Wednesday, October 5, 2011

Child Welfare in New York: Everyday Horrors

An abridged version of this post is available on the website of the trade journal Youth Today.          


UPDATE, OCTOBER 6: At the end of this post see why the organizers of today's webinar will NOT be answering the questions raised in this post


  I read about a horror story last month.

            It wasn’t one of those cases where a child died even though the case file had more “red flags” than a Soviet May Day parade.  Nor was it one of those cases where a child was taken from parents who could have been mother- and father-of-the-year only to die in foster care.

            Those horrors are the extremes and they are very rare.

            What made this case so horrible is the fact that it’s so typical.  It’s also the kind of case child protective services (CPS) agencies almost always hide behind confidentiality rules.

            This one became public – minus identifying information and with all names changed – thanks to a webinar about ChildStat, the pride and joy of John Mattingly, former commissioner of New York City’s Administration for Children’s Services (ACS).  At ChildStat meetings, ACS officials go over data from one region and pour over one case, chosen at random.

            It’s the 12-page narrative of that one case that provides this rare x-ray of the soul of a CPS agency.   They never got to it during the webinar, but they might during a follow-up webinar tomorrow.  They asked for questions in advance.  I've put mine at the end of this post.

To really get the picture, the entire narrative needs to be read, because, in every sense of the term, the devil is in the details.  I hope readers will take the time to go through it, and then compare this example of typical practice to an example of best practice from the latest newsletter of one of the smartest groups helping child welfare agencies improve, the Child Welfare Policy and Practice Group.  Readers also might want to consider these questions:

●How would your own family rate under the kind of scrutiny the family in the New York City case was forced to endure? 

●Can you imagine a government agency trying to micromanage a white, middle-class family the way ACS did in this case?

            Meanwhile, I’ll try to summarize.

            For starters, in half the states, this case never would have brought a CPS agency to the family’s door at all.  The allegation was “educational neglect,” something discussed often on this Blog.  According to a comprehensive study by the Vera Institute of Justice, a study commissioned by the New York State Office of Children and Family Services, half the states wisely leave such cases to the schools to sort out.

            The allegation was that the older child, age 8, missed 25 days of school between September and early April, and was late 44 times.  The parents had gotten lots of warnings and they allegedly were too lenient when the child said she was sick. 

            That’s it.  No allegations of beating, torture, or starvation.  Nothing about sexual abuse or parental drug abuse.

            The parents are Hispanic, their income is about 140 percent of the national poverty line – and remember, this is New York City.  They sleep on a queen size bed.  (I have no idea why that is relevant to anything, but it’s included in the narrative.)

Clearly the family has plenty of reason for stress to begin with.  Nevertheless, the picture that emerges, in spite of the narrative, is of parents who love their children, have been trying their best and are guilty of, at worst, human fallibility.  They also had tried, without success, to get the school to help with the children’s problems – possibly engendering the hostility of the teacher who, by the mother’s account, treated her like dirt – and then reported her to ACS.

LIVES TURNED UPSIDE-DOWN

            But this one allegation against this admirable family was enough to turn their lives upside down for at least a month (the case was still open when the narrative was written).  There was one inspection visit after another.  Over and over the children were questioned about the most intimate aspects of their lives.  Had anyone touched them inappropriately? (No.) Did their parents ever hit them? (Yes, they got spankings.) Did the parents ever hit each other? (No.)  Do they argue? (Yes – imagine that.)   Because of the spankings the caseworker was ordered to be sure she “assessed the children for marks and bruises each time she visited.”  I wonder what the children had to endure to meet that requirement?
           
            The parents underwent a similar grilling.  When ACS wasn’t at the door at all hours, ACS was dragging them down to the borough office.

            Though best practice in child welfare says you assess a family’s strengths as well as their weaknesses, from day one these parents were treated only as suspects.  Every alleged failing was documented in the most minute detail, creating a 12-page litany of finger-wagging. 

            “The parents denied any domestic violence substance abuse or problems with physical and mental health,” the narrative says.  Denied?  They’d never been accused of anything like that in the first place. Yet throughout the narrative that word, - denied - is used over and over to describe the parents’ responses.  The same information could have been conveyed to the ChildStat meeting by writing “the parents said they did not…” 

            And the denials were never enough.  When asked, the younger child, age 6, says Dad sometimes drinks alcohol.  So the caseworker is instructed to go back and grill the child about “what he drank and his behavior.”  The children repeatedly say there’s no domestic violence.   But a supervisor says “domestic violence assistance was also a possibility.” Another supervisor tells the worker to “inquire more about Joy’s [the older child’s] exposure to her parents’ arguments and how it might affect her.” 

            The Child Protective Manager (CPM), the highest-ranking official to look at the case,  

noted that her concern was that Joy held herself responsible for getting her mother into trouble because she did not want to go to school. The CPM added that the mother should have provided Joy with more structure regarding her school attendance.  … She added that [the mother] should take full responsibility for having not provided structure for her children.

            The caseworker concluded that the parents did not “demonstrate developmentally appropriate expectations of all children” and did not “attend to the needs of all children and prioritizes [sic] the children’s needs above his/her own desires.”  Apparently this was based on the fact that when the bus was late, they didn’t find another way to get the children to school.

            It wasn’t just the parents put through the wringer.  The amount of time put into the case by the caseworker boggles the mind.  At one point, the caseworker came out of a meeting with her supervisor with “a list of at least 22 follow-ups … to complete” including “counseling the parents about inappropriate uses of corporal punishment” though there was no allegation or evidence that this was a problem.  No wonder caseworkers are drowning in the demands placed upon them and may well miss a child in real danger, as is well documented in an excellent New York Magazine story.  According to the Vera Institute study, fully 19 percent of the cases investigated by ACS are allegations of “educational neglect.”

THE PRICE OF “SUCCESS”

            At no time were the children taken from the home.  What happened to this family was probably the minimum amount of trauma a CPS investigation can inflict. In the end, the intervention by ACS may have improved the children’s attendance and prompted the school to get them some help the parents couldn’t get on their own. 

            But the family paid way too high a price for this “success” - and it was entirely unnecessary.

            In one of the seminal works of the 20th Century about child welfare, the late Joseph Goldstein, Anna Freud, and Albert J. Solnit write that:

Children react even to temporary infringement of parental autonomy with anxiety, diminishing trust, loosening of emotional ties, or an increasing tendency to be out of control. The younger the child, and the greater his own helplessness and dependence, the stronger is his need to experience his parents as his lawgivers, safe, reliable, all-powerful, and independent.

            And that’s even without all those assessments looking for bruises from spankings.

            In this case mom is faulted for being too lenient, too willing to accept it when her daughter said she was too sick to go to school.  But what happens now, when she tries to be more assertive, after ACS has spent a month badgering the family and undermining mom’s authority?

            And then there’s the incident with the lamp.

            Sometime after the investigation began, the older child explained that Danny, the six-year-old, “burned himself on a lamp when he attempted to fix a light bulb that blew out. She said that Danny’s teacher told him that he needed to help his mother more and so her brother wanted to fix the light bulb. Joy said that the lamp hit Danny in his face, but he did not cry. Joy denied that her parents have been arguing.”

            Yes, Danny explained the incident the same way, a pediatrician confirmed that this was a credible explanation and, fortunately, the caseworker accepted it.  But try to imagine the fear this family endured when it happened, knowing they were in the middle of a CPS investigation.


            The rationale for doing all this to a family, of course, boils down to “you never know.”  Like the fanatical drug warriors who see marijuana as a “gateway drug” today’s “child savers” to use the term their 19th Century counterparts gave themselves, see educational neglect as a gateway allegation. The child missed school.  So maybe mom’s a drunk and dad’s a pervert – you never know, right?


            But there is no evidence that children suffer more abuse in the states that don’t require their CPS agencies to investigate “educational neglect.”  And after doing a comprehensive reading of a random sample of cases, the Vera Institute researchers found that the notion that educational neglect is the "tip of the iceberg," is nonsense. The study found that generally, "educational neglect" is the tip of nothing except some kind of school problem, often one that is not the parent's fault.  Sending a CPS worker to the door only makes the family defensive and makes it harder to solve whatever problem may be causing absenteeism.


            As regular readers of this Blog know, the study authors recommended that if New York must keep investigating “educational neglect” it should be done through “differential response” in which either the CPS agency or a private contractor sends out a worker to offer a helping hand instead of a wagging finger.   Had that been done here, the same potential positive results would have been achieved with no cross-examination of young children, no comprehensive visual inspections for bruises and no documentation in the case file of the size bed on which the parents sleep.

            State after state has adopted this approach.  Every study finds no compromise of child safety and some find that safety improves. 

            But for at least a decade, since before he ever got to ACS, John Mattingly has opposed differential response.  Finally, late in 2009, he agreed to pilot it in some educational neglect cases.  Several months later, and without announcing it publicly, he put the pilot on hold indefinitely, something uncovered by some enterprising journalism students.

            So right now, some other New York City family is enduring the same trauma as the one in this narrative.  It happens all the time.  That’s why it’s a horror story.

                    Some questions for the webinar 
                   (and why they won't be answered)                               

Tomorrow, the same people who held the original webinar will conduct a follow up webinar.  They asked for questions in advance.  Here are mine:

●The narrative repeatedly uses the word “denied” to characterize comments by the parents and the children, as in “denied any domestic violence” “denied use of any drugs” etc.  In the absence of any evidence contradicting the “denials,” why wasn’t neutral wording such as “said he did not use any drugs” used in this narrative – and what does this say about the mindset of ACS workers and the author of this narrative?

●There is repeated discussion of alleged deficits in this family, and no explicit discussion of strengths.  Why not?

●On page 12 it states that “The supervisor told the CPS that she needed to “document that she assessed the children for marks and bruises each time she visited.”  How, precisely, are such “assessments” done?

●What did these children gain from this process that outweighed their being repeatedly questioned about the most intimate aspects of their lives and “assessed” on every visit for marks and bruises? 

●What did the family gain that outweighs the stress of a full-scale child abuse investigation?

●What did they gain that couldn’t have been accomplished, without the collateral damage, through a family assessment (differential response) instead of an investigation?

●Was all of the time and effort expended on this case the highest, best use of the time of the caseworker and the supervisor?

●According to a study by the Vera Institute of Justice in roughly half the states a case like this would not be subject to the jurisdiction of the child protective services agency at all.  What evidence do you have that children who miss a lot of school in those states are less safe or more poorly served by other interventions short of CPS involvement than children in New York City?

●The Vera study recommended that cases like this one be handled through “differential response.”  Every evaluation of differential response across the country shows that it does not compromise safety and some show safety improvements. Why did ACS at first agree to try differential response in some educational neglect cases and then renege on that promise?

UPDATE: And here is the response I got from the organizer of the webinar concerning why these questions will not be answered:


Thank you for sharing your blog posting with us. You have raised some very important case practice issues that merit further dialogue and debate. The focus of our webinar/learning lab is on the implementation of ChildStat, not on ACS case practice or policy decisions. Of course, many of the issues you outline are the very ones that the ChildStat initiative itself was designed to address - by providing time for managers and administrators to review and critique case narratives such as this one, to "get on the balcony" and observe what is actually happening on the frontlines, the agency can really examine "the devil in the details," as you put it, and have an open, honest dialogue about what happened, why it happened, and what needs to happen going forward to better reflect best or promising approaches.


Our national webinar series, including learning labs like this one, provides information about what it takes to implement specific workforce and leadership improvements - helping states, tribes and counties learn about promising macro-level approaches from one another, not analyzing case practice on the frontlines in a particular jurisdiction. This case narrative was provided as a learning tool, to illustrate the information provided to ChildStat session participants, and was not intended to be discussed in detail during the session. That said, we can certainly ask what might have happened in a session when presented with a case such as this one. I also hope you will raise any questions you may have about ChildStat as a tool for improving case practice and systems functioning on the call today.


Thanks, Sara
Sara T. Munson, MSW


National Dissemination Coordinator
National Child Welfare Workforce Institute
University at Albany School of Social Welfare