Costa’s defense of residential treatment left someone out

In his response to reporter Karen de Sá’s searing expose of the misuse and overuse of psychiatric medication on foster children in general and one case from his own institution in particular, Joseph Costa, CEO of Hillsides, serves up all the usual buzzwords and boilerplate.

“The typical child referred to a residential treatment program has experienced multiple failed treatment interventions and placements,” Costa writes. “Often they have been traumatized by family dysfunction, overwhelmed by learning challenges …” etc., etc.

It’s the standard party line. Of course the kids have to be prescribed lots of drugs, we’re told, look how messed up they are when we get ‘em! It’s the same argument Shay Bilchik, former president of the Child Welfare League of America, used to try to explain away the fact that study after study has shown residentialtreatment to be a failure.

But something – or rather, someone – is missing.

That would be Tasia Wright, the now 27-year-old flesh-and-blood human being whose story was the centerpiece of the article to which Costa objects. Tasia courageously told her story – and shared her medical records – with de Sá.

Tasia’s story doesn’t fit Costa’s boilerplate.

She was taken from a mother who did not beat or torture her. The charge was neglect because of her mother’s drug use. Tasia was placed at Hillsides at age six. As de Sá reports:

 The little girl arrived at … Hillsides … with a nurse noting in her files that Tasia “appears bright, answers questions, smiles. … Says she has no aches, pains or problems.”

In the intervening years, Tasia was put on 23 different medications. Ten different meds were tried in her first year at Hillsides – again, when she was six years old.  At one point, she was on five meds at once.

And what happened to that bright, smiling six-year-old? de Sá writes:

She left the group home 13 years later, morbidly obese, with Type 2 diabetes and medication-induced tremors.

 She’s been homeless and in and out of jail for minor offenses.

 Of course Costa didn’t want this to happen. Like most people in child welfare, I’m sure he’s in it for the right reasons. But imagine how things might have turned out if all the money taxpayers spent to achieve these results, probably hundreds of thousands of dollars, had been spent instead on drug treatment for Tasia’s mother.

Costa also fails to address another issue.

According to de Sá’s story, one of the psychiatrists who treated Tasia, Dr. Eliot Moon, was among the California doctors most likely to prescribe antipsychotic medications to foster children. He also runs a firm that received more than $1.2 million in research grants from drug companies between 2013 and 2015.

Moon’s dual role was so disturbing to one volunteer and big donor to Hillsides – Lorraine Triolo –  that she withdrew a major donation when Costa refused to remove Moon from the Hillsides staff.

Triolo got to know Tasia well when she was at Hillsides. She says she never saw the behaviors Hillsides cited as justification for using all those meds on Tasia. She told de Sá that Tasia “was always a sweet, sensitive kid.”

That jibes with the general observations of a former Hillsides counselor, Rosa Martinez.  Again, from de Sá’s story:

Martinez said  … [t]he staff would complain in meetings about kids acting out, and a therapist would take those complaints to Moon as prescription recommendations. … “What I saw is everybody just trying to get through their shift, versus what’s best for the kids.”

Costa’s column offers no response to Triolo or Martinez. Instead, he writes that Hillsides follows “the practices and regulatory protocols governing the prescribing of medication to a child in the foster care system.”

Well, yes. But the whole point of de Sá’s years of painstaking reporting is that those protocols are grossly inadequate.

Costa also tells us that judges have to approve the medications. But as the former presiding judge of the Los Angeles County Juvenile Court, Michael Nash, told de Sá in 2014, “there aren’t too many psychiatrists or psychologists on the bench. So how in the heck are we able to make good decisions about these meds?”

Costa also notes that “the children and youth are also advised they have a right to refuse medication.” I’d love to know how that’s explained to someone like Tasia who, at one point, was so doped up that a doctor described her as “markedly Zomboid in manner and function.”

And finally, Costa falls back on that old standby: Hillsides is “accredited” by the so-called Council on Accreditation.  I’ve explained previously why such accreditation is meaningless.

Well, almost meaningless. The accreditation and the fact that they have nurses on the grounds means that Hillsides almost certainly would make the grade as a “qualified residential treatment program” under the so-called Family First Act. That tells you plenty about how toothless that bill is and why the hopes expressed so poignantly by former foster youth such as Brittney Barros are unlikely to be realized, even if it passes.

A lot of good journalism about child welfare

There have been several impressive stories and series over the past week:

The Atavist magazine has a deep dive into how Child Protective Services really works.

The Sun Herald in southern Mississippi did a six-part series on wrongful removal in that state.

There’s been a lot of coverage of Simone Biles’s childhood; but this is the only story I’ve seen that learned the right lesson.

And this story offers a reminder that “free-range” parenting generally is not an option if you’re poor or nonwhite.

A good decision for New York City foster children

Judge sees New York foster care suit “settlement” for the sham that it is

A federal judge wisely threw out a proposed settlement in a lawsuit brought against the New York City Administration for Children’s Services (ACS) and – supposedly – against New York State.  The suit was brought by the city’s “public advocate,” Letitia James, and by Marcia Lowry, who used to run the group that calls itself “Children’s Rights” before they had a parting of the ways.

I say supposedly against the state because under the settlement the state wasn’t actually required to do much of anything – just “monitor” the city.  So of course the state rushed to “settle” – it was a great way for Gov. Andrew Cuomo to stick it to his far more progressive rival, Mayor Bill DeBlasio at the expense of the city’s most vulnerable children.

Perhaps most appalling, the settlement actually would have barred anyone else from bringing a class-action suit against the state during the term of the settlement. (Presumably Lowry would have sought a similar ban against suing ACS had she reached a settlement with ACS.)  In other words, Lowry simultaneously maintained that her suit was essential and every other possible class-action suit was worthless.  The arrogance behind this position is breathtaking.

The fact that not just lawyers for parents but also the lawyers who represent children in foster care proceedings called b.s. on this one tells you everything you need to know about this suit.  It also tells you that Marcia Lowry, who long ago did some real good with some of her lawsuits, no longer understands what works, and what doesn’t, in American child welfare. 

Details about Lowry and “Children’s Rights” are in this NCCPR report.

 ACS has made real progress

 Yes the city child welfare system still has big problems.  It’s also made a lot of progress – that’s why lawyers who in the past might have backed a suit like this one now feel this particular suit and the particular remedies it sought were the wrong approach.

The part of the suit that seems to have gotten the most attention is the part pointing out that

the average length of stay in foster care is longer in New York City than the national average.  But that is partly because the city has curbed needless removal of children from their homes.  So there is less “churning” in which children are taken from everyone they know and love and then “thrown back” a few weeks later – much the worse for the experience – because everyone realizes the child never should have been taken at all. 

States and localities that engage in that pernicious practice actually can wind up looking good when you measure average length of stay.

The judge should be commended for throwing out the settlement. And Marcia Lowry should stop bringing foolish, arrogant lawsuits before whatever legacy she has is tarnished beyond repair.

New columns about a child welfare tragedy and the foster care "Twilight Zone"

In the Chronicle of Social Change: How Child Protective Services took an almost unimaginable tragedy - and made it almost unimaginably worse.

Read the column here.

And in Youth Today: How child welfare agencies hide the true number of children they take from their families.

Read the column here

Think a tragedy can’t get any worse? just add child protective services

In a field filled with subjectivity and bias, it’s sometimes assumed that one determination is easy: figuring out if a death was caused by child maltreatment.

In fact, that’s often as subjective as everything else. I usually illustrate this with the following hypothetical.

Early one Sunday morning, a young child finds a way to unlatch the back door while his parents are asleep. He wanders off, falls into a body of water and drowns. Accident or neglect? If the body of water is a pool behind a McMansion, it probably will be labeled an accident. If it’s a pond behind a trailer park, it probably will be labeled neglect.

But no hypothetical can demonstrate how much cruelty such subjectivity can inflict on children. For that, only real life will do.

Consider the story of the Wartena family – mother, father, and five children – who were passing through Amarillo, Texas, on their way home to California last month.

Seven-year-old Alexis Wartena, who was autistic and fascinated by water, opened a broken latch on their hotel room door and left the room. She wandered to a nearby lake and drowned.

The Amarillo police, who apparently watch too many episodes of Law & Order, seem to have jumped immediately to the conclusion that the parents must have killed the little girl. So they allegedly browbeat the parents for 12 hours, possibly delaying the search for the child in the process.

Emotional “torture”

The family’s pro-bono attorney, Jesse Quackenbush, calls what was done to the girl’s mother emotional “torture.”

But it was mild compared to the emotional torture endured by Alexis’ siblings, aged 6, 5, 4 and 2. At the worst moment of their lives, the moment when they most needed the comfort of their parents, they were torn away from them by strangers – child protective services workers – and consigned to foster care, with no idea when or if they’d ever go back. The parents talk about the family’s ordeal here.

For children of this age it can feel like a kidnapping; you can’t explain good intentions to a two-year-old. And young children often believe anything that happens to them somehow was caused by them. So these children may well have felt the death of their sister somehow was their fault and now they were being punished. They may carry these scars forever.

For one child, the harm was not just emotional. Child Protective Services admits that one of the children was physically abused in foster care, which one could almost have expected giventhe high rates of abuse in foster care.  And the Wartena children were subjected to the special hellscape that is Texas foster care.

Once the child was abused in foster care, CPS gave all the children back. How did parents who supposedly were a terrible threat to their children instantly become no threat right after one of the children was abused in foster care?

Unless, of course, they never really needed to be taken away at all.

CPS was only protecting itself

The harm inflicted on this family by CPS had nothing to do with protecting children and everything to do with protecting CPS. The workers probably were terrified of having the next high-profile tragedy on their caseload.

What are the odds this would have happened had the tragic accident occurred in that hypothetical backyard pool, instead of a pond behind a hotel where the rooms rent for an average of $67.50 per night?

We don’t need to rely on hypotheticals here, either.

Several weeks ago, I wrote about a Michigan case in which a little boy died and the parents really did kill him. But in the case of Ricky Holland, the murderers were affluent adoptive parents.

During the time after Ricky Holland disappeared but his body had not yet been found, Michigan child protective services not only left Ricky’s siblings in the home, they actually gave the Hollands final approval to adopt another foster child in their care. “This worker has no concerns regarding the safety of the other children,” a CPS caseworker wrote in a report.

One more burden?

Even after all they’ve endured, the Wartena family may have to bear still another burden – if, that is, they live in a community where the latest fad in child welfare, predictive analytics, is taking off. After all, what would an algorithm say about a family in which one child died and the other children already been taken away and thrown into foster care?

Wherever predictive analytics rules, families like the Wartenas will be under suspicion forever.

 This column was co-authored by Johana Scot, executive director of the Parent Guidance Centerin Austin.