Child welfare loses two heroes

There are not many true heroes in child welfare. Recently, we lost two of them.

Paul Vincent

Paul Vincent died on July 25. Paul led the child welfare division of the Alabama Department of Human Resources when it was the subject of a pioneering class-action lawsuit that demanded the system rebuild to emphasize keeping families together. (A member of NCCPR’s Board of Directors, Ira Burnim of the Bazelon Center for Mental Health Law, was co-counsel for the plaintiffs.) Paul welcomed the suit and worked hard to make it succeed.  And it did. For a while, Alabama was the unlikely leader in doing child welfare right – to the point that it made the front page of The New York Times. 

Paul also served on the “Marisol Panel,” an advisory group that grew out of a class-action lawsuit settlement in New York City. The group was strictly advisory. But because of who was on it, and because the head of New York City’s Administration for Children’s Services, Nicholas Scoppetta, surprised almost everyone by taking a lot of the panel’s advice, it did a lot to set in motion some of the changes for the better in  New York City. 

Then Paul founded the Child Welfare Policy and Practice Group, which issues outstanding reports on systems across the country, including Iowa, Indiana and Philadelphia. You can read more about Paul here. 

Karl Dennis 

Karl Dennis, the "father of Wraparound” -- or, as he preferred to call it, Unconditional Care -- died in June.  In a tribute to Dennis in Youth Today, David Osher writes: 

Karl also understood that each person and each context was unique and that settings, programs and even systems had to adapt to the youth and family rather than the opposite. Just as Karl never wrote off a young person, he never wrote off families even though most or perhaps all Kaleidoscope youth had experienced trauma, and agencies claimed the parents were hard to find and would not comply. He believed in family ties and understood that family included aunts, uncles, grandparents, even close friends, neighbors, and the whole tribe. Because Karl viewed families as valuable resources — and Kaleidoscope worked hard to find them — when they found them they treated them with respect and worked to earn trust, believing that wraparound should be family-driven. 

Karl understood the toxic impacts of language on people, worker-youth/family alliance, and organizational behavior. Karl insisted that his staff never applied the pejorative clinical language of “dysfunction” to families; rather, he saw systems that did not provide appropriate support to families and youth as dysfunctional. 

But it’s best to let Karl Dennis speak for himself, as he did in this presentation in 2009: 

Alabama child welfare reforms hold lessons for everyone - but especially, at the moment, Oregon, Iowa and Indiana

The Arizona Daily Star is in the middle of publishing the results from a year-long investigation into how to fix the child welfare system in that state.  As I’ve noted before, the answers are relevant to every state.  Right at the moment, the answers may be especially relevant for three states (besides Arizona, of course): Oregon, Iowa, and Indiana.

For part two in the series, the Star spent a lot of time on the reforms that have turned one of the last   

places most people might expect - Alabama - into, relatively speaking, a national model. (See especially the first three stories.)

The Star isn’t the first newspaper outside Alabama to take a close look at the Alabama reforms.  The first that I know of was the Springfield (Missouri) News-Leader. They did outstanding work in 2003 – but, unfortunately, like most Gannett papers, when they switched to a common website format they lost or hid their older stories so they’re no longer available online.

But a New York Times examination of those reforms is still available.

Now the Star stories bring things up to date.

It started with a lawsuit

The reforms began with a lawsuit brought by the Bazelon Center for Mental Health Law and the Alabama Disabilities Advocacy Program.  (The Bazelon Center’s Legal Director, Ira Burnim, also is a member of NCCPR’s volunteer Board of Directors.)  The Star stories show that, even though the system is no longer under court supervision, and though there has been some backsliding, the reforms remain in place. And, precisely because Alabama is a leader in family preservation, it’s also a leader in keeping children safe.

The stories are especially relevant to Oregon, Indiana and Iowa for several reasons:

● Oregon has been an extreme outlier for decades when it comes to taking away children. Iowa is a more extreme outlier. Indiana is an even more extreme outlier.

● Oregon remains deep in denial about the harm that does to children. Iowa is in even deeper denial. Indiana remains to be seen.

Perhaps most important for Indiana and Iowa:

● The Alabama lawsuit actually was welcomed by the leader of that state’s child welfare agency at the time, Paul Vincent. Vincent’s leadership was crucial to getting the reform effort underway and keeping it on the right track.  He’s got one of the best track records in the field.

Now Vincent runs the Child Welfare Policy and Practice Group, which helps other states and localities fix their child welfare systems. Two of the states CWG is working with right now are Iowa and Indiana.  They’ve already had some things to say about Iowa - and it's high rate of taking away children.  And they’ve already zeroed in on Indiana’s high rate of removal as one of the key “challenges” facing the system there.

Perhaps most important for Oregon:

● Oregon was, at one point, the state most likely to follow Alabama’s lead.  A lawsuit settlement in the 1990s called on Oregon to institute similar reforms. But unlike the Alabama suit, there was no real enforcement mechanism, no independent court-appointed monitor. And, unlike in Alabama, the child welfare agency in Oregon was not receptive to change.

As usual, the Oregon Department of Human Services proved to be the place where child welfare reform goes to die.  (Another NCCPR Board Member, clinical Psychologist Marty Beyer, who worked on the Alabama effort also was involved in the attempt to fix child welfare in Oregon. She discusses it in the epilogue to this story from the Salem Statesman Journal and Oregon Public Broadcasting.)

Spending smarter beats just spending more

The Alabama reforms also teach us something else. You can’t fix a child welfare system just by throwing money – or caseworkers – at it.

Yes, as a result of the lawsuit, Alabama spent more – but it also spent smarter.  Here’s how the Star explains it:

Child welfare leaders spread the word, through community meetings, that the state was shifting contracting dollars away from expensive services like group homes and residential treatment centers, in favor of less costly and more effective programs like therapeutic foster care and in-home services. 

         Providers had a choice: Evolve or risk going out of business.

In other words, while the Indiana child welfare agency was cozying up to private providers, Alabama was standing up to them.

As of 2014, the most recent year for which data are available, Alabama was spending on child welfare at one of the lowest rates in the country, while Oregon, Indiana and Iowa all were  spending at among the highest.

That doesn’t mean the answer is to cut spending. On the contrary, Alabama is good, compared to most of the rest of the country, but it could be better if it were willing to spend more.  But at least Alabama spends smart.

Oregon, Indiana and Iowa spend dumb, throwing away money on needless foster care and institutionalization – “services” that are both worse for children and more expensive than safe, proven alternatives to foster care.

As I’ve said many times before, I’m a tax-and-spend liberal and proud of it. But anyone who says the answer to these states’ child welfare problems is just to spend more is ignoring reality.

Instead, let’s imagine for a moment what kind of child welfare system you would get if you combined the amount that Oregon or Indiana or Iowa spends with Alabama’s priorities for how to spend it.

You’d probably get the best child welfare system in America.

UPDATED: In Indiana, a child welfare chief resigns with a “ransom note” and the Foster Care Excuse Machine cranks up

Child welfare has been much in the news in Indiana lately for all the usual reasons – deaths of children “known to the system” and a surge in removals of children from their homes blamed – falsely – on the opioid crisis. 

When she resigned as head of the state’s child welfare agency, the Department of Child Services, Mary Beth Bonaventura threw gasoline on the fire.  As I noted in an op-ed column for the Indianapolis Star, her resignation letter had all the subtlety of a ransom note.  The message boiled down to: “Give DCS more money or children will die!”

[UPDATE, FEBRUARY 8, 2018: It turns out, children in Indiana were dying at a higher rate long before Bonaventura submitted her ransom note / resignation letter.  Indiana is in the midst of a foster-care panic, a sharp, sudden increase in children taken from their homes. The panic began in 2014, while Bonaventura was running the agency. In the years since the panic began child abuse deaths are up significantly over the years before the panic. Bonaventura had to know this long before she "predicted" an increase in future years.  Details on this are in this NCCPR column for Youth Today.]

Brian Bosma, speaker of the
Indiana House of Representatives

Among other things, I pointed out that Indiana already spends on child welfare at a rate that is, proportionately, well above the national average. That’s because Indiana tears apart families at the fourth highest rate in America, and in child welfare the worse the option the more it costs. Spending more won’t do any good unless Indiana learns to spend smarter, by bolstering services to families instead of going on a caseworker hiring binge.

At about the same time, Brian Bosma, Speaker of the Indiana House of Representatives, played the role of the boy in the fable of The Emperor’s New Clothes. While so many others shouted about the need to just spend more money, Bosma said, in effect: Hey wait a minute. Why are we throwing so many more children into foster care than neighboring states?

At that point, the Foster Care Excuse Machine cranked up:

A Star story concerning Bosma’s remarks includes this:

[S]tatistics show that the number of children entering foster care because of parental drug abuse — of any kind — has climbed significantly faster in Indiana compared to neighboring states, according to an analysis by Child Trends, a national research organization focused on child well-being.

 
An incentive to check a box on a form

But that’s not quite correct. “[E]ntering foster care because of parental drug abuse …” does not mean such drug abuse was proven – far from it. It means only that a caseworker checked a box on a form saying something like “suspected drug abuse” and a judge then agreed to the removal.

Since judges tend to stereotype and stigmatize drug using parents in much the same way as many in child welfare, the incentive to check the box on the form, regardless of the amount of evidence, is obvious.  So Indiana caseworkers may simply be more prone to check that box on the form.

In 2016, Indiana took away children at nearly two-and-a-half-times the rate of Ohio – yes, Ohio, the state often spoken of in the same breath as Indiana as epicenter of the opioid epidemic. It strains credulity to think Indiana really has two-and-a-half times as many cases of drug abuse that genuinely require removal of a child to foster care.  Rather, this means that while Ohio also is prone to resort too quickly to foster care, at least there are some counties finding better alternatives.

And that suggests another possibility: The workers in Indiana are checking the boxes on the forms correctly, but Indiana’s longstanding culture of child removal makes it more likely than the other states that caseworkers will assume, wrongly, that the best answer to the problem is foster care.

Cozying up to private agencies

There was something else alarming in Bonventura’s ransom note/resignation letter.  She writes:

Foster parents, child-placing agencies and residential treatment facilities are the backbone of the child welfare system, caring for our most traumatized and vulnerable children on a daily basis. Efforts are now being made to undermine the collaborative relationship that has been established and return to the adversarial, litigious relationship that predated me.

           

This is alarming in so many ways it’s hard to know where to start. But I’ll start with residential treatment.  This is, by far, the worst option for children – and the most expensive. There is no evidence whatsoever that it works, and considerable evidence of harm.  Many states are striving to cut it way back or phase it out entirely. To claim that this massive failure is any part of “the backbone of the child welfare system” suggests a leader out-of-touch with best practice in child welfare.

More generally, “child-placing agencies” typically are paid for every day they hold a child in care. That doesn’t make them evil; most people who run them and work for them genuinely believe they are doing what is best for children.

Nevertheless, we know that these kinds of financial incentives prolong needless foster care. And we know that when the relationship between private agencies and the government that is supposed to oversee them becomes too cozy, agency performance tend to deteriorate, leading to far more abuse in foster homes and institutions.

Most of us would be horrified by a Food and Drug Administration Commissioner who bragged about a "collaborative" relationship with the pharmaceutical industry or a Securities and Exchange Commissioner who bragged about cozying up to hedge funds.  It should be no different in child welfare. Any government agency responsible for the health and safety of children should not have a cozy relationship with private providers – it should be an aggressive watchdog over those providers.

And finally, the good news

Indiana Governor Eric Holcomb

At the end of the op-ed in the Star, I write that Indiana “needs a discussion of these issues that is more nuanced than a ransom note.” The good news is, Indiana is likely to get it.  Governor Eric Holcomb made a good choice in bringing in the Child Welfare Policy and Practice Group to study the Indiana system. It’s run by Paul Vincent, one of those responsible for turning Alabama into, relatively speaking, a leader in child welfare. (A lawsuit brought by the Bazelon Center for Mental Health Law, where a member of my group’s volunteer Board of Directors is Legal Director, also helped.)

The Child Welfare Policy and Practice Group’s track record suggests that the reports it produces about Indiana will be tactful in their language, but they won’t pull any punches. Their recent report on Iowa is a good case in point. If the governor was looking for a whitewash, he turned to the wrong consultant. [UPDATE, FEBRUARY 8, 2018: Already, the consultants have pointed to the high numbers of children in foster care as one of two key "challenges" facing DCS.]

If those who now exploit child abuse tragedies for cheap headlines really want to help the state’s vulnerable children, they should pay close attention to the consultants’ recommendations. 

Child welfare in Arkansas: The Legislature is not helping

Last of three parts

If little John or Jane from Little Rock isn't in class today,
a child abuse investigator may be at the door tomorrow.

The previous two posts about Arkansas child welfare deal with the failures of Gov. Asa Hutchinson and the State Division of Children and Family Services.  But while the governor has been leading the state backwards, the legislature has been no help.

Consider the issue of “educational neglect.”  This is how we began a blog post on thisissue in 2010:

Late [in 2009] the highly-regarded Vera Institute of Justice, based in New York, issued a report  on one of the seedier back alleys of child welfare: "Educational Neglect." The majority of states, wisely, don't even include such cases in the mandate of their child welfare agencies. Unfortunately, New York, is not one of them. There, educational neglect reports serve one primary function: They're a lever schools can use to force parents to do what they want – like, for instance, not demand too much in the way of special education for their kids, or not complain about school safety.
 

Here are some highlights from the Vera Institute study, which focused on New York State but applies to any state that still lets CPS investigate "educational neglect":

● Overwhelmingly, these are low-risk cases, and it's idiotic to waste the time of child protective services dealing with them. (While that may be obvious, they've got an actual case reading, from Orange County, to prove it.) In addition to wasting the time of CPS workers, sending a CPS worker to the door only makes the family defensive and makes it harder to solve whatever problem may be causing absenteeism.

● The notion that educational neglect is the "tip of the iceberg," a sign of some other, deeper problem, (the primary excuse for CPS investigating such cases), is nonsense. Generally, "educational neglect" is the tip of nothing except some kind of school problem, often one that is not the parent's fault.

So guess what the Arkansas Legislature did this year: It passed a law expanding the jurisdiction of the state Division of Children and Family Services to include educational neglect.  The rationale: Exactly the “tip of the iceberg” assumptions that the Vera Institute study found were wrong.

This is a bad idea in any state.  It’s even dumber in Arkansas, where one of the key problems identified in a report from child welfare expert Paul Vincent (a report commissioned by the state itself) is impossibly high caseloads.

The other issue concerns cases where DCFS does not remove the child, but demands that the family meet certain conditions to keep the child in the home.  In most states, these “safety plans” are used in low-risk cases, and are agreed to by the agency and the family.

The Arkansas Legislature has decided, however, that in Arkansas, every single one of these plans is going to have to be accompanied by a formal charge of abuse or neglect and approved by the court.

According to Vincent’s report:

Regardless of the merits of the Act, it will undoubtedly increase the DCFS workload, including administrative tasks and time in court. It is also likely to increase the number of children placed in foster care.

But there’s more – and it says a lot about the mindset both of DCFS and some in the court system, Vincent writes: 

It is likely that this bill was introduced because of doubts on the part of some stakeholders that DCFS could assure child safety without court oversight. Some legal stakeholders criticized a DCFS practice which they called coercive placements, meaning that DCFS would threaten removal unless the caregiver placed the child with another family member, for example, … 

OK, let me interrupt here.  When I first read this, I thought: Good.  The courts have discovered that DCFS is unfairly strong-arming parents into placing the child into what is foster care in all but name.  This also raises questions about how many times DCFS does this but doesn’t officially report the placement as an entry into foster care, something discussed on this blog here.  So it’s possible the real rate of removal in Arkansas is much higher than the official figures reported to the federal government.

But now, let me allow Vincent to finish his thought (I've put the portion I left out above in bold): 

Some legal stakeholders criticized a DCFS practice which they called coercive placements, meaning that DCFS would threaten removal unless the caregiver placed the child with another family member, for example, without properly reviewing the alternative caregiver’s suitability or petitioning the court.

In other words, these “legal stakeholders” were just fine with DCFS strong-arming the parents – but, in keeping with the profound bias against kinship care that permeates the state, they just didn’t like where the child went after the parents were strong-armed.

Child welfare in Arkansas: Asa Hutchinson and the faith-BIASED orphanage

Second of three parts

The previous post to this blog described how Arkansas Gov. Asa Hutchinson commissioned a good report about the failings of child welfare in Arkansas – and then proceeded to ignore one of its most important recommendations.  The report, issued in July, found that Arkansas could go a long way toward ending a “shortage” of placements if it would just end the bias against kinship care – foster care provided by grandparents and other relatives.  Indeed, Arkansas makes far less use of this option than neighboring states.

In contrast, Arkansas badly overuses the worst form of care – group homes and institutions, in other words, latter-day orphanages.  The child welfare euphemism is “congregate care.” As the report notes:  “There is considerable evidence that children do better in family-based settings than congregate settings.”

That is an understatement.  It takes three single-spaced pages just to list the citations for some of the studies showing the harm of congregate care.  In addition, no matter how well-meaning the founders may be, orphanages have an unnerving tendency to go bad.  Orphanages are institutions for the poor, and institutions for the poor almost always are poor institutions.

None of the standard excuses for these places stands up to scrutiny.  They do not make children’s lives more stable, they do not help siblings, and often, they doom children to languish in substitute care.

Vincent’s report goes on to suggest that Arkansas adopt a series of guiding principles for its child welfare system including:

Placements should be made in the least restrictive, most normalized setting responsive to the child’s needs. Children should not be placed in congregate settings unless that environment is the only setting in which needed services can be provided [emphasis in original].

Five months later, the governor issued a statement touting “progress” in fixing foster care.  The statement said not a word about increasing kinship care.  Instead it touted the opening of new orphanages.  He even released the statement at a dedication ceremony for one of them, a place called Maggie House.

One thing you can say about Maggie House – it doesn’t try to hide its true nature.

Most of the time, modern orphanages try to do just that.  “How can you call us an institution?” the people who run them say.  “We have ‘cottages’ and beautiful grounds.  

  

But no matter what it may look like, a building that houses large numbers of children, most of them strangers to each other, to be cared for by paid staff hired to dispense indiscriminate pseudo-love to whoever walks in the door – staff that, at best, are  likely to change every year or two - is not a home. It's a dormitory. And a collection of dormitories is an orphanage.

Children are not fooled by pretty grounds and immaculate “cottages.” They know the difference between “homelike” and home. An orphanage is an orphanage is an orphanage. The new ones just come complete with Potemkin Village façades.

At Maggie House, it looks like they’ve pretty well dispensed with the façade.  It’s one building, a former nursing home.  The “cottages” are just different parts of the same building.  Have a look around.  Why place children with grandma when they can be at a place like this, right?

Also, although Maggie House is run by a group calling itself Free Will Baptist Ministries, exercising free will may be difficult for those residents whose religious beliefs don’t precisely match those of the people who run the place.  On their website, before they say almost anything else, the people running Maggie House say this: 

At Family Ministries’ Maggie House, we strive to create a Christian family atmosphere. In addition, we will teach the Word of God as the rule of life. Every child is given the opportunity to accept Christ as their personal Savior. Given the circumstances of many of these children, it is of upmost importance that we share the love of Christ with them. We find that most of them have never been taken to church, owned their own Bible, or had the opportunity to learn about Christ.  

That sounds more faith biased than faith-based.

One can only imagine how the governor would respond if a local mosque decided to build an orphanage for foster children because “we find that most of them have never been taken to a mosque, owned their own Quran, or had the opportunity to learn about Allah.” 

What happens to an LGBT youth placed at Maggie House? 

What about a teenager who wants access to contraception?

But the most important question remains: Why does Arkansas keep opening new institutions of any kind to warehouse children, instead of concentrating on keeping children out of the system and, when children must be taken, placing more of them with  relatives?

In part three: How the Arkansas Legislature made things worse

Child welfare in Arkansas: Full-speed backwards

First of three parts

Give Arkansas Gov. Asa Hutchinson credit for this much: When he called in a consultant to examine the dismal condition of child welfare in his state, he chose well: He chose the Child Welfare Policy and Practice Group, headed by Paul Vincent, who led the transformation of the child welfare system in Alabama into, relatively speaking, a national model.

Arkansas Gov.
Asa Hutshinson

In a report about Arkansas issued in July, Vincent found a system so short of places to put children that some were sleeping in offices or moving to a different placement every night. 

Among the key reasons: A deep-seated hostility to kinship care – placing children with relatives instead of strangers.

Read all about that hostility, and what it does to children in this excellent story from Arkansas Times - including a case in which one relative after another was turned down, and the children wound up placed in the care of a stranger who adopted them - and abused them.

Only 14 percent of Arkansas children are placed with relatives.  The average for surrounding states is nearly double – 25 percent.  Many other states that do better still.  If Arkansas simply performed as well on kinship care as its neighbors, a large part of the “shortage” of placements would be over.  In contrast, Arkansas has the worst record among these states for using the worst form of care – group homes and institutions – latter-day orphanages.

(Of course, it also would help if Arkansas reduced its rate of child removal to the rate of, say Alabama.  As of 2014, the rate of removal in Arkansas was nearly 80 percent higher than Alabama and there are indications the gap may have widened since then.)

Consultants try to use gentle language when writing about the agencies that hire them, but it’s clear from Vincent’s report that there is a strong bias against grandparents in the state Division of Child and Family Services and the courts.

Study after study has shown kinship care to be more humane, more stable and, most important, safer than what should properly be called “stranger care” – see this report, and this one.  Nevertheless, Vincent found

DCFS  staff and stakeholders identified a number of factors limiting the use of relatives. Attitudes toward the suitability of relatives as caregivers on the part of some staff, judges and other legal partners were frequently mentioned as a barrier. This negative view seems to be most prominent among those who view some extended families as sharing a common lack of caregiving capacities.

And now we learn that not only does this bias remain, it goes all the way to the top.

At a legislative hearing this month, grandparents spoke of stepping forward to try to take in their grandchildren, only to be stymied at every turn by DCFS.  The agency director, Cecile Blucker responded first with stonewalling, then with bigotry.

According to the Arkansas Democrat Gazette:

Blucker said the situation is complicated. By law, she said she could not comment on the people who made their cases to lawmakers or comment on any specific case.  "Only one side of the story can be told and only one side of the facts can be told," she told lawmakers.

If such a law exists in Arkansas, it almost certainly exists only because DCFS wants it, so the agency can hide its blunders behind “confidentiality.”  If you really feel hamstrung, Ms. Blucker, ask the legislature to repeal any such law.

If she means the federal government would object if she told the agency’s side of the story, then she needs to explain how it is that at least four states have laws specifically allowing their own child welfare agencies to comment on cases when they have been disclosed by another party – and none has been sanctioned.

But then it got worse.  Again, according to the story:

Generally speaking, [Blucker] said, grandparents can be complicit when they see abuse and sometimes cannot adequately keep their grandchildren safe from the grandchildren's parents.

In other words, “the apple doesn’t fall far from the tree.” That is precisely the claim that’s been debunked by all those studies.  Or, as one of the nation’s leading experts on kinship care, Prof. Mark Testa of the University of North Carolina, put it: “Fortunately, trees have many branches.”

In poor communities all over America there are parents who have waged a battle for decades to save  their  children   from poverty, despair, and the lure of the streets.  They have been forced to call upon reservoirs of strength that most of us can only imagine. Is the mother who won the battle with three children and lost it with a fourth to be denigrated and discarded when she comes forward to take in that fourth child’s children?  Cecile Blucker seems to think so.

And the bias may go even higher.  In a statement released Dec. 1, touting “progress” in fixing foster care, Gov. Hutchinson said not one word about boosting kinship care.

Even worse: He made his remarks at the dedication of a brand new orphanage.

More on that in the next post about Arkansas.