Thursday, August 29, 2019

Another bill takes a swing at drug using parents – if it passes, guess who’s going to get hit

            The story on the online news site North Carolina Health News is headlined “Foster care bill could allow faster termination of parental rights.”  Written by the site’s founder, Rose Hoban, it is a far better take than most on issues involving child welfare and drug use, showing rare care and sensitivity.

It’s not unusual to see stories about the effects of opioid use on children in which reporters consider parents too subhuman even to talk to (Case in point: The Washington Post.) In contrast Hoban’s story begins with such a parent, brings out her humanity, and shows her successful reunification with her child.  Although I’ll spend much of this post citing parts of the story with which I disagree, Hoban goes to unusual lengths to present all sides.

            But (paragraphs like the one above are almost always followed by “but…”) I do disagree with one central premise of the story.  Hoban writes:

At issue is the tussle between the rights of children who have troubled parents to live less chaotic lives, in foster care, or with perhaps adoptive parents, and the rights of birth parents to take the time to get their lives in order, to win back their rights to raise those children.

            That is the standard framing of the issue.  But the problem with bills like the one in North Carolina, known as House Bill 918, is not that they hurt parents – the problem is that they hurt children.

Lessons from the last “Worst Drug Plague Ever”

            That is a lesson we all should have learned from the last “Worst Drug Plague Ever,” crack cocaine.

University of Florida researchers studied two groups of children born with cocaine in their systems; one group was placed in foster care, another left with birth mothers able to care for them.  After six months, the babies were tested using all the usual measures of infant development: rolling over, sitting up, reaching out.  Typically, the children left with their birth mothers did better.  For the foster children, the separation from their mothers was more toxic than the cocaine. 

Similarly, consider what The New York Times found when it looked at the best way to treat infants born with opioids in their systems. According to the Times:

[A] growing body of evidence suggests that what these babies need is what has been taken away: a mother.  Separating newborns in withdrawal can slow the infants’ recovery, studies show, and undermine an already fragile parenting relationship. When mothers are close at hand, infants in withdrawal require less medication and fewer costly days in intensive care.
 “Mom is a powerful treatment,” said Dr. Matthew Grossman, a pediatric hospitalist at Yale-New Haven Children’s Hospital who has studied the care of opioid-dependent babies.

It is extremely difficult to take a swing at so-called “bad mothers” without the blow landing on their children. That doesn’t mean we can simply leave children with hopelessly addicted parents.  But it does mean that in most cases, drug treatment for the mother is a better option than foster care for the child. 

Indeed, as I discuss in this column for the trade journal Youth Today, child welfare’s entire approach to substance abuse exists at the intersection of ignorance and arrogance.

The chaos of foster care

That Florida study is only one example of why House Bill 918 would hurt children. 

The story says that part of the issue is the right of children to have “less chaotic lives, in foster care or with perhaps adoptive parents...” Sometimes that’s what happens; often it isn’t.  Foster care is enormously chaotic.  That’s one reason why study after study after study has found what that Florida study found: in typical cases children left in their own homes fare better even than comparably-maltreated children in foster care.

That’s true even when the foster home is a good one. The majority are.  But another series of studies finds abuse in at least one-quarter to one-third of foster homes, and the rate of abuse in group homes and institutions is even worse.

Yes, I know. The story quotes proponents as suggesting families are lining up to adopt these children.  But that’s also what they said when they fooled Congress into passing the so-called Adoption and Safe Families Act of 1997.  (I say fooled because some of those making the case at the time knew that wasn’t true.)  In any event, it didn’t work. Instead, terminations far outran adoptions, and the number of children “aging out” of foster care with no home increased. 

Attacking kinship care

The bill also seeks to undermine the least harmful form of foster care, kinship foster care, in which children are placed with relatives instead of strangers.

            The story also quotes a lawyer for a county social services agency whining about how hard it is to find relatives.  That simply gives away the fact that a lot of the impetus behind this bill isn’t what’s best for children, it’s what’s easiest for agencies. 

In Allegheny County, Pa. to cite just one example, 56 percent of foster children are placed in kinship foster care.  It’s not impossible; it just takes more effort, and a true dedication to putting the interests of children first – because (yes, it’s that pesky research again) study after study has shown that kinship foster care is better for children’s well-being and, most important, safer than what should properly be called “stranger care.”

There also are the usual trendy claims about brain science, bonding and trauma.  It’s not that those issues aren’t real, but those favoring a take-the-child-and-run approach to child welfare have been cherry-picking from the research.  For example, one of the worst “Adverse Childhood Experiences” a child can endure is removal from a parent. Yet those who cherry-pick from the research propose what amounts to trying to fight trauma with trauma.

As for bonding, that too is real, and really important.  But look at what those Florida infants are trying to tell us, and what we’re learning about how to treat newborns with opioids in their system: Don’t break the bond these children were born with.   More generally, bonding is a lot more complicated and nuanced than simply running a stopwatch and declaring that the child is bonded with, and only with, whoever had her or him the longest.

Indeed, one should be especially wary when child welfare agencies play the bonding card – they tend to deal it from the bottom of the deck.  In fact, the Trump Administration is using it to try to justify keeping apart some of the children torn from their parents at the Mexican border.

Racial and class bias

I was surprised that there was nothing in the story about the two factors that are at the root of almost everything in child welfare: Race and class.  The biggest single problem in child welfare is the confusion of poverty with neglect, compounded by the racial bias that permeates the system.

The North Carolina bill would add even more power to a system riven by racial and class bias. What this bill, and others like it, really would do is turn the child welfare system into the ultimate middle-class entitlement: Step right up and take a poor person’s child for your very own.