Monday, November 2, 2009

Child abuse and foster care: The “dead armadillo” school of child welfare reform

Americans may identify as liberal or conservative, but they like best thinking of themselves as moderates. The very word moderate is flattering. Moderation implies thoughtfulness, it suggests looking at each situation individually and rendering a custom-tailored judgment. And it suggests that anyone who disagrees with you is an extremist who believes in "quick fixes" and "one size fits all."

That's why every good politician has one rule: Whatever ground you're standing on, claim it as the middle ground.

That works especially well on journalists, who tend to be, as one excellent reporter I know put it long ago, "knee-jerk moderates." (That's why news stories always seem to be filled with "swinging pendulums" and assurances that "the truth, of course, lies somewhere in between.")

But jerking one's knee toward moderation is as wrong-headed as jerking it in any other direction. And sometimes it's worse. Often, as Jim Hightower says: "there's nothing in the middle of the road but yellow stripes and dead armadillos."


Which brings me to a peculiar op ed column by John Mattingly, commissioner of New York City's Administration for Children's Services (and before that, director of Human Services Reform at the Annie E. Casey Foundation, where he recommending that they fund NCCPR – perhaps not his favorite recommendation right now.)

The op ed is not peculiar in substance – on the contrary, it's the very soul of knee-jerk moderation and claiming the ground you're on as the middle. What's peculiar is the fact that it was published in the Milwaukee Journal-Sentinel and offers advice on how to fix child welfare in Milwaukee. (Much of it is generic, however, and I can imagine other versions turning up across the country.)

Even more peculiar, a lot of Mattingly's advice to Milwaukee appears to be at odds with what's happened in New York City.

The heart of the column appears to be a paragraph in which he sets himself up to claim that sacred middle ground by describing the "typical" response to high-profile child abuse deaths. The paragraph begins this way:

Even more typical, however, are the pressures that Wisconsin already has felt to fix the problem and fix it now, in one of two contradictory ways: 1) Make child protection the "No. 1" response and err more on the side of child safety;

OK, let's stop there for a minute. John Mattingly, of all people, should know better than to equate child removal with "child safety" and "child protection." He knows the data on the inherent trauma of foster care, and what studies say about the rate of abuse in foster care.

Mattingly continues:

or 2) as some advocates suggest, somewhat counterintuitively, remove children far less frequently.

Hmmm. I wonder who he means by that?

Let's get real. When it comes to long-term reform of child welfare systems, NCCPR, and our partners, have accomplished an enormous amount on a shoestring budget. But flattering as it is to think that our efforts to curb needless removal of children can equal the pressure to take-the-child-and-run in the wake of a high-profile death, it's also absurd.

The notion that there are equal pressures pulling and tugging beleaguered child welfare administrations in opposite directions – as they seek to cling desperately to the sacred middle ground and judge each and every situation case-by-case – is so preposterous that I'm tempted to finally break my no-profanity-on-this-blog rule. For starters, can anyone name any child welfare system, anywhere, in which a high-profile fatality was followed by a sharp drop in removals of children?


It's especially preposterous in Milwaukee where, even before the current foster-care panic, the child welfare system was tearing apart families at one of the highest rates among larger urban centers.

Indeed, when consultants were hired as part of a lawsuit settlement and specifically instructed not to look at issues involving alternatives to taking away children (three guesses whose lawsuit it is), the consultants were simply too professional to ignore the elephant in the room. At one point they wrote:

"…Milwaukee has a relatively high rate of children placed in out-of-home care per 1,000 children … This suggests that stakeholders that believe the Bureau [of Milwaukee Child Welfare] needs to expand and strengthen its in-home child protective services supports may be correct in seeing an opportunity to further reduce the number of children in out-of-home care."

And later, the report states:

The author also believes that increasing the intensity and scope of in-home supports for families at-risk of having a child enter foster care can prevent additional placements. Because that population was not part of the scope of the review, no specific recommendations are made in that regard.

Milwaukee also is where a major peer-reviewed study found that many foster children could be home right now, or could have been spared from foster care at all, if their parents had decent housing.

Most people in Milwaukee don't know this, however, because Milwaukee also is where the last two reporters to have the child welfare beat at the Journal-Sentinel have almost completely shut out our perspective. One of them, a longtime crusader for taking away more children, who no longer is at the paper, even tried to denigrate us to the then-op ed editor, something I became aware of when the reporter made the classic "reply all" mistake. (

The op ed page itself has always welcomed all points of view, however, and published several NCCPR commentaries, for which we are grateful. But those columns notwithstanding, in Milwaukee 99 percent of the pressure on everyone from the frontline worker to top officials is to take-the-child-and-run.


Mattingly continues:

Unfortunately, experience across the country indicates that there is no quick fix (such as more or fewer removals.)…

Oh, come on – John Mattingly knows better than to stereotype our position that way. Almost every reporter who has spoken to me often enough has heard me explain that there is a right way and a wrong way to reduce entries into care, by saying something like this:

"As a group that believes strongly in family preservation, we feel that a high rate-of-removal almost always is a sign of a bad system. But a low rate-of-removal is not necessarily a sign of a good system. A low rate-of-removal can be accomplished either by embracing safe, proven programs to keep families together, or by ignoring children in real danger." Indeed, that language comes from our Rate-of-Removal Index, a document we've published annually for six years.

But we also maintain that reducing entries into care – the right way - is both vital to spare children who could remain safely in their own homes the trauma of needless foster care (for whom it may be a "quick fix" but also a safe, wise and humane fix) and an essential prerequisite for creating a better child welfare system. That's been proven in Alabama, Illinois, Maine, Pittsburgh, Pa. and, most recently, Florida. In contrast, there is not one child welfare system in America that has become, even relatively speaking, a national model by taking away more children. If the middle ground is leaving your rate of child removal right where it is, then, almost everywhere in America, and certainly in Milwaukee – and New York City – the truth does not lie somewhere in between.


But perhaps the oddest aspect to Mattingly's claim that neither increasing nor decreasing removals is a solution is that he doesn't seem to have followed that advice. In New York City, entries into foster care have shot up by 50 percent in the wake of the death of Nixzmary Brown in January, 2006.

Mattingly also lists other things he believes won't work, writing that:

there is no silver bullet (such as privatization); there is no free lunch (caseload sizes always matter); there is no knight in shining armor (a new and better leader from out of town).

He's right about privatization and right about caseloads – but hiring more caseworkers often isn't the best way to reduce caseload size; doing more to keep families together usually is the better option.

But the comment about leadership is odd. Outstanding new leadership (sometimes from out of town sometimes not) was crucial to reform in most of the systems that now are among the best in the nation. And, notwithstanding all my concerns, I also believe the New York City system would be worse today had not Mayor Michael Bloomberg brought in John Mattingly from out of town to run it.

There are other "solutions" Mattingly implies often are bad ideas – and I agree with him. But these bad ideas also bear a striking resemblance to things that actually happened in New York City. Items from his bad ideas list include:

•Someone will be blamed and disciplined.

Mattingly fired workers involved in the Nixzmary Brown case. I'm not saying he was wrong in that particular case, I'm just not sure why this is now on his not-to-do list.

•Task forces will issue reports that yet again express shock over the quality of decisions made by the agency and place increased pressure on staff and managers to make fewer mistakes.

But when the New York City Department of Investigation issued a preposterous report, generalizing about his agency based on the 11 worst cases, Mattingly threw his arms around the document – and fired or disciplined 14 workers involved in those cases.

•Rules will be tightened; levels of case monitoring will be added. The latitude for independent judgment by the only staff with knowledge of the family will be decreased yet again.
But it was John Mattingly who issued the draconian sibling confiscation policy, under which his workers must take away the newborn siblings of any foster child unless multiple levels of supervisors sign off on allowing that newborn to remain home.

Sadly, Mattingly also takes the all-too-common cheap shot at unions, decrying "a labor-management system in the public sector that is weighted heavily against holding people accountable."

Union bashing is a failing not only of mainstream child welfare managers but, I'm sorry to say, of many in the family preservation movement as well. People who pride themselves on being able to work with the most difficult families, and see the best in them, somehow see only the worst in their own employees when those employees act collectively to assert their right to fairness in the workplace. If one wants more flexibility from those employees there's a way to get it: it's called negotiating.


Mattingly's big solution is for government to respond to child abuse fatalities the way the National Transportation Safety Board responds to plane crashes – with careful case-by-case analysis to see what lessons can be learned.

But the best child abuse fatality review programs already do just that. In the process, they may, unintentionally, make things worse.

Because the trouble with child fatality review is it studies only child fatalities. And though each is the worst form of tragedy, they also are every rare. Therefore, there is no way to know if the problems you find are truly systemic – and you may well be missing more serious problems that could cause the next tragedy. The way to find out the typical problems is to look at the typical cases. What's really needed is systematic regular outside review of a random sample of cases, supplemented by near total transparency – all court hearings and nearly all records should be open in every case – so we all can be the "review committee."

The other problem with Mattingly's suggestion has to do with the crucial difference between air crashes and child protective services system failings: The civil aviation system is not shielded from almost all public scrutiny by "confidentiality" laws.

A large proportion of the public has had personal experience with air travel. And while we may not have enjoyed the long lines and the cramped seats, generally we get where we need to go safely every time. So even though air travel usually makes the front page when there is a crash, we know that, in fact, air travel is the safest form of transportation, and our personal experience reinforces that knowledge.

In contrast, the only time the child welfare system makes the front page is when there is a high-profile death. The day-to-day crisis of children wrongfully torn from everyone loving and familiar remains largely hidden by "confidentiality" laws. And most of us who are not poor have never had the personal experience of being falsely accused, much less losing a child to foster care. So we assume that the system errs in only one direction – leaving children in dangerous homes. Building accountability around fatality review only reinforces that misperception.

Kevin Ryan realized this when he was New Jersey's Child Advocate. His office did a superb job of reviewing child abuse fatalities. But he realized that no matter how careful the review and the recommendations, the process inherently left the impression that the errors go only one way. That's why he also commissioned the Families Under Supervision report, which looked at decisions from a wider perspective, including whether children were in foster care unnecessarily.

NCCPR has suggested a number of solutions in our publications Twelve Ways to do Child Welfare Right and Civil Liberties Without Exception. But here's one more, for New York City:

Use safe, proven alternatives to substitute care to reduce the rate of child removal to the rate in metropolitan Chicago – where children are taken at less than a third of the rate of New York, and independent court monitors have found this has been done with no compromise of child safety. Or at least use those approaches to roll back the surge in removals in New York since Nixzmary Brown died. That puts me squarely between Mattingly on one side and, on the other, the extremists who say any child welfare system is modern day slavery and CPS is a latter-day Gestapo.

Well, what do you know? I've found the middle ground.