Another major failure of Iowa foster care

Among the many tragedies that await many children once they are torn from everyone they know and love and forced into foster care is the prospect of being needlessly doped up on potent, sometimes dangerous psychiatric medications.

It is a frequent topic of newspaper exposes, including this one from reporter Karen de Sa when she was at the San Jose Mercury News.  Indeed, when the Trump Administration started tearing apart families at the Mexican border, it was among the first of many abuses to be exposed.

That’s because it’s inevitable.  Most of the people who control these children’s lives have no real stake in them. Many are well meaning and genuinely want to help the children. But they don’t love those children.  So it’s a lot easier to deal with their trauma by rushing to the prescription pad.

It should be no surprise that one of the states that is most callous in its use of foster care to destroy families now is revealed as among those most likely to misuse and overuse psychiatric medication on the children they tear from their homes.

And it should be no surprise that this same state does a horrible job of policing how it dispenses these meds.

That state is Iowa.

Iowa has a long ugly history of child welfare failure. Year after year Iowa is one of the states most likely to resort to a take-the-child-and-run approach to child welfare. 

And now, a report from the Department of Health and Human Services Office of the Inspector General shows that Iowa is among the five states most likely to use psychiatric medication on foster children.

Using a random sample of cases involving children in foster care during the six months ending March 31, 2015, the report examined the five states at the top of this dismal list. It looked at how their regulations for dispensing these medications compared with national model standards and how each state complied with its own regulations.

The other states examined are Maine, New Hampshire, North Dakota and Virginia.

The report found that none of the states has controls on the use of these medications that meets national model standards.  And none of the states does well at living up to the minimal standards it does have.

But the Iowa results are particularly dismal.  Among them:

● In 72 percent of the cases examined, there was nothing in the case file to indicate the caseworker had documented whether the medication was meeting the child’s needs.

● In 83 percent of the cases examined, there was no evidence that caseworkers even asked the foster parents if the medications were working.

● In 84 percent there was no documentation of why the child was being medicated (which may help explain the other two findings).

The report suggests various bureaucratic solutions – all of which miss the point.  As the report itself pointed out:

Unlike children from intact families children in foster care often do not have a consistent interested party to coordinate treatment planning or to provide continuous oversight of their mental health treatment.

That’s bureaucratese for: Foster children don’t have someone who loves them watching out for them – because often, those are the very people from whom they’ve been taken.

This is a lesson we should have learned by now from Florida which, when the late George Sheldon was running the child welfare agency, was particularly aggressive in trying to reduce the overuse of meds. As they dove deep into the data they found something fascinating: When children were placed in kinship foster care, that is, with their own relatives, they were far less likely to be placed on psychiatric meds than they were when placed with strangers or in institutions.

Drugging is one more way foster care endangers large numbers of children it is intended to help – and it is one more example of why the only way to “fix” foster care is to have less of it – especially in states like Iowa.

An open letter to two Florida columnists

Their anguish over the death of another child “known to the system” is genuine.  I think they’ll also be open to some new ideas.

A little over a week ago, two columnists for the Tampa Bay Times, Sue Carlton and John Romano, wrote about still another death of a child “known to the system” in Florida.  Often, when that happens, I reach out to the journalists in a letter.  This time, I’m sharing that letter with everyone.

  

Dear Ms. Carlton and Mr. Romano:

            I am writing to you because you’ve both written columns about the tragic death of Jordan Belliveau, another child “known to the system” in Florida – apparently on the same day.  More particularly, I am writing because your columns were not the usual quick-and-dirty “Boy do I hate child abuse!” rants – the kind of column that is filled with scapegoating; the kind that’s really just a cheap and easy way to meet a deadline.  On the contrary, the anguish in your columns is real and you both seem seriously interested in answers.

            Indeed, I first got in touch with you, Ms. Carlton, after you wrote a brave, counterintuitive column on some of these very issues. That was in 2010, a time when Florida child welfare finally was starting to improve.  As you may recall, when I wrote to you then, I predicted a backlash against reform.  Sadly, that’s exactly what happened.  I did not predict that it would be led by the Miami Herald – and the editorial board at the Tampa Bay Times.  But that’s also exactly what happened.  So the need for bold, counterintuitive thinking is even greater now.

            I am using the open letter approach because you’re certainly not alone in agonizing over how to fix child welfare in Florida.  And I am hoping that your interest in answers includes a willingness to look past the usual failed solutions – just as you did, Ms. Carlton, in 2010. Because those “solutions,” and the false premises that underlie them, are a large part of what has gotten Florida, and much of the country, into this mess in the first place.

            Among those false premises is one that both of you mention in your columns.  That’s understandable, since it is probably the most common misconception in all of child welfare: The idea that family preservation and child safety are inherently at odds – competing interests that somehow have to be “balanced.” The implication, of course, is that if you leave a child in or return a child to a home where abuse or neglect has been alleged, that’s inherently risky. Keep the child in foster care and it may ruin his psyche, but at least he’s physically safe.

            That is not true. 

What I will argue in this long letter is that in the overwhelming majority of cases family preservation isn’t just more humane than foster care, it’s safer than foster care.  And the real reason for horrors such as the death of Jordan Belliveau has nothing to do with any supposed “policy of reunifying families at all costs” at Gay Courter, a volunteer “guardian ad litem (what most states call a Court-Appointed Special Advocate (CASA)) claims in a Times op-ed column.

On the contrary, it’s almost always because of caseworkers so horribly overloaded with cases of children who don’t need to be in the system that they lack the time to properly investigate any case.  As a result, they make terrible mistakes in all directions.  Even as they take many children needlessly they leave others in, or return them to, dangerous homes.

            Those false premises are laid out most clearly in Ms. Courter’s op-ed.  Since I’ve followed Florida child welfare for about 30 years now, and NCCPR has issued reports on child welfare dating back to 2000, I am familiar with Ms. Courter’s work. I know that, like most people in child welfare, she has only the best of intentions. I also know that at least one of you has written admiringly about her in the past.  I, on the other hand, am that guy who keeps saying those terrible things about the whole approach to child welfare taken by the Times and the Miami Herald. I make no apology for that. When children’s lives are at stake - literally – good intentions aren’t enough.

The Times and the Herald didn’t make a good child welfare system bad. But they helped make a bad child welfare system worse – and they helped to halt and reverse what had been the first real improvement in that system in decades.  You are in a position to do better.  And if you are willing to reconsider old assumptions then you can help break the cycle of tragedy-investigate-repeat that Ms. Carlton aptly described in her column.

A lawyer on what standing up for “children’s rights” is really all about.

Crystal Baker-Burr is a lawyer for the Bronx Defenders. But before that, she worked for the Legal Aid Society Juvenile Rights Project representing children in child welfare cases.  

In a post for an outstanding blog called Rethinking Foster Care, she writes about some of the cases she’s seen – particularly cases involving when New York City's Administration for Children's Services abuses its “emergency" removal power. 

Here's how her column begins:

"Can I have that quarter?" Anita asked me, pointing to the change she found in the chair in the courthouse interview room. I asked her what she needed it for. "I am saving all the change I find on the ground and keeping it with me,” she said. “If they ever kidnap me and my brothers again, I can take a cab back home to mommy."

You can read the rest here.

(And while you're there, you can click on the icon in the upper left corner to subscribe to get posts from Rethinking Foster Care by email.)

Want to know how what Trump did to families at the border compares to how the foster care system works? Use this handy chart!

UPDATE: There's actually still another similarity that emerged just this year.  Details here.

The Trump Administration policy of tearing apart families at the Mexican border brought home to many Americans the enormous harm done to children when they are taken from everyone they know and live.  It wasn’t long before people started to wonder: How different is that from what U.S. child protective services agencies – the agencies that investigate allegations of child abuse and put children in foster care – do every day?

We discuss the similarities, and the differences, in detail in this previous post.  But now we’ve added something else: This handy chart for easy comparison:

More evidence of racial bias in child welfare – and an ingenious new way to curb it

When writing about the racial bias that permeates child welfare, I often mention a study in which caseworkers were given hypothetical cases. Everything was identical except the race of the family.  The result: Children were assessed as being at greater risk when the family was identified as African-American.

That suggests one obvious way to curb racial bias.  Or maybe not so obvious.  Because it didn’t even occur to me until I saw this video, a TED Talk by Prof. Jessica Pryce, director of the Florida Institute for Child welfare at Florida State University:

She discusses an approach that stands the hypothetical on its head, and applies it to real cases: If caseworkers are biased when they know the race of the family, what would happen if they didn’t know?

The county-run child welfare system in Nassau County, on Long Island, New York, decided to try to find out.  As one top administrator told Prof. Pryce:

Child welfare is very subjective, because it's an emotional field. There's no one who doesn't have emotions around this work. And it's very hard to leave all of your stuff at the door when you do this work. So let's take the subjectivity of race and neighborhood out of it, and you might get different outcomes.

And another worker in the agency acknowledged that

 Once you hear certain towns, right away, automatically you think the worst of that particular community. And it’s probably about six towns that I can think off the top of my head that they think is like, “Oh my God.” So I think that the name and the address have a lot, and also the next part of it is the presentation of the [case]worker.

So Maria Lauria, Diretor of Children's Services in Nassau County came up with a practice known as Blind Removal Meetings.  It works like this: When caseworkers want to remove a child from the home, they first must go before a committee. 

But, as Prof. Pryce explains:

When they present to the committee, they delete names, ethnicity, neighborhood, race, all identifiable information. They focus on what happened, family strength, relevant history and the parents' ability to protect the child. With that information, the committee makes a recommendation, never knowing the race of the family.

Now, of course, there is an entire group within child welfare that insists that there is no racial bias in child welfare.  If that’s true, then, of course, Blind Removal Meetings should have no effect on removal decisions at all.  On the other hand, if there is racial bias then Blind Removal Meetings should lead to fewer removals of Black children.

Prof. Pryce has the results:

In 2011, 57 percent of the kids going into foster care were black. But after five years of blind removals, that is down to 21 percent.

So add Blind Removal Meetings to the huge pile of evidence that yes, there is a serious and real problem of racial bias in child welfare.

Limits of Blind Removal Meetings

There are some limits to this approach.

● In many big cities, almost every child removed is nonwhite, so, presumably, there’s no way reviewers won’t know that much about the family.

● The CPS agency has to be willing to get serious about workers not declaring cases to be phony “emergencies” and needlessly removing children on the spot – before anyone has a chance to review them at all.  In New York City, for example, that probably happens in nearly half of cases, and maybe more.

● Blind Removal Meetings curb bias at one stage of the process – the decision to remove a child from the home. They can’t curb bias in who gets called in to child abuse “hotlines” in the first place.

● Blind Removal Meetings can curb racial bias, but not class bias.  In the case example Prof. Pryce uses at the start of her talk, we don’t know the race of the family, but we know the family is poor.

But in places such as Nassau County, Blind Removal Meetings are one way to curb the needless removal of African-American children.  And there are plenty of places across the country like Nassau County.

Unfortunately, Prof. Pryce leaves one question unanswered: Who was it in Nassau County who first thought up this idea that now seems so obvious – but obviously wasn’t?  Someone really ought to thank her or him.  UPDATE: Prof. Pryce got in touch with me to let me know that, as is now noted above the idea originated with Maria Lauria, the county director of children's services. So, thank you Ms. Lauria.

Fox News and the Fox News of child welfare: We compare. You decide.

Once again, a blogger who used an ugly racial stereotype against an impoverished Black mother is showcased in the so-called Chronicle of Social Change

Andrew Gillum, the mayor of Tallahassee, is the Democratic nominee for governor of Florida.  Gillum is African-American.  He won an upset victory in a Democratic primary.  As soon as his Republican opponent, Ron DeSantis, found out who he’d be running against, he declared that Florida voters shouldn’t  “monkey this up” by voting for him.

The comment was widely called out for exactly what it was – a racist dog whistle. 

Of course, he made the statement on Fox News, and Fox News hosts rushed to defend him.

There are striking parallels between this incident and the behavior of the Fox News of child welfare, the so-called Chronicle of Social Change.

I refer of course to the infamous column in which the Chronicle’s one-time “blogger of the year,” Marie Cohen, used an ugly racial stereotype about a poor African-American mother.

I do not believe Marie Cohen – or Chronicle publisher Daniel Heimpel – is a racist. I am sure  both believe they are genuinely helping to “protect” children from child abusers.  But that doesn’t make the column any less ugly.  I’m sure a lot of people at Fox News sincerely believe they’re helping to “protect” America from illegal immigrants.  Good motives are no excuse for stereotyping or bullying.  Cohen’s column engaged in both.  And now, Heimpel is publishing Cohen again.

The column and the stereotype

In seeking to rebut a New York Times story about foster care as the new “Jane Crow”  Cohen implied that one of the parents  who told the Times about the needless removal of her children was wasting money buying sneakers – something that is never mentioned or suggested in the Times story itself.

As I noted at the time,

I don’t know why Cohen brought sneakers into the discussion. I do know that there is a crude, pernicious racial stereotype that says African-Americans are poor because they waste money on expensive sneakers.

It’s a staple of right-wing rants on internet comment boards. In one such rant on Glenn Beck’s site, The Blaze, about “HOW TO PREVENT BLACK CHILDREN FROM GETTING MURDERED” (caps in the original, of course) a commenter writes: “#5 INSTEAD OF BUYING THEM EXPENSIVE SNEAKERS AND SMARTPHONES - BE A REAL PARENT.”

Heimpel, the Chronicle publisher, should have apologized for the column and attached an “editor’s note” disavowing it. Instead, he promoted it on his personal Twitter feed.

If anything, what Cohen and Heimpel did was worse than what DeSantis did. At least DeSantis picked on someone his own size.  Cohen used the stereotype against one of the most defenseless members of society, a low-income African-American mother whose only “crime” was daring to tell her story to The New York Times.  That isn’t just stereotyping.  It’s bullying.

The point is not that the mother should be immune from criticism by those who may disagree with what she did that got her into trouble with child protective services. The point is that there are ways to do that without stereotyping and without bullying.

The column was not Cohen’s only blunder on matters of race. In another column, she falsely claimed that the Alliance for Racial Equity in Child Welfare had “quietly suspended its work.”  The Chronicle didn’t check the false claim before publishing it, and knew the claim was false for weeks before finally correcting it.

In still another, her defense of the use of “predictive analytics” in child welfare was almost identical to former House Speaker Newt Gingrich’s defense of stop-and-frisk.

In yet another column, Cohen complained that “As a social worker in the District of Columbia, I was subjected to multiple low-quality, heavy-handed trainings that tried to help me discover my hidden biases.”

Now, the encore

And now Heimpel, the self-proclaimed “child welfare expert” whose own extremist rhetoric includes dismissing concerns about racial bias in child welfare as a “panic” and suggesting that the spread of family preservation is analogous to cancer, has brought Cohen back for an encore.

She coauthors a column that tries to draw false distinctions between what Donald Trump and his administration did to children at the Mexican border and what child protective services agencies do all the time.  No, I will not link to the column because, though this column did not stereotype anyone, I try to avoid linking to people who have sunk to using racial stereotypes.  But their claim can be summarized as follows: When CPS does it it’s different because we mean well and we only take children from horrible abusers.  

It is reasonable to have a debate over the extent to which the two forms of tearing apart families are similar.  No one, in fact, claims they are identical – only that there are far more similarities than people such as Cohen – and Heimpel – want to admit.  What is unreasonable is including in the debate someone who previously invoked a crude racial stereotype and used it against a low-income African-American mother.  Once you do that you’ve crossed a red line – and journalists should recognize that line.

There are plenty of people who sincerely disagree with the analogy between what Trump did at the border and how the foster care system works who do not resort to racial stereotyping.  In fact, the Chronicle already had run a column by one such person, who attempted to make the same case as the Cohen column.  Since that author has not used racial stereotypes, I will link to it.

The Cohen column was redundant.  Perhaps Heimpel published it because he is such a fan of that point of view – and of his former “blogger of the year.”  Or perhaps he published it because what Trump did has indeed brought home to millions of Americans just how awful it is for children to be taken from their parents, and some of those Americans might indeed reach a conclusion the Chronicle doesn’t like: that U.S. child welfare agencies can and should take away far fewer children.

Other parallels to Fox News

This is not the only way in which Heimpel’s behavior mirrors that of Fox News.  In a recent post to this blog I wrote about how Trump has exploited the death of Mollie Tibbetts, allegedly killed by an undocumented worker, to push his agenda of fear and hatred toward immigrants.  As Columbia Journalism Review noted, the White House rushed out a video featuring relatives of people killed by undocumented workers – and, of course, Fox News was glad to amplify the message.

All of it was in support of the Big Lie of American immigration. Or, as CJR explained:

The president’s hardline immigration stance is grounded in the false belief that undocumented immigrants represent a clear and present danger to American citizens, and Tibbetts’s murder fits the narrative that has been a hallmark of Trump’s rhetoric since the first moments of his campaign.

(CJR should have said false claim – we don’t know if even Trump really believes it.)

The exploitation of the Tibbets case by Trump – and by Fox News - is very much like the way Heimpel exploited another tragedy, the death of five-year-old Jeremiah Oliver in Massachusetts, in support of the Big Lie of American child welfare – that family preservation is inherently at odds with child safety.

Heimpel co-authored an op-ed for the Boston Globe with Elizabeth Bartholet, one of the most extreme advocates of a take-the-child-and-run approach to child welfare, and a leader of a movement that denies the existence of racial bias in child welfare. Heimpel and Bartholet used the Oliver case to attack “differential response” an approach to handling child abuse allegations that has been found safe and effective in more than two dozen studies.

It would have been bad enough to exploit the tragedy had Oliver’s case actually been diverted to differential response.  But it wasn’t.  Heimpel and Bartholet admit this – in the fourth paragraph. Then, they argue, Trump-style, that it’s o.k. to exploit the tragedy because other cases that might be like Oliver’s might be diverted to differential response.

Just the kind of argument Fox News would love.

In recent months the Chronicle had tried to pass itself off as more mainstream – more Shep Smith, less Sean Hannity.  It even publishes dissent from its party line once in awhile, just as Fox News occasionally brings on a liberal pundit.  And because of all the cutbacks in newspapers, editors may find it tempting to reprint material that the Chronicle hands to them.

But any potential partner should understand: This is an organization that accepts, and condones racial stereotyping.  Almost everything it publishes comes with an agenda.  Until that changes, the Chronicle should be viewed as a conduit for extremism, not a news organization.  Just like Fox News.

NCCPR in Youth Today on the little law that couldn’t

The law is the so-called Child Abuse Prevention and Treatmente Act (CAPTA).  It codifies everything wrong with how we “fight” child abuse.

The idea of using CAPTA as the organizing framework for coping with child abuse, or even thinking about it, is absurd. And the notion that somehow a more powerful CAPTA with more money and more enforcement would somehow help children is profoundly dangerous.

Read the full column in Youth Today here.