Sunday, January 27, 2008

The floggings will continue until morale improves

If you’re ever feeling a little down and discouraged, and you need a pep talk, here’s a word of advice: Don’t call Adrian Fenty, mayor of Washington D.C.

As was discussed in last week’s Blog, Fenty arbitrarily and capriciously fired six people after the death of four children known-to-the-system. (We still don’t know who the six are, but it appears that Fenty simply swung his ax at anyone who came near the case.) A few days later, he held a meeting with the demoralized caseworkers who still work at D.C.’s Child and Family Services Agency.

According to a story in The Washington Post, here’s how it went:

As Fenty (D) began an address that his aides said was aimed at motivating 200 District social workers Wednesday after having fired six of their colleagues, he heard a hissing sound. Who was that? Fenty demanded, to no avail. Collecting himself, he continued his remarks, challenging the employees to lift their performance, only to be interrupted again, this time by a woman who complained loudly that she felt disrespected by the mayor.
Fenty demanded her name. "You're dismissed," he said after she identified herself, waving his hand for emphasis. The crowd murmured. Anyone else who intended to be disrespectful could leave with her, the mayor added.
At least 20 others got up and walked out.

If the mayor’s arrogance were not bad enough, there’s the small matter of hypocrisy. When it comes to the problems that continue to plague the D.C. child welfare agency, problems which may have contributed to the deaths, the Mayor may well bear at least as much responsibility as any of the workers he fired. If he really wants to set an example for taking responsibility for child welfare failure, he’ll have to fire himself.

Because there is no elected official in Washington D.C. in a better position to know what a mess things are in child welfare than Adrian Fenty.

The D.C. child welfare system has had serious problems for decades. It holds the dubious distinction of being the only system to get so bad it was once taken over by a federal court. The court still oversees a far-reaching consent decree. And while clearly the system has been improving, those improvements have come far too slowly.

But Adrian Fenty didn’t just walk in the door. He’s been mayor for a year; plenty of time to review all the court monitor’s reports and get himself up to speed on the state of child welfare. And before he became Mayor he chaired the City Council’s human services committee. I can’t claim to have followed the committee’s deliberations, but I assume that, at least once in awhile, information about the condition of the child welfare system was brought to the committee’s attention.

So fixing child welfare should have been priority one from day one. He should have been looking then to see if the slow pace of reform was due to management resisting change or unable to implement it. If so, that was the time for carefully justified, well-targeted dismissals.

But the mayor didn’t act. And when the warnings grew louder he still didn’t act.
Just over two months ago, the independent court monitor overseeing CFSA’s performance called for “immediate and intensive action” to fix failings in how caseworkers assess the risk to children. Where was the mayor then? But it wasn’t just the Mayor who was AWOL. There was no outcry from the City Council and I have not been able to find a single news story about this report anywhere. What part of “immediate and intensive” don’t the council, the mayor and the entire D.C. news media understand?

But don’t expect any D.C. media to ask these questions. They’re all too mesmerized by Fenty’s supposedly refreshing bluntness and his supposed bold action in firing a bunch of mostly low-level employees.

And that’s not unusual. Although I was a reporter for 19 years there are a couple of things about my former profession I still don’t get. One of them is why reporters so often fall in love with anyone who promises to kick a-- and take names.

Almost inevitably, the arrogance – the sneer and the swagger – are confused with candor and frankness. In fact, anyone can be candid in dishing out blame, when you’re blaming someone else. In part the journalistic swooning may be simply that such public officials are good copy. But I think it runs deeper. It boils down to the fact that often they are saying, out loud and on the record, what reporters say to each other in the newsroom.

Inevitably, we all remember our worst encounters with municipal, state or federal “bureaucrats.” Anyone ever remember the DMV clerk who worked quickly and efficiently and greeted you with a smile? Not likely. Civil servants on the front lines whether police, teachers, or child protective services workers, are easy scapegoats for very big problems. And as reporters have grown more affluent (relatively speaking) they become more distant in every respect from people who often make less money doing harder jobs.

So anyone who comes in promising to kick around those “dopey bureaucrats” (to use the favorite phrase of another Fenty type who wreaked havoc on child welfare in his city for years) becomes, at least at first, a media darling.

Except, of course, when someone tries it in a newsroom.

The Fenty personality-type is familiar in newsrooms. It sometimes turns up among the less distinguished “investigative” reporters. The sneer and swagger permeate their dealings with people, and bleed through into their copy. In contrast, the very best in the business harbor as much, or more, outrage at real injustice, but still manage to treat everyone they encounter with dignity and respect – just ask anyone who, for example, has had the privilege of meeting the legendary team of Donald L. Barlett and James B. Steele, formerly of The Philadelphia Inquirer and Time magazine. The best in the business are like my favorite journalism professor, the late Phyl Garland: She always knew the difference between being tough and being mean.

When too many sneer-and-swagger types rise through the ranks, or when one makes it to the very top, an entire newsroom can wind up governed by a hierarchy of fear. The results can range from debilitating to disastrous, and at least once recently the disaster became a public spectacle.

Fenty’s rants about the D.C. government sound remarkably like the things another
kick a-- take names type said when he took over the job of running what is arguably America’s most important newsroom. His name was Howell Raines, and his tenure as executive editor of The New York Times didn’t go too well.

The case can be made that, in some government agencies, and in newsrooms, creating a hierarchy of fear can get results – at first. (Because of the tendency to set off foster-care panics, I wouldn’t say a child welfare agency is one of them.) But the combination of terror, burnout, and resentment ultimately backfires. At that point, rather than blame the tyrant, the reporters tend to blame a “bureaucracy resistant to change” – except of course when the tyrant was running the newsroom, and the reporters were the bureaucracy.

The real lessons

Last week, I also promised to answer a question I’ve been getting ever since I began dissenting from the Mayor’s approach. The question was put best by someone identified as jgarcia2 in a section of comments on the Washington Post website in response to the op ed column I wrote about this case. Writes Mr. or Ms. Garcia:

It's clear that Mr. Wexler disagrees with the mayor's reaction; however, it's unclear to me what he believes would have been the most appropriate community reaction or follow-up to this case. I get the feeling that he believes that we should have just chalked it up as an unfortunate incident; that there's nothing for the community to learn or do here as far preventing future things like this from happening.

That’s a fair question, and I’m going to defer to someone with more expertise than I to answer it. The following is from the City Council testimony of Judith Meltzer, the court monitor overseeing the D.C. child welfare agency:

Missed Opportunities with the Community
The District of Columbia’s pioneering work to establish the Healthy Families Thriving Communities Collaboratives grew out of a theory of change which acknowledges that public child welfare agencies, good, bad or indifferent, cannot protect children without effective community partnerships. The mantra of the early community partnership work in jurisdictions around the country was “Protecting Children is Everyone’s Business.”

The vision for the District’s Collaboratives over a decade ago was that their work to support families in their neighborhoods and communities was to be accompanied by out-stationing public child welfare workers in the community. The vision was that CFSA workers working in partnership with and with the support of neighborhood workers could more effectively engage families, link them to supportive services and prevent child abuse and neglect. This decentralization has been in the discussion and planning phases in the District for more than a decade. We know, from evidence around the country, that child welfare workers who are out-stationed in schools, neighborhoods, and other community settings are more likely to develop effective working relationships with residents, advocates, and a range of other service providers in the community to help address community and individual family’s needs.

It is a very sad commentary that none of the neighbors, family or family friends who knew the Jacks/Fogle children and family called the child protection agency to seek help. They either did not know who to call or were themselves afraid of the child welfare agency, viewing it only as a route to foster care and more trouble for struggling families. This relationship between the broader community and the child welfare system and its partners must change. The District’s plan for out-stationing workers in the community, in schools and with the Collaboratives has moved forward, stalled, and moved forward again, but has never come to fruition. Current CFSA plans call for moving workers to the neighborhoods and communities of the District this year. This plan needs to be implemented quickly along with the related work to change the ways in which child welfare workers interact with the schools, with the Collaboratives, with the faith based community, residents, advocates and with other community partners so that there are expanded channels of support and communication to both identify and support families in need.

Again, the outcome for Ms. Jacks and her children might have been different if CFSA and a network of helping agencies and community representatives were viewed as partners, and if concerned members of the community had confidence that together they could get help for families.

Sunday, January 20, 2008

Return of the Queen of Hearts*

Walk for a moment in the shoes of a CPS worker in a major American city. Here is all you know:

You have a report from a school social worker concerned about truancy because a 16-year-old girl has not been in school for several weeks. She says the mother won’t let the 16-year-old return to school because she fears the child will run away, and, mom says, the teenager is hanging out with the wrong crowd. Mom won’t let the social worker in and won’t let the teenager talk to her. The social worker characterizes this as “holding [the 16-year-old] hostage in the home.”

When you get to the home no one answers, so you leave a note asking the mother to call. That happens on Friday, April 27, 2007.

The following Monday, April 30, the school social worker herself returns to the home and speaks again to the mother. She calls police and says she thinks the mother has mental health problems. She thinks the children are “abused and neglected,” something she did not say before. The basis for this claim apparently was the truancy and the fact that the children and home don’t look clean.

When a police officer arrives that same day, he is not allowed in either. But he does speak to the mother and he sees all four children. He finds the children “well and healthy.” Mom claims she’s homeschooling the children. The officer sees the books mom says she is using, and tells her what procedures she needs to follow.

When you get there, once again, no one comes to the door.

What do you do?

Remember, the police officer saw no evidence of abuse or neglect. Yes, Mom wouldn’t let him in without a warrant, but in America, that is her right, and, indeed, many good parents would be wary about exposing their children to the trauma of a child abuse investigation. The school social worker suspects mental illness – but she’s also the one who characterized not sending a child to school because of fears of running away and hanging around with the wrong crowd as the equivalent of holding the daughter hostage – something also apparently contradicted by the police.

If you happen to be psychic, and know that the mother is named Banita Jacks, of you know what will be discovered months later; if you know that Banita Jacks may have been in the midst of a descent into madness after her boyfriend, father to two of her children, died; if you know that the children will be killed and their bodies left to rot in the home, if you know that the mother will be arrested and allegedly claim she thought the children were possessed by demons – if you know all that, then, presumably you drop everything and find a way to get into that home.

But if you are simply a typical caseworker in Washington, D.C.– juggling many other cases - then you move on to all those other cases that, on the surface, look far worse than a homeschooler with “well and healthy” children.

Yes, the case I’ve described is the same one you may well have been reading about; the one in which politicians have been racing to outdo each other in scapegoating frontline workers, the one in which, by telescoping incidents that happened over many months and leaving the impression that workers knew about all of them, it sounded as though caseworkers knew far more than they actually did.

And because the Mayor of Washington D.C., Adrian Fenty, has proven far more interested in making himself look good than in actually trying to improve the child welfare agency, he’s almost certainly set off a foster-care panic.

The mayor rushed to fire six people at the D.C. child welfare agency. Although we don’t even know who they are, commentators across the city have been cheering him on, assuming that he must have made the right decision. In fact, it appears that his deliberation amounted to little more than the equivalent of shouting “Off with their heads!” as he summarily fired anyone who came anywhere near the case.

While it certainly was not his intent, his actions have put the vulnerable children of Washington D.C. in more danger today than they were in yesterday. And his actions virtually guarantee that the D.C. child welfare system will be worse tomorrow than it is today.

Self-indulgence at children’s expense

The horror, the sadness, the revulsion we all feel after a case like this make all of us want to lash out at someone, at anyone. That might ease our pain, but it will only increase the chances that more children will suffer in the future. That’s why the Mayor’s embrace of the Queen of Hearts* School of Personnel Management is so damaging. We all owe the District’s children more than so self-indulgent a response.

Right now, every hotline operator, every worker, every supervisor in the District of Columbia Child and Family Services Agency (CFSA) is terrified of having the next case like the case of Banita Jacks on her or his caseload. So you can be sure they’re taking away more children for less reason than they were two weeks ago. Not only will that cause enormous harm to all the children needlessly taken, it also will actually increase the chances of another tragedy involving a child abuse death.

Like most of the nation, Washington D.C. is too small to be able to detect trends from child abuse fatalities, for a reason for which we all should be grateful: Though each is a terrible tragedy, there are few enough of them so the number can rise and fall due to random chance. But foster-care panics have swept through the few places large enough to detect such patterns. And, as is documented elsewhere on this Blog and all over this website, but especially in NCCPR’s Issue Papers, such panics have repeatedly been followed by increases in deaths of children “known to the system.”

And no wonder: With a foster care panic overloading workers, they have less time to make good decisions in any case. So they make more bad decisions in all directions. So more children wind up dead.

And I’m not the only one concerned about a foster-care panic. Washington D.C. is one of several child welfare systems operating under a consent decree as part of a class-action lawsuit, something I’ll discuss more in next week’s Blog. One of the few voices of reason in recent weeks has been the court-appointed monitor for the consent decree, Judith Meltzer of the Center for the Study of Social Policy. No one knows the D.C. system better. Meltzer’s taken no position on the Fenty firings. But in a part of her testimony at the obligatory City Council hearing (a part that went entirely unreported in the City’s media) Meltzer said:

In states across the nation, we have witnessed the negative fallout of public tragedies like this one, particularly in terms of the demoralization of the vast majority of workers who come to this work because they want to help people and who every day go above and beyond expectations. The work itself is difficult and emotionally charged, and we know all too well the difficulty of attracting and retaining staff in this field. We must be very careful that proper decisions to hold people accountable for performance do not have the unintended consequence of eroding the public’s confidence in the good work of many.

In addition, CFSA can expect an increase in calls to their hotline as the community is awakened to its responsibilities to notify others when they see families in trouble. In many systems, the fear that something is being missed typically results in increased and sometimes inappropriate decisions to remove children from their families. CFSA and the Family Court must expect these results and plan to respond appropriately – by having additional staff trained and available to appropriately handle all hotline calls and investigations and by being vigilant about their practice and decision making so that children who can be maintained at home safely are not unnecessarily removed.

So now, lets go back to that crucial moment when the CFSA caseworker knocked on the door of Banita Jacks and no one answered.

What else should the CFSA worker have done?

● Break down the door? That’s illegal in America.

● Get the police to break down the door? Still illegal.

● Get a search warrant and then break down the door? On what grounds? There’s no evidence of abuse or neglect – a school social worker’s peek-through-the-door assessment of cleanliness is not evidence. It’s not even clear the children are truant, since the children had been in charter schools and apparently, in Washington, D.C., there are few rules about removing children from charter schools and homeschooling them.

What the worker did do was return the next day, with a police officer. And then return the day after that on her own. Both times, again, no one answered the door. Then she turned the case over to CFSA’s Diligent Search Unit. More on that later.

What were the other cases like?

I keep asking the question about what the worker should have done, but I get very few answers, and, frankly, the answers I’ve gotten aren’t very good.

One answer I’ve heard is that the worker should have spent hours canvassing all the neighbors, and then trying to track down all of Ms. Jacks’ relatives.

Just one problem: We don’t know how many other cases this worker had and what those other cases involved.

What if the next item on her “to do” list was a mother who claimed her ex-husband was raping their daughter. What if the one after that was another school social worker calling about a child who came in that day covered with bruises? We don’t know if this is the case, of course – but neither does the Mayor. He told WWWT Radio he made his decision based solely on “the file” – apparently the written record for the Jacks case alone – and a recording of the school social worker’s call to the District’s child abuse hotline. Not only did he fail to speak to any of those he fired, he did not even examine the rest of their caseloads, much less their history with CFSA, something I’ll get back to below.

So while we don’t know what else this worker had to do, it’s hard to imagine a case which, on the surface, without benefit of hindsight, would seem less serious than a mother whose children looked “healthy and well” to a police officer but who, apparently, failed to file the right paperwork before homeschooling them.

It’s also been suggested that, based solely on the social worker’s call, the worker should have gotten a warrant or figured out some clever ruse to talk her way in, or even broken down the door.

The irony here is, that probably would have worked with someone who was sane. “Open the door or I’ll take away your kids!” generally works, even though it shouldn’t. And, in point of fact, judges are so prone to rubber-stamp child welfare agencies that it’s quite possible that had she asked for a warrant, a judge would have taken the usual Fourth-Amendment-be-damned attitude and issued one.

But only with hindsight could that be considered the right course of action. Those calling for such actions should think long and hard before suggesting we should live in such a society.

Even when it does not lead to removal from a home, a child abuse investigation is not a benign act. It can be enormously traumatic to a child; indeed, it can scar a child for life. That danger is increased if, as often happens, the investigation is accompanied by a stripsearch as a worker looks for bruises.

Before you force your way in and do that to a child, you need more than a social worker's guess about mental illness and the fact that a child has been truant. Yes, this time the guess was right. Many more times it will be wrong.

Worshipping at the altar of social work

Indeed, among the most alarming ideas to spring from this case is the notion that we should bow and scrape before the guesswork of anyone who happens to be – and this seems to be spoken with reverence and awe - a licensed social worker.

For starters, in this case it was a school social worker, who may or may not have had expertise in child abuse investigations. (And by the way, the investigator who didn’t break down the door was, herself, an MS-W; D.C. is one of the few systems to require this of all child abuse investigators.)

If anything, a licensed social worker should know better than to offer a diagnosis based on a quick conversation through what was probably a barely-opened doorway.

Second, psychology is as much art than science. I wouldn't trust a licensed psychiatrist to diagnose mental illness from a brief conversation in someone's doorway, let alone a licensed social worker. Indeed, you can be sure that somewhere there can be found a licensed psychologist, psychiatrist or social worker who would diagnose any of us as mentally ill – and another one who would contradict it. And that’s not hyperbole. A review of scores of studies on the psychiatric decision-making process concluded that we would do about as well if we tossed a coin. “There is good reason to believe that psychiatric judgments are not particularly reliable or valid, and that psychiatric diagnoses and predictions convey more erroneous than accurate information,” the researchers wrote.

Third, there is the little matter, overlooked in almost every news account, of the police officer contradicting the social worker.

Ah, but of course, say those who insist the firings were justified, we should always listen to the social worker – she’s the expert! What do cops know?

Funny thing: As was noted in this Blog on August 13, 2007, after the horrifying death of Nixzmary Brown in New York City, when caseworkers missed much more obvious warning signs, everybody said the solution is more cops, because they're more likely to know there's trouble in a home – so the New York City child welfare agency rushed out to hire retired cops.

The hindsight brigade

The hindsight brigade also is pointing out that the incident I’ve described so far was not the only warning in this case. Recall how the case was turned over to the Diligent Search Unit. Apparently they were not very diligent. After hearing that the family had moved to a county in Maryland they contacted the county. More than a month later, when that county reported being unable to find the Jacks family, CFSA did nothing.

Negligence this time? Maybe. Or maybe the Diligent Search Unit had so many cases that looked a lot more pressing than what looked at the time like no more than a truancy case involving a mother who did not fill out the right homeschooling forms that it gave those other cases priority. Once again, I don’t know. And, once again, neither does Mayor Fenty.

But there also was still another warning, before the two I’ve mentioned. This one goes all the way back to August 2006. Suffering from cancer, Jacks’ boyfriend left a hospital against doctors’ advice. A nurse suspected that he and/or Jacks might be abusing drugs. And the entire family was living in a van. When the nurse gave this information to a hotline operator he refused to accept the call – because the family had no fixed address.

This is the one absolutely unambiguous failure on the part of the child welfare agency. But if we’re going to use hindsight, that cuts both ways. A few months later the family apparently was o.k. They were living in their own rented home. The children were in school and had been seen by the D.C. Health Department.

In fact, if what is widely suspected, as reported by The Washington Post, is correct, even had CFSA accepted the call it is unlikely it would have changed anything. That’s because it appears that things did not start to go terribly wrong until the following February when the father died. That is when, if news accounts are correct, Banita Jacks began a descent into madness.

But Mayor Fenty’s response to all this was to take no care, and draw no distinctions. Like the Queen of Hearts, he effectively yelled “Off with their heads!” and swung his ax wildly, hitting, as a union representative put it “everyone who touched this case.”

As of now, we don’t know who these people are. We don’t know how close any of them really were to the case. We don’t know what else was on their plates. And, perhaps most important, we don’t know their overall records. We don’t know if the six fired workers were lazy clockwatchers with long records of mediocrity or worse, or whether they were outstanding employees whose personnel files are filled with commendations for saving children’s lives. Perhaps it’s neither. Perhaps it’s some of each. We don’t know. And the Mayor almost certainly doesn’t know either.

As a result, the firings do nothing to enhance accountability. On the contrary, they enhance a CYA mentality. They tell workers that nothing they do, good or bad matters; all that matters is whether their name winds up in some way somehow connected to a high-profile fatality. Such arbitrary, capricious personnel management is the opposite of true accountability. And in the case of Mayor Fenty, it’s all laced with hypocrisy.

That story next week. Also next week, I’ll give the long answer to a question I’ve gotten a couple of times in the past couple of weeks: “Are you saying nothing can be done in cases like this?” Here’s the short answer: No, that’s not what I’m saying.

Meanwhile, as the cliché goes, it seems that in the Washington D.C. child welfare agency, the floggings will continue until morale improves.

In contrast, consider the approach taken by a gutsy child welfare administrator in Florida, first noted on this Blog last August and reprinted below. Then ask yourself: Where children are dependent on the child welfare agency to be safe, in which community are they likely to be safer?

*-I am indebted to the copy desk at The Washington Post for pointing out, when I submitted an op ed column on this incident, that my original choice of phrase “Red Queen school of management,” also used below, is incorrect. They are two different Lewis Carroll characters, and it’s the Queen of Hearts who yelled “Off with their heads!”

REPRINTED FROM: August 6, 2007

This is a story about class and courage at a child protective services agency – in Florida, no less.

It doesn’t begin well, of course. It begins the way many stories begin with the death of a child “known to the system” in Palm Beach County, Florida, last year. The case was ambiguous; not one of those where the file had more “red flags” than a Soviet May Day parade. It’s clear the caseworker should have asked more questions. But there is nothing to indicate the worker’s supervisor, Michele Fuhrman, did anything wrong.

And Fuhrman, a 20-year veteran, was not your average supervisor. According to The Palm Beach Post:

DCF bosses regularly judged Fuhrman's work as outstanding. As an investigator, she routinely came to work at 6:30 a.m. to field calls and joined the rapid response team, which meant that she could be called in at any hour to investigate critical incidents of child abuse.
"Michele's honesty, caring attitude and excellent child safety assessment skills stand out the most," a supervisor wrote in 2002.
Over one 17-month period from 1999 to 2000, Fuhrman investigated 336 cases, many of them time-consuming and complex, according to her file. She volunteered to take the most difficult cases and often pitched in to help others with their own cases.

But child welfare agencies are firm believers in the Red Queen School of Management. And the aftermath of the death of a child “known to the system” is never complete without the Ritual Sacrifice of the Caseworker. So the Florida Department of Children and Families first demoted Fuhrman and then forced out of her job.

And there the story would have ended, if not for Alan Abramowitz. Abramowitz has become something of a trouble-shooter for DCF – and that makes him a very busy man in Florida’s now heavily-decentralized, heavily privatized child welfare system. He and the head of the privatized lead agency in Volusia and Flagler Counties, Ron Zychowski, played a key role in turning around that district. Then he led major changes in the Orlando area. About a month ago, he was sent to Palm Beach County as acting District Administrator there.

Some years ago, Abramowitz had been Deputy District Administrator in Palm Beach County. He knew Fuhrman and he knew her good work. So among his first acts as acting District Administrator: Offered Fuhrman her job back.

Fuhrman, in fact, had landed another, very good job. She was doing just fine. But she cared too much about the children to turn the offer down. So I don’t know which is more impressive: Abramowitz making the offer or Fuhrman, who had every reason to tell DCF exactly what it could do with its job, accepting.

Now, an injustice to one individual has been at least partially rectified. The children of Palm Beach County once again will benefit from Fuhrman’s experience, dedication and good judgment. And, for once, a child welfare agency is sending the right message to the frontlines: We’ll hold you accountable when it’s really your fault, but we’re not going to make you scapegoats.

A little class and a little courage can trump the Red Queen.

Sunday, January 13, 2008

Sleepless in St. Petersburg

Fresh from suggesting that pretty much every child who drowns in the state of Florida is, in fact, a victim of neglect, Manatee County Sheriff’s Major Connie Shingledecker, who chairs the Florida Child Abuse Death Review Committee, has another target: Co-sleeping.

There is considerable controversy over co-sleeping, as there is over many things involved in child rearing. In the United States, a lot of medical authorities, including the American Academy of Pediatrics, discourage it. Even advocates support it only if parents adhere to a list of common-sense precautions. News stories that emphasize the urgent need for such precautions, and include the perspective of those who think co-sleeping is beneficial and those who feel the benefits never outweigh the risk, perform a valuable service.

It would have been nice if such a story had appeared in the St. Petersburg Times a week ago instead of what actually turned up in that newspaper. Judging by the comments from Shingledecker and everyone else quoted, you would never know there is more than one side to this story. You’d never know that some advocates argue that mothers and babies were “designed” for co-sleeping, and they think it can benefit both. More important, the story went well beyond what could best be described as the cons and cons of co-sleeping into a series of finger-wagging attacks on any parent who engages in the practice. The message from almost everyone quoted in the story is that any parent who shares a bed with her infant is a selfish lout.

Co-sleeping is, in fact, the norm in much of the world, often by necessity, but also sometimes by cultural custom. According to a more balanced story in The New York Times, “some ethnic groups, especially Asians and Latin Americans, consider the North American norm of relegating infants to separate rooms to be coldhearted and psychologically harmful.” But in the St. Petersburg paper, the only hint that this might be a cultural issue comes when the story says that one doctor “doesn’t believe it’s a cultural issue as some advocates assert.

"’People just out of habit, when the baby is crying, they bring them into bed,’" the St. Petersburg pediatrician said. ‘It's a convenience. It takes a lot of effort to break them out of the habit.’

But he was outdone by Florida’s leading advocate of a take-the-child-and-run approach, Andrea Moore who heads a group called Florida’s Children First. Said Moore: “For some parents it’s an issue where the parents want the warmth and contact, but it’s based on more of the parent’s need, not the child’s need.”

Such a comment is especially harmful coming from someone with as much influence as Moore. For some Florida reporters, Moore is the Godsource – she turns up in almost every story, her words are viewed as Holy Writ and dissent is marginalized, or doesn’t appear at all.

According to The New York Times, in America, “Black infants were four times as likely as white infants to share an adult’s bed, and Asian Americans were almost three times as likely.” So I have to wonder: Does Ms. Moore believe that Blacks and Asians are inherently more selfish than her fellow middle-class whites?

The St. Petersburg story combines horror stories and data about the raw number of co-sleeping deaths – plus speculation from Maj. Shingledecker that the “real” number of such deaths is “huge.” But the data draw no distinction between the alcoholic who falls asleep in a drunken stupor and then rolls over on the baby next to her on the couch, and people who take proper precautions. That’s like reporting on children killed in auto accidents without breaking out children killed by drunk drivers and children who were not properly strapped into their carseats. (And, just as in the story discussed on this Blog last week, about drownings, the story includes an example of a death in foster care labeled “neglect” that, in fact, sounds more like an accident.)

The data also offer no comparison between the raw numbers and the number of parents who engage in co-sleeping, so it is impossible to tell the actual level of risk and how it compares to other everyday risks.

The New York Times also cited those who think co-sleeping is always dangerous. But, apparently based on the quaint notion that readers should hear all sides and make up their own minds, it also noted that

Dr. James J. McKenna, head of the Mother-Child Sleep Lab at the University of Notre Dame, an advocate of mothers and babies sharing beds, drew the opposite conclusion. Baby deaths from suffocation "are in extreme situations — being with Dad on the couch when he's half-drunk," Dr. McKenna said, while the comfort and closeness babies get from sleeping with their mothers makes them "more independent and able to deal with stress better.”

And it’s not as if Florida’s self-proclaimed “best newspaper” has never heard of Dr. McKenna’s Lab. In a box accompanying the story, the lab is cited as a source for some safety tips for those who, to use the St. Petersburg paper’s word, “insist” on co-sleeping.

A good case can be made against co-sleeping, on grounds that overtired parents may not take the proper precautions every time. What is disturbing, however, is the rush to assume the worst of any parent who disagrees – the attitude of the Andrea Moores of this world, who say, in effect: if you’re not exactly the kind of parent I am, you must be stupid or selfish or both.

At a minimum, editors might want to give careful consideration to diversifying the points of view in such stories. Not that they should jump to conclusions. Perhaps they could sleep on it.

Sunday, January 6, 2008

Drowning in Misinformation

You’re late for work one morning. Before you get to work you need to get your two-year-old daughter to day care. You’ve just buckled her into her car seat – or did you? - when you remember some extremely important document you left in the house.

You know what you’re supposed to do – unbuckle your daughter and walk her or carry her back in with you; but you’re running late, it’ll only take a second and, what could possibly happen?

999 times (or more) out of 1000: Nothing. But there’s always that one time that can lead to catastrophe – especially if you hadn’t quite buckled the child in.

That’s just one scenario.

Are you sure you childproofed every electrical outlet? What about the one behind the sofa – until you rearranged the furniture last month? Now that your child is three, are you certain she can’t unlatch the back door? Are there any heavy items of furniture, even big books on high shelves, that can come loose while your back is turned or you’ve just run into another room to answer the phone? And, are you absolutely certain you locked the sliding door that leads to the swimming pool?

The number of such scenarios is endless; I suspect any parent could come up with a dozen variations off the top of her or his head. And, according to the Florida Child Abuse Death Review Team, unless you can honestly say none of them has ever applied to you, you are guilty of child neglect.

That means almost every parent in Florida, and pretty much everyplace else, is guilty of neglect. But if everything is neglect, nothing is neglect. It only desensitizes us to the real thing. And that’s the least of what is wrong with the approach the Team has taken in its latest annual report, which exanmines deaths that occurred in 2006 and was released at the very end of 2007. The worst of it is the incredible cruelty of its recommendations – and the harm those recommendations can do to the siblings who survive after a scenario like the ones suggested above takes the life of a child.

As usual in child welfare, the cruelty and the harm are not intentional. If I’d spent a huge amount of my time pouring over autopsy reports and other documents about the deaths of helpless, innocent children, I think it would distort my perspective as well. The resulting report is another example of the distortion inherent in a skewed sample, something discussed on this Blog previously in connection with reports from the New York City Department of Investigation and the New Jersey Office of Child Advocate. Tragically, the Florida team has a larger sample to work with, since it looks at every child maltreatment death in the state, and it is now applying a very broad definition of maltreatment – but in a state with four million children, the sample is still grossly unrepresentative.

This kind of distorted perspective becomes a form of self-indulgence – indulging one’s righteous wrath, even if the consequences are only more harm to more children.

In one sense, it would be in my interest not to bring all this up. The report generated headlines across Florida about a supposed record number of child abuse deaths. That reinforces what NCCPR has been saying in that state for a long, long time.

We first predicted that deaths would go up in 1999, when the child welfare agency came under the control of a leader more hell-bent on a take-the-child-and-run approach than any we’d encountered anyplace else in the country. She set off a huge foster-care panic; removals soared 50 percent in a single year. Though she’s long gone, and there now are wide variations in different regions, the foster-care panic she started never stopped, and statewide, Florida still takes children at the same rate as in 1999. (For more on all this, see NCCPR’s Florida Rate-of- Removal Index and our other reports on child welfare in Florida).

Unfortunately, our prediction about fatalities was correct. We’ve argued that the only hope for reducing such deaths is to rebuild the system to emphasize safe, proven programs to keep families together. And as the Florida system decentralizes, some parts of the state are trying to do just that.

So, if we used “advocacy numbers” and felt that it was o.k. to bend the truth because, after all, it’s for a good cause, (something done over and over by various alleged ‘child advocates’) NCCPR would put out a press release that said Florida’s ongoing embrace of a take-the-child-and-run approach to child welfare, statewide, had led to still another huge increase in child abuse deaths.

There’s just one problem: We don’t know that it’s true. In fact, it’s probably not.

It’s not entirely clear, either from news accounts or the report itself, but it appears that the “increase” is a result of a concerted effort to label scenarios like those above neglect instead of what they really are: accidents. Terrible, tragic accidents, but accidents nonetheless. The kinds of accidents that should make all parents of young children think twice, but before wagging a finger, also make us think: “There but for the grace of God…”

Consider some real cases, as reported by the St. Petersburg Times in its story about the Death Review Team report:

Joyce White, 54, of Plantation was sitting on the front porch with her 3-year-old grandson when the phone rang.

When she returned, Garcie Luna was gone. He was found in a neighbor's pool. The fence surrounding the pool had been damaged during Hurricane Wilma and was missing a gate.
"It was just a few seconds of carelessness on my part for answering the phone and my neighbor's part because they didn't fix the gate," White said of the death in March 2006.
"It's torn our lives apart. It was more than I could take losing him, especially for something so stupid."

Ann Unger set her 9-month-old daughter on the floor of the family's Plant City home and headed to the bathroom. Angelica, a fast crawler, usually followed close behind. Not this day.
Five minutes passed. Or was it six?
When Unger, 22, returned to the room, Angelica wasn't there. A frantic search ended in the backyard pool, where Unger found the child floating face down.
The mother's screams pierced the neighborhood as efforts to save the baby failed. Angelica Unger died on Jan. 24, 2006, three months before her first birthday.
In the past, her death likely would have been considered accidental, a family tragedy. But investigators labeled her death a result of parental neglect. Unger had left open the door that led to the pool. …

Or consider a case that would, were I to accept the Review Team’s new definition of neglect, reinforce the case I’ve been making for years:

Cara Eaton's drug problems prompted caseworkers to take her infant daughter.
But weeks later, the baby died in foster care. The one-month-old suffocated after her Sarasota County foster mother put her to sleep face down.

Eaton, 31, of North Port blames DCF and its foster care contractor, the Sarasota Family YMCA. She wanted the child with her grandmother, instead of foster care.

But, if this is all that happened, Cara Eaton is mistaken. The Review Team report notes that nationwide there is a “back to sleep” campaign to alert parents to the fact that it is safer to put an infant to sleep on his or her back. Odds are the foster parent simply didn’t know it or, if it was part of her training, she forgot it.

The grandmother might have made the same mistake. (There are lots of other reasons to prefer kin placements, of course). It was an accident. Accidents happen. That doesn’t mean we have to be sanguine about it; on the contrary, we need to focus more efforts on real prevention, but that begins by recognizing accidents for what they are.

Of course the Times story also included some very different scenarios, like these two:

Alyssa Doe's mother left her to die in a West Tampa alley shortly after she was born. Relatives alerted police to her mother, Mary Louise Doe, after finding her no longer pregnant and unable to explain where the baby was. Mary Louise told authorities that alcohol and crack cocaine blurred her memory of the birth in May 2006. A judge sentenced her to five years in prison and 10 years of probation. Alyssa Doe was just one of many children who died while their caretakers were under the influence.

Hunter Lanier, 2, of Santa
 Rosa County died in a car accident after his mother wrecked after drinking and driving.
But that’s the whole point. Any reader can draw common sense distinctions here. The Death Review Team should be able to do so as well. Yes, there also are fact situations that fall in between, where the judgment call is tougher, but that’s part of the job.

Instead, the Review Team seeks to prohibit such judgment calls at all. It demands that every drowning death be reported to the state’s child abuse hotline for a neglect investigation.

The Review Team would argue that I don’t understand; none of this is meant to be punitive, they would say, we just need to label these cases as neglect in order to bolster prevention efforts. But why? Why, exactly, does it require labeling someone neglectful – and possibly taking away surviving siblings – in order to get more people to be sure the door to the backyard pool is locked?

Obviously it doesn’t. As with so much else in child welfare, this is another example of hate disguised as love. It’s not about helping children, it’s about punishing “bad parents.” Almost all of the recommendations involve doing more to treat parents as suspects and/or to punish them. Apparently, nobody on the Review Team even thought of a simple and obvious way to reduce drowning deaths: Florida law already requires fencing around pools built after 2000. So why not give a big tax credit or other incentive to homeowners and landlords who fence in their older pools? But that doesn’t involve wagging a finger at parents, so it’s not on the Team’s radar.

It also is revealing that Manatee County, the county where the chair of the review team is in charge of child abuse investigations, has the highest rate of removal in its region, and one of the higher rates in the state.

And the Review Team’s approach undermines real prevention.

For starters, all the money for all those additional investigations and additional foster care could have been used for things like a more effective “back to sleep” campaign – or those tax credits to put fences around pools.

Worse, it plays into the take-the-child-and-run mentality that still plagues much of Florida.

The worst consequence of that is the danger to the siblings.

There may be no time when it is more important for a family to stay together than in the wake of a tragic accident. But once you label the parent neglectful, the chances soar that the surviving siblings will be torn from their parents, and each other. So at the one time when, say the four-year-old brother of the two-year-old who drowned most needs his big sisters, ages 6 and 8, and his mom and dad, he is taken away from all of them and suddenly placed with strangers. It would be hard to find a better way to almost guarantee lifelong emotional scarring. Indeed, the four-year-old is likely to think he’s somehow responsible for the drowning – why else is he being punished?

Of course that won’t always happen. It depends on who’s running the state child welfare agency. And who’s running the private agency in charge of all substitute care in a given region of the state, under Florida’s “privatized” system. And who’s in charge of the child welfare agency in that particular region. And, perhaps most of all, it depends on whether a high-profile child abuse tragedy is in the headlines locally.

Not only does the Review Team fail to recognize this, the Team actually belittles the compassion of those who do. According to the report: “Often drowning deaths are not reported as neglect. It is felt that ‘the family has suffered enough’ or ‘it’s just a tragic accident.’”

But that’s because, in many cases, the family has suffered enough, and it is a tragic accident. (No one in fact would call something this awful “just” a tragic accident – that’s the Team’s way of stacking the rhetorical deck).

The report argues that any drowning in a bathtub “should be looked at as neglect” since the only way to be sure it never happens is for the caretaker always to be in the bathroom with the child.

And that is the heart of the matter: If a parent in such a circumstances runs out of the room to answer the door or the phone and the child dies, then the death was, indeed, preventable. But what is accomplished by slapping the label neglect on the parent? What is accomplished by, in some cases, throwing the siblings into foster care – where the risk of actual abuse probably is one in three?

Nothing. In fact, under circumstances like these (as opposed to those where the failure to supervise is due to drug abuse, for example) the one person in the state of Florida least likely ever to leave a child alone in a bathtub ever again is the one who has endured such a tragedy.

While not as serious a problem, the Review Team report also contributes to Statistics Abuse. I began this post with one example – claims that there were a record number of deaths in Florida in 2007. This is still another reason why it’s difficult to measure progress, or lack of it, in child welfare based on fatalities. What constitutes a child abuse fatality can be surprisingly subjective. Last year’s accident is this year’s “neglect” death.

And not only can definitions change from year to year, they also vary from state to state, and even region to region within a state. The competence of state death review efforts also varies enormously.

That’s why one of the most intellectually dishonest things an advocate – or a reporter, if she or he knows better – can do is to try to compare fatality rates among the states. The only thing that does is penalize states that are rigorous about determining causes of death and zealous (rightly or wrongly) about labeling a death as maltreatment.

For example, several years ago, Washington State bragged about its low rate of child abuse fatalities compared to other states. Then the Seattle Post-Intelligencer did a series on how many such deaths allegedly were unreported and/or mislabeled.

This kind of statistics abuse also fuels the hype about child maltreatment in general. For example, the St. Petersburg Times story says:

An analysis of 2006 state death reports, the latest data available, shows seven out of 10 child deaths were due to neglect.

Well, yes. And if the Review Team keeps broadening the definition of “neglect” in a couple of years it will be nine out of ten – and it will mean absolutely nothing. But it will make a great “scare number” to make people think “neglect” is far more prevalent than it actually is.

What the Review Team report really illustrates is the need to focus more attention on deaths due to accidents. Of course, Freud said there are no accidents. But I’ll bet Mrs. Freud raised the kids.

Tuesday, January 1, 2008

Turning foster children into unpersons

Correction: This post states that the Kansas child welfare agency licenses the state's foster homes and institutions. In fact, that is done by another state agency.

If torturing logic were a war crime, the Kansas Department of Social and Rehabilitative Services (SRS) would be hauled before an international tribunal.

In previous posts to this Blog I described how the state’s most populous county, Sedgwick, was taking children from their homes and institutionalizing them for more than a week before there was even a court hearing. It was all done at the whim of the state child welfare agency and local law enforcement.

When the legislature told Sedgwick County that it had to do what every other county in Kansas does – hold that first hearing within 72 hours – various county officials threw a fit, declaring that they needed to hold the children in foster care for a week in order to prevent foster care.

That really is what they said. You see, according to both county officials and the State of Kansas that week in an institution is not foster care. Why not? Because they don’t call it foster care, they call it “protective custody.” And if that isn’t absurd enough, the federal government is buying into the distinction, and letting Kansas get away with keeping huge numbers of foster care placements “off the books” for statistical purposes. That has implications for the safety and well-being of children well beyond Kansas.

The deputy district attorney in charge of these cases in Sedgwick County estimates that 80 percent of the children taken away this way go home or are placed informally with a relative within that first week – which raises an obvious question: If 80 percent of the children you take away can go home or be placed with a relative within a week, did those children really need to be taken away in the first place?

One possible way to answer that question is through a process called a Child and Family Services Review (CFSR), a process the federal government uses to examine each state’s child welfare system every few years. It’s actually a pretty pathetic process that can produce misleading results – see NCCPR’s publication The Trouble With CFSRs for details – but unless your particular state happens to be under a good consent decree, there’s not much else out there.

But when the federal reviewers come to Kansas, they’ll never know about all those children taken from everyone they know and love and then “thrown back” within 72 hours (or, until 2007, within a week in Sedgwick County).

That’s because Kansas either is violating federal regulations, or has concocted a clever scheme to exploit a loophole. Either way, Kansas has turned all these children into what George Orwell called “unpersons.” When it comes to the data Kansas shares with the general public, state legislatures, and the federal government’s national database on foster care, these children simply don’t exist.

They don’t exist because they were never in foster care. They were only in “protective custody.” And, SRS says, they were in the custody of law enforcement, not SRS.

Yeah, right.

Here’s how it all works: Every state is required to report data about its foster care system to a central federal database, the Adoption and Foster Care Analysis and Reporting System (AFCARS). It’s administered by the Administration for Children and Families which is part of the U.S. Department of Health and Human Services. AFCARS data help the federal government determine how well the system is serving America’s foster children. They help point out states that may be leaders and states that may be doing particularly poorly. And the data are used for the CFSRs.

AFCARS has bred a plethora of regulations and a huge online policy manual. And where there are lots of regulations, there are lots of potential loopholes. Kansas may have found one.

AFCARS requires that, whenever a child is taken from his parents because of suspected abuse or neglect and kept out of the home for at least 24 hours, the state must report this as an entry into foster care.

AFCARS also requires that states report the total number of foster care placements endured by each child. This is vitally important because the trauma of foster care is compounded when a child is forced to move repeatedly from one placement to another.

In Kansas, when a child is taken away without a court order it is done by law enforcement. Even though, in many cases, it is SRS that asked that the child be removed, the physical act of removing that child and driving him to that first placement, is performed by a police officer. (The trauma is compounded in Sedgwick County, because the first placement often is an institution, the Wichita Children’s Home). Therefore, says SRS, the child is in the protective custody of law enforcement, therefore, SRS says, we don’t have to report it. In addition, if SRS keeps custody after the court hearing, but the child is moved to another placement that same day, that first placement in the Wichita Children’s Home never goes on the books. What is really two placements appears as only one.

But AFCARS regulations don’t actually say that the child welfare agency has to have “custody” for a placement to count.

Rather, the online manual says that “the State is required to count a placement that lasts more than 24 hours while the child is in foster care under the placement, care or supervision responsibility of the State agency” [emphasis added].

When it comes to such placements in Kansas:

● It is SRS that often asks law enforcement to take custody in the first place.
● The children generally are placed in a home or institution that must be licensed by SRS.
● SRS workers visit the child while in the facility.
● In the case of the Wichita Children’s Home SRS workers even are on site to oversee the case.
● SRS develops the plan to either send the child home, place the child in informal care with a relative, find a foster home with strangers, or keep the child in an institution.
● SRS foots the bill. SRS reimburses institutions like the Wichita Children’s Home for the cost of these placements.

That sure sounds a lot like “placement, care or supervision responsibility.”

Whether or not the placement “counts” to SRS, whether or not it “counts” to the Sedgwick County District Attorney’s office, and whether or not it “counts” to the Administration for Children and Families, we may be sure of one thing: It counts to the child.

Apparently the Kansas Legislature thinks so, too. Because under Kansas law, it is not the police, but rather the home or institution where the child has been placed – such as a temporary foster home or the Wichita Children’s Home – that is deemed to “have physical custody and provide care and supervision for the child.” As noted above, such facilities typically are approved and licensed by SRS.

Here’s how all this has an impact on the CFSR process:

During that process, states are evaluated two ways: Evaluators look at the data compiled by the state and reported to AFCARS, and the reviewers conduct what is supposed to be an in-depth examination of a total of 50 cases from three counties. One of those counties has to include the state's largest metropolitan area - in Kansas that's Sedgwick County, where the problem of off-the-books foster care placements is worst. The files examined in these 50 cases are the child welfare agency's case files.

CFSRs are supposed to address issues including:

● Did the agency keep the child safe?
● Did the agency keep the child in her or his own home whenever possible?
● Did the agency avoid moving the child from one placement to another?
● Did the agency avoid needless use of "congregate care" - group homes, institutions, shelters?

So here's what happens when the reviewers come to Kansas:

● They won't know that a large number of placements ever occurred at all.

● Many of these are placements the reviewers probably would say were unnecessary, since the child was returned home or placed informally with a relative within a week. But they won't know about those placements when they "grade" Kansas on avoiding needless foster care.

● Both the state data and the casefiles are likely to understate the number of placements, since Kansas sometimes does not count that first placement in a shelter.

● The data will understate Kansas' use of congregate care, since many of those first placements, at least in Sedgwick County, are in an institution, the Wichita Children's Home.

I am not aware of any other state which engages in this kind of manipulation of data – and no one I’ve spoken to is aware of any either. And NCCPR can confirm that states responsible for at least one-third of entries into care either can’t engage in a similar dodge or won’t. That means Kansas’ evasion has implications well beyond the state’s borders – it compromises the ability to compare state performance and the integrity of the entire AFCARS process.

But ACF is looking the other way. We first asked the Acting Associate Commissioner in charge of the Children’s Bureau, Joe Bock, to tell us if this kind of dodge violated federal regulations without telling him which state was involved. That way we could be sure any opinion would be untainted by even the appearance of political concerns. (The Bush administration has politicized the CFSR process at least once before, when Florida, then governed by Jeb Bush was given special consideration in choosing which counties would be evaluated).

But Bock refused. He claimed it was his policy to refuse such requests, but also said the policy is not in writing. After we then told him the state, Bock sent a letter to NCCPR claiming that Kansas was not violating federal regulations.

Therefore, today – January 2 - we have asked the Acting Commissioner’s acting boss, Acting Assistant Secretary Daniel Schneider, to reverse that decision. ACF has reversed itself before when similarly absurd rulings led to bad press. But this time there may be a complication.

Guess what state Schneider is from.