Child welfare in Maine: Who will remember Logan Marr’s voice?

As a little girl who died in foster care is forgotten, Maine embarks on a course that makes child abuse tragedies more likely.

The gravestone of Logan Marr

First of two parts. Read Part Two here.

I have written many times on this Blog about the death of a little girl in Maine named Logan Marr.  She and her sister, Bailey, were taken from their mother when the mother’s poverty was confused with neglect. They were placed with a foster mother who had once been a caseworker for the Maine child welfare agency. 

Logan herself tried to tell people she was being abused in foster care. She can be heard disclosing the abuse on a video taken during a supervised visit with her mother. But the child welfare agency wouldn’t listen.

One day in January, 2001, that foster mother took Logan down to the basement, tied her to a high chair with 42 feet of duct tape and left her there to die of asphyxiation.

The case was so emblematic of what has gone wrong with American child welfare that the PBS series Frontline devoted three hours of programming to the case and its implications.

Unlike many deaths in foster care, the death of Logan Marr led to real reform. A new governor, John Baldacci, named new leadership to what is now the state Department of Health and Human Services. They rebuilt the system to emphasize safe, proven alternatives to foster care.  They curbed needless removal of children and made all of Maine’s vulnerable children safer.

By 2009, Maine’s child welfare reform was a finalist for an Innovations in American Government award from Harvard’s Kennedy School of Government.

Maine Gov. Paul Lepage
(Photo by Gage Skidmore)

But none of that mattered to the next governor of Maine, Paul LePage.  That should be no surprise.  With his penchant for lying, racism, vulgarity and miscellaneous cruelty, LePage has been aptly called “Trump before Trump.”

As with Trump, facts don’t matter to LePage. So he soon set about getting rid of the child welfare reformers and backing away from the child welfare reforms. 

Maine already was well into a retreat from reform when two children “known to the system,” Kendall Chick and Marissa Kennedy, died in late 2017 and early 2018.  Instead of  “raising questions” about the way the LePage Administration had undermined safe, proven reforms, those deaths kicked the backlash into high gear. LePage embraced the Big Lie of American child welfare; the lie that family preservation and child safety are opposites that need to be balanced.

This flies in the face of the track record of states – including Maine itself – that improved child safety by embracing family preservation.

A pre-Logan Marr mentality

A year ago, Logan Marr’s mother made this plea: “Don’t forget Logan’s voice. Just don’t forget her voice.”

But not only her voice, but her story have been largely forgotten.

Maine has term limits, so the state legislators who were there when Logan Marr died, and who pushed for real reform are no longer in office.  And between the passage of time – it’s been 17 years since Logan died – and the turmoil in the news business, almost all of the Maine journalists who covered the death of Logan Marr are gone.  So there is almost no institutional memory.  In part two of this post, I've published two documents to refresh the memories of those who have forgotten and introduce Logan and her family to those who never knew about them. 

All this leaves LePage and his DHHS free to revert to a pre-Logan Marr mentality. It leaves them free to take actions that endanger all of the state’s vulnerable children and make another tragedy such as the death of Logan Marr – or the death of Kendall Chick or Marissa Kennedy - more likely.

So in a letter to lawmakers, LePage writes:

First, we will be recommending that Maine’s statutes are revised so that the priority is on what is best for the child, not family reunification. Placing the priority on family reunification forces the system and the courts to try to keep vulnerable children in a family when the best thing would be to remove the child from the situation.

The claim is echoed in a report issued by Maine DHHS.  Neither LePage nor DHHS specify which Maine law supposedly forces “the system and the courts” to keep children in dangerous homes. That’s because there is no such law. It is, however, far easier for LePage and DHHS to say “these tragedies happen because the law makes us do it” than to say “these tragedies happen because we screwed up.”

Much of the harm LePage and DHHS are doing to children is obscured by invoking a phrase that seems entirely benevolent: “what is best for the child” – a variation of the classic “best interests of the child.”  After all, who could be against that? In fact, these are among the most dangerous words – for children – in the entire child welfare lexicon.

An unchecked “best interests” test gives caseworkers and courts free reign to impose their whims and prejudices on families. What is “best” is whatever a caseworker happens to think is best.  So it devolves into comparison shopping, in which birth parents, often poor and disproportionately people of color, are forced to compete with overwhelmingly white middle-class foster parents – people with whom caseworkers can far more easily identify.

Material poverty is easy to see – the love between an impoverished child and her or his parents is harder to see. So the child is needlessly consigned to the chaos of foster care – because the caseworker can impose her arbitrary, capricious and cruel vision of “best interests” on the child.

A phrase filled with hubris

Because of term limits, the Maine lawmakers who fought
for reform after the death of Logan Marr are no longer in office.

“Best interests of the child” also is a phrase filled with hubris.  It says we are wise enough always to know what is best and capable always of acting on what we know.  In fact, those are dangerous assumptions that can lead us to try to fix what isn’t broken or make worse what is.

More than forty years ago, three scholars, Albert Solnit, Joseph Goldstein, and Anna Freud, proposed an alternative phrase.  They said “best interests of the child” should be replaced with “least detrimental alternative.”

“Least detrimental alternative” recognizes that whenever we intervene in family life we do harm.  Sometimes we must intervene anyway, because intervening is less harmful than not intervening.   In other words, foster care, even when done well is not “good for children.” But sometimes it is less bad than any other option.

The phrase “least detrimental alternative” is a constant reminder that we must always balance the harm that we may think a family is doing against the harm of intervening. It is exactly the shot of humility that every child welfare system needs.

It is exactly the shot of humility that was missing when the Maine child welfare agency first intervened in the life of Logan Marr.

● When Logan Marr was torn from her loving mother, largely because that mother was poor, it was done in the name of her “best interests.”

● When Logan Marr’s complaints that she was being abused in foster care were ignored, it was because workers were convinced that her placement in foster care was in her “best interests.”

● And when Logan Marr’s foster mother tied her to a high chair with 42 feet of duct tape and left to die of asphyxiation, that happened, in part, because caseworkers were convinced the placement was in her “best interests.”

When anecdotes collide

Of course one could argue that Logan Marr’s tragic death is a horror story and shouldn’t be the basis for policy.  But the current undermining of reform in Maine also is rooted entirely in horror stories – the deaths of Kendall Chick and Marissa Kennedy.

When anecdotes collide, it’s time to look at the data.   As I have written before, I would be glad to negotiate a mutual moratorium on the use of horror stories and stick strictly to what research and data tell us about what happens in typical cases.

● It is the data that tell us that in typical cases, not the horror stories, children do better when they are left in their own homes. 

● It is the data that tell us that, while extremes like the death of Logan Marr are, of course, rare, abuse in foster care is not. 

● It is the data that tell us that when Maine reformed to emphasize family preservation, there was no compromise of child safety. 

So it is the data that tell us that the best way to really promote the best interests of the child is to do more, not less, to keep families together.

Other bad ideas

LePage’s second bad idea is to create criminal penalties for mandated reporters who don’t report when they have “any reason to suspect” abuse or neglect. 

But the real reason for most tragedies involving deaths of children “known to the system” almost always is that caseworkers are overwhelmed. Penalizing mandated reporters for not calling in anything and everything will deluge the child abuse hotline with even more false reports and trivial cases.  That will do enormous harm to the children needlessly investigated.  But it also will further overwhelm workers, leaving them even less time to find children in real danger – so more such children will be missed.

Indeed, although we have had mandatory reporting laws for more than 50 years, there is not a shred of evidence that they make children safer. Even some of the biggest original proponents of mandatory reporting laws are having second thoughts.  But there is abundant evidence that they make politicians happy because they can issue press releases about how they “cracked down on child abuse.”

Though not mentioned by LePage, still another DHHS initiative undermines the state’s differential response program, known in Maine as “alternative response.”  Differential response has become a favorite scapegoat for those wedded to a take-the-child-and-run approach to child welfare – despite more than two dozen studies showing it is safe.

Tyranny of Personal experience

There is one more complication in Maine: As he notes in his letter, Gov. LePage himself was abused as a child. So even beyond his Trump-like disdain for facts, the governor also is a victim of the tyranny of personal experience – an inability to recognize that other people have very different personal experiences, and no one personal experience can be a rational basis for policy.

After all, what if Logan Marr has survived and grown up to be governor of Maine.  What would her personal experience have told her to do?  Of course, we’ll never know. Because Logan Marr never survived Maine’s strenuous efforts to protect her “best interests.”

In part two of this post: A letter from Logan Marr's mother, and a college admissions essay from her sister.

Mr. Butts and the foster-care apologists

Saying we don’t know if foster care causes rotten outcomes for foster children is like saying we don’t know if cigarettes cause cancer Photo from Libreshot

There is an old Doonesbury cartoon in which Mr. Butts, the anthropomorphic apologist for the tobacco industry is testifying before Congress.

“Good News, Congressfolk!” says Mr. Butts. “The evidence linking smoking with cancer and heart disease is still inconclusive!  That’s right, the jury is still out! Is that great or what?”

I thought of Mr. Butts as I read a column by Naomi Schaefer Riley in which she tries to persuade us that, when it comes to whether it is harmful to tear a child away from everyone he knows and loves and consign him to foster care – well, the jury is still out.

Riley, you may recall, is a now former blogger for the Chronicle of Higher Education. She was kicked off that blog after writing a vile column smearing the entire field of Black Studies – based solely on her disdain for the titles and summaries of three dissertations in the field.  Years later, in a column for Rupert Murdoch’s New York Post, she would go on to explain that racism is so over because

African-Americans have full legal rights. Hate crimes are anomalies. Black people are running corporations, universities and until recently the White House.

So who could possibly be a better judge of whether children in foster care – children who are overwhelmingly poor and disproportionately nonwhite – are harmed by being there?

Pipeline, what pipeline?

Riley is upset by the notion of a “foster care to prison pipeline” – that is, the idea that if a child is placed in foster care the harm of that experience makes it more likely that the child will wind up in jail.  She seems even more upset by the notion that racial bias might contribute to the needless removal of children - after all, racism is over, remember?

Riley doesn’t deny that former foster children are overrepresented in our prisons. She does not deny – but also doesn’t mention – a whole slew of other rotten outcomes for a shocking number of children who endure foster care, such as their high rates of unemployment, food insecurity and homelessness, and their extremely low rate of college graduation.

Rather she falls back on the classic excuse of America’s foster care-industrial complex: Hey, it’s not our fault; those kids were all messed up by their no-good parents before we ever got 'em. What do you expect us to do, actually make things better?

So Riley claims that “We can’t separate the effect of kids being in abusive and/or neglectful homes and the effect of the foster care system.”

There are two problems with this claim. First, not all children placed in foster care came from “abusive and/or neglectful homes.” Many came from homes that were simply poor.

And second, the claim that we can’t separate the effect of the children’s circumstances before foster care to the effect of foster care itself is simply not true.

We can. And we have.

Findings from the definitive studies

MIT Prof. Joseph Doyle did a direct head-to-head comparison of outcomes in typical child welfare cases. He looked at records of more than 15,000 children, followed them all the way into their late teen years and, in some cases, young adulthood.  He compared children placed in foster care to comparably-maltreated children left in their own homes. He focused on the typical cases, not the extremes. Most important, he didn’t simply make a subjective assessment of the youths, or rely on the subjective assessments of others.  Rather, he looked at what actually happened to them.

Compared to the comparably maltreated children left in their own homes, the foster children were:

● Less likely to hold a job for at least three years.

● More likely to become pregnant as teenagers.

● More likely to be involved in the juvenile justice system.

● More likely to be arrested as young adults.

And, by the way, these studies are not alone. A third study, from researchers at the University of Minnesota, using different methodology and outcome measures also found that children placed in foster care fared worse than comparably-maltreated children left in their own homes.

So yes, Naomi, there is a foster care to prison pipeline – and a whole lot of other harm, too.

To make her Mr. Butts-style the-jury-is-still-out case, Riley cites one article, by Youngmin Yi and Christopher Wildeman of Cornell University in which the authors claim that

prior research provides little insight into the direct effects of foster care placement on children: the few studies designed to isolate the effect of foster care placement haven’t reached a consensus regarding its impact on children.

A foundation of sand

But Yi and Wildeman build their case on a foundation of sand.  They rely on a single, smaller study by Lawrence Berger and colleagues at the University of Wisconsin, using far more subjective criteria than the MIT studies, and suggest this somehow is equal to the MIT studies. (They don’t mention the University of Minnesota study at all.)

The MIT studies followed children well into adolescence and beyond, and looked at what actually happened to the children. The University of Wisconsin study followed children for an average of only two-and-a-half years, measured only two outcomes and, for one of those outcomes – the extent of the children’s behavioral problems - relied on questionnaires filled out by the children’s current caretakers. Obviously that’s a far more subjective method than the method used for the MIT studies – seeing what actually happened to the youth.

Compounding the problem: Berger and his co-authors admit that when these sorts of questionnaires are filled out by different people at different times, it “may be problematic.”  No kidding.  In fact, alleged “differences” in behavior may simply mean differing perceptions by the people filling out the questionnaires.

They fail to acknowledge still another problem: Foster parents were asked to fill out a questionnaire assessing the children’s behavior while in their foster homes.  In effect, they’re being asked how well they are doing as foster parents. No chance of bias there!

Berger & Co. then use several different “analytic models” to compare the two outcomes, including the subjective evaluations of behavior for the foster children and the subjective evaluations of behavior for the children left in their own homes. They argue that the model that produced the results most favorable to foster care is the least biased.

After all that: no improvement

But even this method for calculating results from this one study did not find that foster care made things any better for the children.  The best Berger and Co. could say is that, using some of the models they applied to a partially subjective evaluation of only two outcomes, the foster children didn’t do any worse than the children left in their own homes.

Consider the implications:  Suppose you went to a doctor complaining of an illness.  The doctor said: “I’d like to prescribe this medicine. Massive studies indicate that the medicine has terrible side effects and may well make you sicker.  But there is one study that says it won’t do you any good, but it won’t actually hurt you.”

Would you take the medicine?

Of course, it’s worse for foster children. They have no choice. Similarly, the Mr. Butts approach to research is worse when the topic is foster care than when the topic is tobacco. At least no one is forced to smoke cigarettes.

Trashing kinship care

But Riley doesn’t stop with sliming birth parents. She also slimes the least harmful form of foster care, kinship care - placing children with relatives instead of total strangers.  She quotes a conference speaker from Harvard who claimed that “If you have a parent who has been arrested, you are twice as likely to have an aunt or an uncle who has been arrested.”

To which the proper scientific response is: So what?

For starters, many parents who lose children to foster care have not been arrested. Others have been arrested for the same basic reason their kids were taken: they are poor and nonwhite. And being arrested does not preclude being a good parent – something that is apparently beyond the ability of some academicians to understand.

And here, again, the evidence is in. Multiple studies have found that kinship care typically is better for children’s well-being, more stable, and, most important, safer than what should properly be called stranger care.

In fact, even Youngman Yi and Christopher Wildeman admit this.  In the same article Riley cites when it supports her point of view, Yi and Wildeman also write that:

A wealth of evidence illustrates the benefits of kin-based care relative to other placement types and shows that existing social networks play a critical role in supporting children’s wellbeing.  

For some reason, Riley doesn’t mention that part of the article.

Foster care is fundamentally unfixable

And what does Riley propose as an alternative to curbing the needless removal of children? The usual foster care-industrial complex bromide: Make foster care “better.”

Well yes, we could make foster care better.  But not by much.  Here again that pesky research gets in the way.

One of the many, many studies documenting the horrible outcomes for foster children found that only 20 percent of the children studied were doing well as young adults.  But this same study also attempted something else: It came up with a formula to estimate how much better the outcomes would be if somehow everything wrong with foster care were fixed and the system were perfect. The answer: The outcomes would improve by 22.2 percent.

So if foster care were made perfect, it would churn out walking wounded only three times out of five instead of four.

That’s well worth trying. But the real lesson from that study, and all the others, is that foster care is fundamentally unfixable.

But Riley really reveals her true colors when she explains how to “fix” foster care. Her first recommendation “We could do a better job recruiting more stable middle-class families of all races.” [Emphasis added.]

Right. Because nothing is more important for a child’s well-being than how much money his caretakers have.

None of this means that no child ever should be placed in foster care.

There are times when parents really are horrible and children really need to be saved from those parents. There are times when foster care clearly is the least bad option. Not a good option, but the least detrimental alternative.

Burden of proof

As so often happens when foster-care apologists try to defend the system, they put the burden of proof in the wrong place.   Long ago, when I was just starting out as a reporter, it was actually the head of an adoption agency who said something I've never forgotten: "The burden of proof should always rest with those who believe children don't belong in their families."

Yet Riley suggests the fact that there exists a study showing that foster care does not make things worse is reason enough to keep right on throwing children into the system – and failing to hold the system accountable for what happens to those children.  When will we finally demand that the foster-care apologists prove that their intervention is actually better for children in typical child welfare cases?

Of course they can’t do that.  Because, contrary to Riley’s claim, when it comes to the way the foster care system harms children in typical cases, the jury is in.  And the verdict is best summed up by another famous line from Doonesbury:

“Guilty, guilty, guilty!”

NCCPR in MinnPost on Minnesota's obscene rate of child removal

Minnesota tears apart families at one of the highest rates in the country. And Minnesota has been an outlier for nearly 20 years - maybe even longer.  Our take on what's gone wrong and how to fix it is in this column for the online news site MinnPost.

Predictive analytics in child welfare: The harm to children when “the stuff stays in the system.”

Marc Cherna is was once one of the best human services leaders in America. But even he shouldn't have the power to be the Mark Zuckerberg of child welfare.

Today, across America and much of the world, the big story will be Facebook CEO Mark Zuckerberg testifying before Congress about how personal data from millions of Americans wound up in the hands of Cambridge Analytica. Although the data breach is outrageous, at least those data were originally uploaded voluntarily – Facebook users have the right to not share their data in the first place.

In Pittsburgh, Pa. poor people have NO. SUCH. CHOICE. They are forced to surrender their data.  And their data can be used to decide whether to take away their children. I’ve written about the implications here and here.  Another example comes courtesy of a Pennsylvania dentist:

Last week, I published a post about a dentist in Pennsylvania who sent threatening form letters to some of his patients. The patients had dared to not schedule follow-up appointments when the dentist thought they should. In the case which brought this to public attention, the patient didn’t like the dental practice and had made clear her intention to go elsewhere.

The letters threaten to report patients who don’t schedule follow up appointments to child protective services.  According to at least one news account, the dentist acknowledges following through on the threat 17 times last year.

The earlier post discusses the potentially devastating consequences for children. If the report is “screened in” – as is likely because it came from a medical professional – it means, at a minimum, a highly intrusive investigation that could do lasting emotional harm to the children.  That harm can’t be undone if the child welfare agency realizes the report was false.

The mere existence of a false report in a child welfare agency file can increase the chances that, if there’s another false report, the new report will be wrongly substantiated – because of a bizarre notion in child welfare that enough false reports are bound to equal a true report. This increases the odds that the children will be consigned to the chaos of foster care.

And, of course, all those false reports steal time caseworkers should be spending finding children in real danger.

The only good news here is that this dentist practices in eastern Pennsylvania.  At least in that part of the state a child abuse “hotline” operator deciding if a case should be “screened-in” can check the file and, seeing a previous allegation based solely on a missed dental appointment, might realize how absurd it was.

Were this dentist at the other end of the state, in Allegheny County (metropolitan Pittsburgh) it could be far worse.

Automating absurdity

That’s because Allegheny County is home to the nation’s most advanced experiment in using “predictive analytics” to decide when to investigate if a child is in danger of being abused or neglected. 

Whenever the county receives a report alleging that a child is being abused or neglected, an algorithm known as the Allegheny Family Screening Tool (AFST) uses more than 100 different data points to spit out a secret “risk score” between 1 and 20 -- an invisible “scarlet number” that tells the county how likely it is that the child is, in fact being abused or neglected or is at risk of abuse or neglect.  The higher the number the more likely the report will be “screened in” and investigators will be sent out.

Though the investigators don’t know the risk score, they do know that a high risk score is why they are being sent out in the first place.

Prof. Virginia Eubanks offers a devastating critique of AFST in her book, Automating Inequality. Part of that chapter is excerpted in Wired magazine. I discussed her findings in detail in Youth Today and I discussed the ethically-challenged “ethics review” used to justify AFST on this blog, so I would repeat that overall critique here.

But the case of the disgruntled dentist prompts me to focus on one particular piece of the Allegheny algorithm: The mere fact that a previous report exists – regardless of how stupid that report may have been – raises the risk score.  No human being intervenes first to see if the report had any legitimacy.

In fact, it appears that the Allegheny County algorithm even counts previous reports that were considered so absurd they were screened out with no investigation at all. 

So suppose, hypothetically, an Allegheny County dentist reported someone just for missing a follow-up appointment.  This was considered too absurd even to investigate.  A few months later someone else calls the child abuse hotline about the same family.  The existence of that previous, uninvestigated report from the dentist raises the risk score.  So now, the child has a higher scarlet number.

Making it even worse: In the Allegheny algorithm still another factor increasing the risk score is if a report, no matter how absurd, was made by a medical professional – such as a dentist.

And Cherna is pretty fanatical about keeping and using data – regardless of the data’s reliability.  This is clear in what he told Prof. Eubanks about a related issue: reports that are legally allowed to be kept for far longer, those in which caseworkers “substantiate” the allegation. In Pennsylvania, as in most states, that means only that the caseworker decides it is slightly more likely than not that abuse or neglect occurred.

In cases alleging actual abuse, there is a long, almost impossible appeals process.  And in a bizarre twist of Pennsylvania law, in less serious cases there is no appeals mechanism at all.  In such cases, the county keeps a record of the case until the child who was the subject of the report turns 23. 

This is where we find out how Marc Cherna feels about keeping junk reports and using them in his algorithm.  He told Eubanks: “The stuff stays in the system.” And, of course, Cherna said what those who hold onto junk reports of child abuse always say. In effect, enough false reports are bound to equal a true report. Said Cherna: “A lot of times where there’s smoke there’s fire.”

But a lot more often there’s someone who’s just blowing smoke.  So let’s just be grateful that a certain dentist hasn’t opened a branch office in Pittsburgh.

And, as we watch what's happening in Congress today, let’s also remember one thing more.  Marc Cherna is now the Mark Zuckerberg of child welfare. Both Zuckerberg and Cherna amass huge quantities of data. Then they decide what will happen to those data.  There are two key differences: Marc Cherna isn’t doing it to make money. In fact both his intentions, and his track record as a child welfare leader are excellent.  On the other hand, Facebook can’t use data to take away your children. Marc Cherna’s agency can.

UPDATE: 11:45 am: In an earlier version of this post, I asked whether inclusion of certain elements in AFST violated Pennsylvania law concerning expungement of records involving unfounded reports. This was based on a list of factors included in AFST. I noted that I had e-mailed Cherna and his deputy Erin Dalton on April 5 and received no response.  I have just received a response from Cherna, in which he makes clear that, in fact, AFST does NOT include any information that legally should be expunged.  Therefore, I have deleted that portion of the original post.

A middle-class adoptive mom’s unusual response to being falsely accused of child abuse: "I learned a lot about the less privileged. I learned a lot of empathy."

It happens over and over. Foster parents and, to a lesser extent, adoptive parents complain about how badly they are treated by child protective services agencies.  Decisions are made about the children in their care without consulting them, they say. They’re not treated as part of a team, they say. They’re even victimized by false allegations of child abuse, they say.

Foster and adoptive parents are more likely to be white and middle class – in other words, people like us instead of people like them. As a result, to paraphrase the old brokerage slogan, when foster and adoptive parents talk, people listen.  They get enormous public sympathy, as in this case.

I don’t begrudge them that.  A lot of the time, their complaints are justified.

But every time I read another story about foster or adoptive parents complaining about their ill-treatment, I keep waiting for one thing to happen – I keep waiting for the proverbial lightbulb to appear over the complaining foster or adoptive parents’ heads. I keep waiting for someone to say:  “The child welfare system really needs us.  If this is how they’re treating us imagine how they’re treating birth parents.  Maybe I need to reconsider my assumptions about who CPS takes away, and why.”

It’s not that it never happens. When Maine foster parent Mary Callahan noticed that almost every child placed with her could have remained safely in their own home had the birth parents simply gotten the aid she received as a foster parent, it helped change an entire state foster care system. 

But such instances are few and far between. When one turns up, it’s worth highlighting, even when it happened five years ago, and I missed it at the time. 

So I want to offer belated thanks to Dr. Christine Deeths, formerly of Bakersfield, California, to her lawyer Shawn McMillan, who has championed families in many similar cases in California, and to former Bakersfield Californian columnist Lois Henry who wrote about what happened to Dr. Deeths’ children.

The details concerning what Kern County Child Protective Services did to doctor Deeths’ adopted children are in this column by Henry, so I won’t go into them here. Suffice it to say that it falls into one of those rare categories of cases in which the overreach of child protective services hits the middle class.  And suffice it to say the needless removal of the 4-year-old and 6-year-old children was so outrageous that the county offered Deeths a settlement of $1.4 million – before she even sued.

As Deeths put it:

My children will never be the same. They lost their innocence the day they were taken. CPS stole that from them and it can never be replaced.

But instead of taking pains to claim she was different from people who typically get caught up in the system, Dr. Deeths realized how much she and they had in common.  As Henry writes:

As part of the original CPS case, Deeths was ordered to attend parenting classes put on by Human Services. The classes themselves were useless, she said. But she met dozens of parents who, like her, had lost their children. Unlike her, however, they weren't nearly as educated nor did they have the same resources, money, strong family support, friends, colleagues, etc.

"I learned a lot about the less privileged," she said. "I learned a lot of empathy."

She had the resources to fight CPS, she said, when most other parents don't. She wonders how many more families have been unfairly torn apart.

"A lot of what they're taking kids for is a lack of knowledge about life skills and CPS isn't helping parents learn those life skills," she said. "Meanwhile they're creating generational problems because when you take a child, they're changed forever.

"They're creating a cycle."

If only more middle class people who encounter the child welfare system had that kind of empathy.

Mandatory child abuse reporting laws: An appalling letter from a dentist – and the awful law that made it possible

When I first saw this photo on Facebook, I thought it might be a hoax. It's not.
A dentist in Pennsylvania actually sent this letter to some of his patients.

A child abuse investigation sometimes is a necessary act. But at other times, it can do great harm to children.

At a minimum, government investigators with the power to have children removed on the spot will question the children about the most intimate aspects of their lives, often stripsearch those children and leave the entire family terrified of what might happen if those government agents come back again. The younger the child the greater the extent to which the investigation becomes, in itself, an act of emotional abuse.

A recent study estimates that about one-third of all American children, and a majority of African American children, will be subjected to this trauma at some point in their childhoods.  And more than 80 percent of the reports turn out to be false.

Even if the report ultimately is labeled false, it often is retained in child welfare agency files and can be used against that family if they are victimized by another false report on the theory that, by some magic, enough false reports equal a true report. 

The consequences go beyond the harm to children victimized by false reports. Workers spend more than four-fifths of their time spinning their wheels, leaving them less time to find children in real danger.  Rushing to report “child abuse” with little or no reason to suspect it makes all children less safe.

So it is an act of willful ignorance for those who defend needlessly inflicting this intrusion on families and needlessly overloading the system to claim that no harm is done as long as the investigator concludes the allegation is false.

What the dentist did

That is the context in which we need to consider what happened to Trey Hoyumpa when she took her children to a dental practice known as Smiles 4 Keeps in eastern Pennsylvania.  As she would later explain on Facebook, and elsewhere there were a number of things that disturbed her about Smiles 4 Keeps. According to Hoyumpa:

            ● They do not allow parents to stay with their children during dental procedures.

            ● The parent never even meets the dentist, only the hygienist.

            ● They claimed her children had seven cavities between them – but she says, they never showed her the x-rays.

            ● They will treat only one child for fillings per day. If the parent has more than one child in need of procedures, they have to make a separate appointment.

Having to take two days off from work for two separate follow-up appointments was the last straw.  So Hoyumpa exercised her right not to return to Smiles 4 Keeps. She told the receptionist she would be seeking dental care elsewhere. And she made her displeasure loud and clear.

At least she thought it was her right.  Until the threat arrived in the mail.  It wasn’t even a custom-tailored threat. It was a form letter threat:

“Dear patient,” the letter says:

“At Smiles 4 Keeps our goal is to keep children as healthy as possible through education, regular dental checkups and timely treatment as needed. In order to do that, you must bring your child to one of our Smile Centers for regular professional cleanings and treatment.

Then things turn ominous:

According to law, failure to bring your child for dental care is considered neglect. Pennsylvania Act 31 (Child Abuse Reporting and Recognition Requirements) states that health care providers must report your failure to bring your child to the dentist for evaluation and care. … Smiles 4 Keeps has not reported your child’s outstanding dental treatment as of yet.  Since this law is in effect, we hope this letter encourages you to schedule an appointment to follow through with needed dental treatment for your child. ...

To keep your child as healthy as possible and avoid a report to state authorities, please call Smiles 4 Keeps immediately to schedule a treatment appointment within the next 30 days…

As for seeking care elsewhere: Well, Smiles 4 Keeps says, you could do that, but you had better prove it – to our satisfaction.  According to the letter:

If you sought a second opinion, please also contact us with the name of your new provider. We would be happy to forward your child’s records upon signing a release form.

 “Highly unethical” …

Another dentist told WNEP-TV the letter is “highly unethical.” Dr. Richard Grossman adds:

I think it's used as a scare tactic actually, to scare parents to bring their kids to those offices … I'm shocked that it's a Pennsylvania group of dentists who've resorted to something like this.

Scott Shackford, an Associate Editor of the libertarian magazine Reason goes further:

Neither Hoyumpa nor any other consumer has any obligation to communicate with Smiles 4 Keeps or to set foot in its offices if she doesn't want to, and she is not required to tell them why or where they've gone instead. Yet [Smiles 4 Keeps founder Dr. Ross] Wezmar and his offices are threatening families with government investigations for declining to do business with him. … Does he even care that he could upend families' lives by reporting them to the state? … Citing this law to try to scare parents into patronizing your business is pretty damned low.

…and inaccurate

The letter from Smiles 4 Keeps also is inaccurate.

Like most state definitions of child abuse and neglect, the one in Pennsylvania is so broad and so vague that almost anything could qualify.  Thus, Pennsylvania’s definition of neglect includes “The failure to provide a child with adequate essentials of life, including food, shelter, or medical care.” But there is nothing in state law requiring that, as the letter claims “health care providers must report your failure to bring your child to the dentist for evaluation and care.”

And while it is true that dentists in Pennsylvania, as in most states, are required to report child abuse, in Pennsylvania they are required to report only when they have “reasonable cause to suspect” such abuse or neglect has occurred – not simply because a parent failed to schedule a follow-up appointment.

As for “Act 31” – which Smiles 4 Keeps enclosed with the letter, that’s just a long, turgid section of state law concerning training requirements for mandated reporters. It says nothing about what must be reported. 

The dentist’s response

In a follow up story, Wezmar, the founder of Smiles 4 Keeps, not only defends the letter, he brags about running the first dental practice in all of America to send such threats to patients.  He makes the usual argument: Horror stories.

Wezmar supplied the television station with photos of severely diseased teeth – though it is never said if these are photos of actual Smiles 4 Keeps patients or simply something from a textbook.  And he claims the threat letters were sent to only 17 patients last year.

But if it involves only 17 patients why a form letter?  Presumably, if Dr. Wezmar cares so profoundly about these particular children’s dental health he’d want to write letters outlining the specific problems in each case and why an appointment supposedly is urgent.  The “Dear Patient” form letter sounds like Smiles 4 Keeps has determined that simply failing to schedule an appointment with Smiles 4 Keeps is de facto evidence of neglect sufficient to merit a report to child protective services. That jibes with Hoyumpa’s account.  (Smiles 4 Keeps is now promising to re-word the letter.)

The fact that she objected so loudly to the practice’s practices also may have contributed to getting Hoyumpa on the Smiles 4 Keeps threat letter list.

Smiles 4 Keeps also issued statements claiming that their threat letters are consistent with the definition of neglect used by the American Academy of of Pediatric Dentistry. That group told Yahoo Lifestyle that it defines dental neglect as

willful failure of parent or guardian, despite adequate access to care, to seek and follow through with treatment necessary to ensure a level of oral health essential for adequate function and freedom from pain and infection.

But  no evidence has been offered indicating that Hoyumpa’s case fits that definition.

An Academy spokesman added that dentists also have obligations to their patients:

To the best of his or her ability, the pediatric dentist should be certain that the caregiver understands the explanation of the disease and its implications and, when barriers to the needed care exist, attempt to assist the family in finding financial aid, transportation, or public facilities for needed services. If, despite these efforts, the parent fails to obtain therapy, the case should be reported to the appropriate child protective services agency.”

Smiles 4 Keeps claims that it makes lots of phone calls and emails to patients urging them to make follow up appointments before sending the threat letters. (Hoyumpa says, however, she received no such warnings). And I know of no public statement from the practice about offering the kinds of help described by the Academy.

Instead, Trisha Richards-Service, described in The Pocono Record as a “spokeswoman” for Smiles 4 Keeps did what people doing this kind of harm to children often do – suggest that they and only they really care about the kids. Said Richards-Service:  “It’s heartbreaking to us that the focus is not on the best interests of the child.”

Right.  Because what could be better for a child than to face the trauma of a child abuse investigation because the family chose to find another dentist?  And what could be better for children than bothering child protective services agencies with more false and trivial reports, stealing the time of caseworkers from finding children in real danger?

 
Little or no real recourse for families

There have been suggestions that Hoyumpa complain to state consumer protection authorities.  That’s not likely to do any good.

Mandatory reporting laws make it easy for professionals who work with children to abuse their power.  There is no penalty for false reports made in good faith – and good luck proving that a medical professional wasn’t acting in good faith.  Indeed, Wezmar and his colleagues may well have persuaded themselves that they are doing the right thing by sending these letters – rationalization is powerful.

But false reports by medical professionals, even when well-meaning, are among the most dangerous, since they are among the reports most likely to be “screened in” for investigation by child protective services hotlines.

All this in spite of the fact that, even after more than 50 years, there is not a shred of evidence that mandatory reporting laws actually make children safer.  Many former proponents of those laws have had second thoughts.

And the climate is especially ugly in Pennsylvania, where hype and hysteria over child abuse have been at a fever pitch for years, largely as a result of the scandal involving former Penn State coach – and former group home operator and foster parent – Jerry Sandusky.

The Pennsylvania Legislature responded to that scandal with 23 separate laws broadening definitions of child abuse and generally encouraging anyone and everyone to report anything and everything.

It’s unlikely that any consumer protection agency is going to want to look “soft on child abuse” by helping families fight back.

Lasting consequences

Even beyond the trauma of the investigation, the consequences for the children of the falsely accused can be severe.

Even when child protective services decides an allegation is patently false, that’s not necessarily the end of it. Laws vary from state to state, but a record of the allegation can stay in a state central registry, sometimes for a decade or more.  And, if another false allegation is made the mere existence of the prior allegation may raise the level of suspicion.  Indeed, you hear it from child welfare agencies all the time: “Where there’s smoke, there’s fire.”

But in child welfare, a lot of people are just blowing smoke.

Blogger Lenore Skenazy, of Free-Range Kids fame, wrote about a strikingly similar case in Canada last year. Mom dared to switch dentists, was reported for “oral neglect,” the case was unfounded – but she can’t get her record expunged.  Skenazy writes:

The child protective agency says it hangs onto files for “accountability.” But if the charges were found meritless, it makes no more sense to keep Melissa’s case on file than it would if she were investigated for bank robbery and found to have been six states away the night of the crime. Should the authorities keep a file on her just because they once, completely mistakenly, thought she robbed a bank?

The issue here is how easy it is to drag a family into an abuse investigation, and how hard it is for the family, like an impacted molar, to get itself extracted.

Still, it could have been worse.  At least this happened in eastern Pennsylvania. Everything would have been worse had it happened at the other end of the state – in Pittsburgh. This post explains why.

If it’s April Fools, it must be Child Abuse Hype and Hysteria Month

Back in 2003, one of the groups most responsible for fomenting hype and hysteria about child abuse came remarkably close to admitting that they did just that – and that it had backfired.

Rather like Dr. Frankenstein admitting he’d created a monster, in a 2003 Request for Proposals concerning how to improve their messaging, Prevent Child Abuse America wrote:

While the establishment of a certain degree of public horror relative to the issue of child abuse and neglect was probably necessary in the early years to create public awareness of the issue, the resulting conceptual model adopted by the public has almost certainly become one of the largest barriers to advancing the issue further in terms of individual behavior change, societal solutions and policy priorities.

This is especially worth remembering as we begin “Child Abuse Awareness Month” – a month, which, appropriately starts on April Fools Day.

So I’ve reprinted below our 2010 blog post on the topic – with some updates and links to newer data – since, unfortunately, aside from those data, nothing has changed. Because it's a lot easier to create a monster than to bring it under control

ORIGINALLY PUBLISHED APRIL 1, 2010 , UPDATED APRIL 1, 2018

Get ready for a seemingly endless stream of cookie-cutter news stories and Astroturf op ed columns (the kind written by national groups with blanks to fill in to make them sound home-grown) touting "Child Abuse Awareness Month" – based on the bizarre premise that the American people are blissfully unaware of child abuse.

There is something appropriate about the fact that "Child Abuse Awareness Month" starts on April Fools Day, since it involves fooling the public in order to push an agenda of hype and hysteria that obscures the real scope of the problem, and real solutions, in favor of approaches that only make a serious and real problem worse. Your typical Child Abuse Awareness month news story or op ed column follows a standard formula:

1.     Take the most horrifying case to occur in your community over the past year, the more lurid the better.

2.     Jump immediately from that story to a gigantic number which actually is only the number of "reports" alleging any form of child maltreatment. Ignore the fact that the vast majority of those reports are false and most of the rest are nothing like the horror story, and often involve the confusion of poverty with neglect. Or…

3.     Use only the total number of cases that caseworkers guess might be true, but call them "confirmed" giving the guesses, which are simply the opinion of a worker checking a box on a form, far more credibility than they deserve. A major federal study found that workers are two- to six-times more likely to wrongly label an innocent family guilty than to wrongly label real child abusers innocent.

4.     Throw in huge lists of "symptoms" or "warning signs" that "might" be "signs" of child abuse – and might as easily be signs of any number of other things.

5.     Instruct us all that it is our duty to phone the local child abuse hotline with any suspicion of anything no matter how vague and how dubious – instead of advising us to report when we have "reasonable cause to suspect" maltreatment, the same standard often used in law to guide "mandated reporters."

6.     Remind us that we are welcome to call the hotline anonymously – thereby encouraging those who want to harass an ex-spouse, a neighbor or anyone else against whom they may have a grudge to go right ahead, secure in the knowledge that they'll never get caught because they can conceal their identity.

It all comes from the same ends-justify-the-means mentality behind the egregiously-misleading report published by Every ChildMatters – the mentality that says: what's a little distortion and exaggeration in the name of a good cause?

In fact, such distortion and exaggeration can do enormous harm to children. 

Hotlines wind up with more false reports and trivial cases; children are harassed and traumatized by needless child abuse investigations – often including stripsearches as caseworkers look for bruises - and some of those children are forced needlessly into foster care. The caseworkers wind up even more overloaded by these false allegations, so they have even less time to find children in real danger.

Reality check

NCCPR has some resources on our website for any journalists and others interested in putting all this into context, countering the hype and hysteria and pressing for real solutions:

·         Issue papers on Understanding Child Abuse Numbers and False Allegations: What the Data Really Show

·         Our analysis of the latest comprehensive study of child abuse, which puts the scope of the problem into context

·         Our Solutions pages, Doing Child Welfare Right and our Due Process Agenda.
·         Our essay on how to really prevent child abuse: take a social justice approach instead of a public health approach.

If the people behind "Child Abuse Awareness Month"  (also known as "Child Abuse Prevention Month") really want to prevent "child abuse" then how about campaigning to ameliorate the worst effects of poverty.  

Poverty increases the stress that can lead to actual abuse and, as noted above, poverty itself often is confused with "neglect."  This can be seen by the fact that the simple act of raising the minimum wage $1 an hour cuts "neglect" by ten percent.

The problem of child abuse is serious and real, but the solutions have been phony. The distortion and exaggeration that typify child abuse "awareness" campaigns only promote phony solutions and make those serious, real problems even worse.

If only there were a Statistics Abuse Prevention Month.