Maybe someone should ask the mule

“I've flogged the Department of Children and Families like a rented mule. Where has it gotten us?”

--Sam Cook, columnist, Fort Myers News-Press, after another child “known to the system” died
in spite of all his previous columns excoriating the agency.

“The definition of insanity is doing the same thing over and over and expecting a different result.”

--Unknown, sometimes attributed to Albert Einstein.

The never-ending game of "May I?"

Last month, The New York Times published a column about a teenager torn between a “mentor family” that wasn’t prepared to adopt him and someone he barely knew in a state far away who was.

Most of the column revolved around how the institution in which he was living was pressuring him into an adoption he didn’t really want. The column didn’t say why, but getting those adoption numbers up would help the institution get a good evaluation from government officials – and, of course, it might help the state collect a bounty of $4,000 to $8,000 from the federal government.

But it was one small part of the column, mentioned only in passing, that was truly striking. And it is that one small part that sheds light on a battle now underway here in Virginia. (That battle, and the issues in this post are discussed in detail in NCCPR’s new report on Virginia child welfare.)

Here’s what one of the parents in the “mentor family” remembers of the first time they invited the young man to spend a weekend with them:

His first visit we're all waiting for him to come down to breakfast. I go up, he'd been in the group home so long, he was making hospital corners on his bed. He thought he couldn't eat breakfast until the bed was perfect.

And here’s a former resident of a group home in California, writing in L.A. Youth, in an essay reprinted in the trade journal Youth Today:

You have to ask permission for everything: to get food from the fridge, cook, watch TV, use the phone, go in the backyard or take a shower.

If the mountain of research such as the Surgeon General’s review of the literature, and the University of North Carolina review of the literature showing the failure of “congregate care” be it in group homes, orphanages or “residential treatment centers” (which are essentially orphanages rebranded) isn’t enough reason to get rid of a lot of them and scale back the rest, listening to the young people describe life there ought to be. Even when the residents are not abused by staff or abusing each other, which happens all too often, life in congregate care is an almost sadistic, never-ending game of “May I?”

No wonder one study found that seven years after getting out of institutions, 75 percent of the residents were back in the only setting where they knew how to live: Institutions. They were in jails or psychiatric centers.

Of course the residential treatment providers, who scarf up huge sums of government money, have a euphemism for this regimentation of day-to-day living. They call it “structure.” Whenever you hear a residential treatment provider babble about how his program provides young people with “structure” what he means is: Nobody gets breakfast until they get those hospital corners right!

Children don’t need this kind of rigidity – but institutions do. They need it in order to keep large numbers of troubled children in line and prevent their institutions from descending into chaos. So they turn around and claim that, by amazing coincidence, all the things that ensure that their institutions run smoothly happen to be “therapeutic” for children.

If that were true, we wouldn’t have that mountain of evidence showing institutionalization doesn’t work. If that were true, even Shay Bilchik, the former head of the trade association for residential treatment providers and other child welfare agencies, the Child Welfare League of America, would not have been compelled to admit that they lack "good research" showing residential treatment's effectiveness and "we find it hard to demonstrate success.”

But then, common sense should be enough to figure that out. Imagine if we were starting from scratch to figure out how best to help severely-troubled young people. And suppose somebody said, “I’ve got a great idea! Let’s take teenagers with the most difficult problems and throw them all together in one place – just at the time in their lives when they are most influenced by their peers.” If anyone suggested that, people might well wonder about his mental health. And yet, thanks to an accident of history – and the enormous political clout of the group home industry - that is exactly what we do.

To top it off, residential treatment is a prime example of an iron law of child welfare: The worse the option, the more it costs. Residential treatment bleeds child welfare systems of huge amounts of money, leaving very little for better alternatives.

Occasionally, institutions themselves have crises of conscience, shut down most of their institutional beds and embrace better alternatives. But then they come up against what the director of one such conscience-stricken institution called “the group home industry” which opposes any attempt to change government funding formulas to redirect money from their largely worthless, incredibly expensive institutions into better alternatives.

And that brings me to what’s happening in Virginia right now. Virginia is one of the states in which individual counties run child welfare systems. Governor Tim Kaine is proposing to reduce the state share of reimbursement for placements in group homes and institutions, while increasing the state share for better alternatives – in other words, families.

The group home industry has mobilized in opposition.

How do they fight reform? The group home industry will never say no to reform. Rather, they try to “Yes, but…” it to death.

First, they pretend they’re not institutions at all. How can you call us an institution? they say. Look how beautiful the grounds are. The children live in pretty cottages. They have “house parents.” It’s so “home-like.”

But children are not fooled by pretty buildings. Children know the difference between “home-like” and home. They know the difference between a Potemkin Village family and a real family.

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 likely to change every year or two or, in some cases, with every shift - is not a home. It's a dormitory. And a collection of dormitories is an institution.

Then, they’ll claim that the institution provides “structure” and “stability.” Stash the children in our institution, they say, and they won’t bounce from foster home to foster home.

But stability means that the human beings in a child’s life remain constant. Between the shift changes and the staff turnover, a child in an institution may have to cope with ten different caregivers – none of whom loves him – in a single day.

Even in institutions using “house parents,” those house parents typically quit every year or two, making an institution every bit as unstable as multiple foster home placements.

The way to prevent children from bouncing from foster home to foster home is to take away fewer of them in the first place, and provide the necessary support for the rest.

As for “structure,” that’s where I started on this post – it’s just a euphemism for that never-ending game of “May I.”

The group home industry will piously proclaim that they, too, favor alternatives. They, too love foster homes, and therapeutic foster homes – just as long as these siphon not a single child, or dollar, from their institutions. That is essential, they claim, because, after all, there always will be some children who need to be institutionalized, they’d hate to see a system that didn’t have a full “continuum of care,” we must guard against anything that smacks of “one size fits all” blah, blah blah.

The argument goes beyond disingenuous all the way to Orwellian. One-size-fits-all is what Virginia has now, and the one size is institutionalization.

According to the Annie E. Casey Foundation’s Strategic Consulting Group, which studied the Virginia system and recommended changing financial incentives, ideally no more than ten percent of children should experience a first placement in a group home or an institution. The national average is 18 percent. But in Virginia it’s 24 percent – and for teenagers it’s 52 percent. (The Casey Foundation also funds NCCPR).

Furthermore, even though Virginia’s Comprehensive Services Act funds programs that involve far more than children in the child welfare system, congregate care eats up 45 percent of the entire CSA budget. In contrast, only nine percent is spent on community-based services.

It is, of course, impossible to get away from one-size-fits-all when the group home industry is scarfing up all the money that could be used for alternatives.

Then the group home industry cites what it claims is the severity of the children’s problems. They piously proclaim that they wish these children could be cared for by families – really they do – but it’s just impossible; the children’s problems are too severe. After all, they say, many of the children already have been through multiple foster home placements and it didn’t work – or to use the charming phrase often heard by RTC operators, “these children blow out of foster care.”

In fact, often the children’s problems aren’t so severe. Children wind up stashed in residential treatment because that’s where the beds are.

But even for children who do have very serious problems, there are far better alternatives. Yes, sometimes such children fail in families. But that is almost always because those families – be they birth families or foster families – didn’t get the help they needed. And that’s because the money that could buy that help is being thrown away on institutionalizing children.

The group home industry’s reasoning is circular, and it is cruel: Deny families the support they need to make a placement work, then justify your institution’s enormously-expensive existence on grounds that the children couldn’t stay in families.

It was all explained remarkably well by Dr. Ronald Davidson, Director of the Mental Health Policy Program at the University of Illinois at Chicago Department of Psychiatry.

“Sadly,” says doctor Davidson, “there is a certain element within the child welfare industry that tends to look upon kids in the way that, say, Colonel Sanders looks upon chickens…”

If anything, Governor Kaine’s plan does not go far enough. Just as foster homes are better than institutions, safe, proven programs to keep children in their own homes are better than foster homes. So the money the Governor wants to spend on another initiative recommended by Casey’s Strategic Consulting Group, a pay raise for foster parents, would be better spent on such alternatives.

But the proposal to reduce the state subsidy for largely worthless institutions is a good first step. No one should be allowed to “yes, but…” it to death.

The baby market is booming

The Chapin Hall Center for Children maintains its own database of child welfare statistics. About 20 states provide all sorts of data beyond what they are required to give to the federal government. Chapin Hall analyzes the numbers and puts out reports full of broad general statements about broad general trends. They can’t say much more because, while Chapin Hall can list which states are part of the database, in exchange for providing the data, the states demand that Chapin Hall not link particular trends our outcomes to a given state.

Since states volunteer, the states in the study are not necessarily a representative cross-section, but enough states, including some very large ones, contribute data to suggest that trends nationwide probably are similar.

Chapin Hall is not prone to explaining the reasons behind the trends that show up in these data, however.

So they offer no explanation for a couple of startling figures about infants found in a new report they’ve put out on foster care trends. In a nutshell: Infants are far more likely than any other age group to be torn away from their parents – and far less likely ever to go home again.

Of all children entering foster care in 2004-2005, fully 20 percent were infants. No other age group, not even children aged one to two, represented more than seven percent of all children entering care.

Even more disturbing is the trend concerning exits. For children who enter foster care over age one and under age 17, between 40.5 and 46.4 percent exit to reunification. In contrast, about ten percent typically exit to relatives and another ten percent exit to adoption.

The figure for reunification drops for children who were already 17 when they entered care, which is understandable since many of them will “age out” of the system entirely. (And some of them will return home after aging out, something that won’t show up in the figures.)

But there is a much greater drop among infants. Indeed, the figure is staggering. Among children who enter foster care before their first birthday, only 28.6 percent return home. Another 9.5 percent exit to relatives and 30 percent are still in the system after turning one. In contrast, fully 24 percent exit to adoption.

But how can that be? After all, we are constantly assured that the system is careful and objective. There’s that line in almost every news story in which someone questions the system in which the child welfare agency piously responds that “We never make these decisions on our own, a court has to approve everything we do.” Yet somehow, if that is true, then parents must suddenly become vastly more “fit” after the child turns one year old.

It’s hard to believe that parents of infants are inherently more abusive and less capable than parents of children of any other age.

I can imagine child welfare agencies claiming that all this is just because infants are more vulnerable – so someone who can be a good parent to a 12-year-old might not be a good parent to an infant. But children aren’t exactly self-sufficient at 18 months – yet even by that age, child welfare systems are far more prone to return a child to birth parents. Among children aged one to two years old 40.5 percent return home and only 13.6 percent are adopted.

So the real answer is as obvious as child welfare agencies are desperate to deny it: Supply and demand.

Infants are, by far, the most marketable of commodities in child welfare. There is far more likely to be a “nice” (translation, affluent, white professional) couple - people like us – anxious to adopt, so it’s much easier to take them away forever from parents who are “unfit” – translation, poor, minority and so, presumably, nothing like us.

And, of course, the federal government will pay the child welfare agency a bounty of $4000 to $8,000 for every finalized adoption over a baseline number. There is no comparable incentive for returning that adorable infant to her or his own parents.

In Britain, where former Prime Minister Tony Blair imported much of the worst of U.S. child welfare policy, the press has been a lot more willing to take its collective blinders off. Newspapers from the liberal Guardian to the conservative Daily Telegraph have zeroed in on the trend to tear infants from impoverished birth mothers and hand them over to more affluent adoptive parents.

In the United States, as early as 1999, the Pittsburgh Post-Gazette did an excellent series on the propensity of one county in Western Pennsylvania to rush impoverished infants out of their homes and into the arms of affluent adoptive parents who sometimes had connections to the county’s child welfare and court systems. The Lexington Herald-Leader has done excellent reporting on a similar scandal in parts of Kentucky.

But other than that, discussing why infants, once torn from their parents, are so much less likely ever to go home again, is apparently taboo. Maybe that has something to do with how many reporters have friends or colleagues who are adoptive parents – and how few are ever likely to have a friend or a colleague who once had a child taken away by child protective services.

"We are a better country than that"

Because NCCPR is non-partisan, and we take that seriously, I did not post the item below on this Blog when it happened, during a Democratic presidential debate on January 21. But now that the candidate who uttered the words, John Edwards, is out of the race, I thought I’d share this excerpt from the debate transcript:

JOHN EDWARDS: You know, we talk about 37 million Americans who live in poverty -- that's more than the population of California -- in the richest nation on the planet.

I've been to hundreds of places around this country who take care of the poorest of the poor, extraordinary, wonderful places. But I'll never forget, just a year or so ago, I was with a woman in Kansas City who told me the story -- worked full-time, worked full-time. She had several children.

Every night in the winter, she could not pay both her heating bill and her rent. She had to choose. Single mom, working full-time, she had to put her kids in all of their winter clothing, in their coats, bundle them up in the bed together, put as many blankets on top of them as she could.

And she'd get them out of bed in the morning and send them off to school. And the last thing she would say to them? "Please, for goodness's sakes, don't tell anybody at school what's happening here, because they'll come and take you away from me."

No mother in America should have to live like that. We are a better country than that.

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.

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
CLASS AND COURAGE TRUMP THE RED QUEEN

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.

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.