of the children taken away should ever go home, someone beloved by Kathleen Kearney, who constantly consulted him (and almost no one else) on child welfare policy - the aforementioned Richard Gelles. But not only did he say it, he said it specifically about Florida, after he was commissioned to write a report about the Florida hotline, released in 2001:
"The hotline is supposed to be a gate," Gelles said. "They've got the gate rusted, stuck open." As a result, he said, cases pile up, creating a backlog of uncompleted investigations. "I equate that to the game of playing Russian roulette. It's just a matter of time before some child in the backlog pool is really badly injured."
Of course, now, even though Florida is screening calls at just about the rate he suggested, Gelles might change his mind and agree with the Herald. But someone who is fanatical about taking away children calling for less screening is no surprise, someone like that warning about too little screening, however, merits attention. In fact, what Florida, and every similar state needs is not less screening but better screening, and that should be the target of any effort to further reform the hotline.
STATISTICS ABUSE AT THE HERALD
In 2000, when Gelles studied the hotline, there was virtually no screening at all at the hotline, only about six percent of calls were screened out, according to data Florida reported to the federal government. Gelles said it should have been at least 35 percent. (The data DCF reported to the federal government, and discussed in this post, through 2005, mistakenly include both child and adult protective services cases, but since there are relatively few adult cases, that should not affect the percentages too much. Data from 2006 on do not include this error.)
In 2002 and 2003, Florida's rate of screening out calls approached the national average, then the state fell back below that average again in 2004. It was actually in 2005 and 2006 that Florida started screening out cases at a rate above the national average. That was back in what the Kearney DCF-in-exile still viewed as the good old days, when Florida still was taking away huge numbers of children. In State Fiscal Year 2007, the year reform really began in Florida, screening out of calls fell back to the national average, and the next year only 27.8 percent of all reports were screened out. In SFY 2009 the proportion of calls screened out rose to 40.2 percent – close to what probably will be the national average, when those data become available. It's also a figure not much higher than that recommended by Gelles, an extreme advocate of child-removal – and a lower figure than 2005 or 2006.
For details, see the table at the end of this post.
But even that figure underestimates the number of cases for which DCF reaches out in some way to families that have been reported. One of the other targets of a cheap shot from the Herald is a new practice of making "prevention referrals" – offers of help – in response to some calls. In the past, most of these calls would have been screened out with no outreach at all. So not only is DCF screening in just about as many calls as the national average, it's also doing some outreach, however limited, to a proportion of the calls it screens out.
DATA OUT OF CONTEXT
The Herald gets around all this by taking the numbers out of context. The Herald compares only four months in 2009 to the same months the year before. But as we've seen, 2008 was the aberration – a year in which exceptionally few reports were screened out. The Herald further distorts the data by using numbers without percentages. One would expect more cases to be investigated in 2008 than 2009 because more people called the hotline to report alleged child abuse in 2008 than 2009 – something else the Herald leaves out.
But, unfortunately for the state's vulnerable children, no one who reads the Herald story is likely to care about any of this.
Because nothing is more boring than a bunch of numbers – and nothing is more riveting than horror stories about allegedly unprotected children.
Everyone, even Richard Gelles, believes you have to have some screening. But once you do that you are guaranteed to have tragedies – some children will be harassed by traumatic interrogations and needless stripsearches, or worse, needlessly thrown into foster care. Other children in real danger will be missed because their cases will be screened out. You screen anyway because you endanger far more children if you don't screen.
But, of course, only one kind of tragedy was the focus of the Herald's "reporting."
If the Herald summaries are accurate – and I no longer take that as a given, particularly since the Herald is wrong about the one case, later in the story, where detailed information is available – then these were indeed tragic errors at the hotline – the same kind of tragic errors that are made in every child welfare system, and the same kind that you can bet were made in Florida even back in 2000, when almost nothing was screened out. But rather than give any sense of how common these errors are, the story moves immediately from three horror stories to a heart-of-the-hype paragraph that says:
"These decisions and thousands more are the result of a little known – but potentially dangerous – practice …" [emphasis added], a reference to the alleged increase in screening. That deft bit of weasel wording leaves the impression that all the cases screened out are like the horror stories. There is not a shred of evidence for that in the story. Instead, there's more innuendo: The story declares that "Among the callers being turned away: school counselors, grandparents, circuit court judges, hospital social workers, day care workers and juvenile justice staffers." The implication of course is that these are experts who couldn't possibly be wrong. Buried far deeper in the story is a comment from DCF Secretary George Sheldon that some of these same categories of mandated reporters have complained about having to phone in cases they knew were nonsense because they feared penalties if they didn't.
There was a time when, in fact, the hotline was barred from screening out anything from a mandated reporter – 2000, when the Legislature passed the notorious "Kayla McKean law." That was when the gate was "stuck open" – with all the horrors that followed.
The one tragic case where we have more to go on than the Herald's word for it concerns the death of two-year-old Bryce Barros. That was the subject of a Herald story in July that essentially previewed today's - complete with the same loaded language and innuendo. But for that story, the Herald also posted a number of source documents on its website, and those documents undercut the paper's own conclusions, something I will discuss in detail in a future post.
But horror stories about actual bad decisions were not enough for the Herald. They also mention what the story calls a "report" listing options for future policy changes involving screening. The actual report is not on the Herald website, so I can't tell what kind of a "report" it is. It sounds like a bunch of suggestions from people invited to come up with all sorts of ideas, no matter how off-the-wall.
And at least one of them certainly qualified. It allegedly suggested narrowing the definition of "lack of supervision" to the point where it could require, literally, a smoking gun. Under this proposal, which never went anywhere, a three-year-old playing with a loaded gun while adults watched would not be "lack of supervision" if the gun didn't go off. Idiotic? Of course. But I guarantee you that if every numbskull idea that was ever bandied about at a newspaper story meeting were made public, with the implication that they'd actually happen – nobody would ever trust their local newspaper again.
To make absolutely sure this long-form-editorial-disguised-as-a-news-story had its intended effect, the sourcing deck was stacked. All the outside "experts" and "child advocates" were suitably shocked and appalled at all the things that shocked and appalled The Herald (one was neutral, allowed to mention briefly that Florida was not out of line with the rest of the nation). Those left to defend the reforms were those people trust least: officials at DCF.
THE REAL SCREENING PROBLEM
There is, in fact, a problem with screening at child abuse hotlines, in Florida and most other states: There isn't enough of it. This is clear from what happens, nationwide, to all those calls that are screened in for investigation: nationwide, 61 percent of those reports turn out to be false, all the trauma of investigation inflicted on all those children was for nothing. (In Florida about half of reports are false, in part because Florida has three categories instead of the usual two.) Of course, just as with the initial screen-in/screen out decision, sometimes workers will wrongly declare a case unfounded. But the only major study I know of found that workers are two to six times more likely to wrongly substantiate a report they investigate than to wrongly declare one unfounded. All that wheel-spinning only steals more time from finding children in real danger. And that's probably one reason why, when Florida screened out even fewer reports than it does now, and took far more children, deaths of children known-to-the-system kept going up.
And that's why the lack of context in today's story in the Herald is so dangerous for children. It is likely to promote not better screening, but less screening. That means more false allegations investigated, more children traumatized – and less time for workers to find children in real danger; exactly the conditions that caused so much harm to children when Kearney was in charge.
The only acceptable goal for hotline errors is the same as the only acceptable goal for child abuse deaths: Zero. But we must seek those goals knowing that our reach always will exceed our grasp, and knowing that the wrong "fixes" will only make everything worse. So while the Herald story shows what everyone already knew – that every screening system needs improvement, that means helping the people at the hotline to make better decisions, not going back to leaving the gate stuck open. And it means remembering the same lesson every doctor is supposed to be taught in medical school: First, do no harm.
Talenfeld's absurd comment notwithstanding, there always will be screening in child welfare. The choice is not between screening and no screening, rather the choice is between rational screening, in which hotline personnel are trained to make better decisions, or irrational screening – in which the gate is stuck open again, cases cascade down upon workers and the case that gets "screened out" is whichever one happens to be on the bottom of the pile at the end of an overwhelmed worker's day.
SHELDON ON THE SPOT
Three months ago on this Blog I wrote that John Mattingly, Commissioner of New York City Administration for Children's Services was the only reform-minded leader of a big child welfare system who was still around when the backlash against his own reforms hit. I said that no one else in the country could have handled it better – but Mattingly himself could have done better than he did. He caved too much.
Now, it looks like he won't be so lonely. Right now hotline workers with copies of today's Herald at their desks are going to be scared to screen out anything, politicians already are jockeying for position – the governor is in a primary for an open U.S. Senate seat next year - legislators are going to have a field day – and I'll bet the Herald will fan the flames with one of those phony "react" stories, the kind that begin: "Responding to revelations in The Miami Herald that call screening at Florida's child abuse hotline endangers children, state lawmakers called for…"
And the buck will stop at the desk of Secretary Sheldon.
Whatever state lawmakers "call for" Sheldon probably shouldn't do it, since they'll probably call for things that will endanger more children. There should be no changes in current guidelines, no backing down from the fact that screening calls rationally makes children safer – and no new blue-ribbon commission or equivalent. To make sure the message goes out, loud and clear, that the errors go in all directions and errors in any direction can be equally harmful, any review of cases to see if they have been wrongly screened out should be accompanied by a review of an equal number of cases that may have been wrongly screened in. There should be a focus on helping frontline workers do a better job, call by call. The message to the frontlines has to be: We will help you to do your job better, but don't be afraid to exercise your best professional judgment.
PERCENT OF CHILD ABUSE HOTLINE CALLS SCREENED OUT IN FLORIDA AND NATIONWIDE
YEAR FLORIDA NATIONAL AVERAGE
1999 28.2 39.6
2000 6.3 37.9
2001 25.9 32.5
2002 36.9 32.9
2003 36.7 32.1
2004 27.8 37.3
2005 42.0 37.9
2006 53.2 38.3
2007 34.1 38.3
2008 27.8 37.5
2009 40.2 n/a
This chart was updated on April 3, 2010 to add the national average data for 2008.
Sources: 1999-2005, Florida and 1999-2008, national average: U.S. Department of Health and Human Services, annual Child Maltreatment reports, available online at http://www.acf.hhs.gov/programs/cb/stats_research/index.htm#afcars
2006-2009, Florida: Florida Department of Children and Families
Due to a mistake by DCF in reporting its data to the federal government, the figures through 2005 actually represent a combined percentage of child and adult protective services reports, but there are relatively few adult reports, so that is unlikely to change the percentages much. Data through 2005 also are by federal fiscal year (Oct. 1 through Sept. 30) data for 2006 through 2009 are for the state fiscal year (July 1 through June 30).