Friday, April 28, 2017

Richard Gelles Argues for a Child-Centered Approach to Child Welfare

I was very excited to get my copy of Richard Gelles’ widely awaited new book, Out of Harm’s Way. Gelles is one of the giants of child welfare. He wrote the The Book of David, which raised awareness of the unintended consequences of the prevailing family preservation ideology and helped inspire passage of the Adoption and Safe Families Act of 1997.
Gelles spends two chapters of his new book on the case of Daniael Kelly, a little girl with cerebral palsy who was allowed to waste away and die in a dark room despite repeated reports to Philadelphia child protective services and an open in-home case. Her case resulted in 17 individuals being convicted of, or pleading guilty to, charges ranging from manslaughter to perjury, including the child’s parents and numerous system employees.
Gelles asserts that governments respond to horrific deaths like Daniael’s by “rounding up the usual suspects.” These include adding money, staff and training; firing the commissioner; forming a blue-ribbon panel; and even changing the name of the agency. Advocates for children often respond by filing class action lawsuits, which result in court receiverships that often fail to achieve significant changes for children. 
In the rest of the book, Gelles lays out his own blueprint for system reform that “eschews the normal calls for more money, more staff, more training, and more lawsuits.” His proposal is structured around  four key “centers of gravity” that he says must be changed to improve the child welfare system and stop the horror stories.
Gelles’ first recommendation is that the system must become child-centered. He asserts that most child welfare workers and administrators consider the parent, not the child, to be the main client. In the Daniael Kelly case, workers used their home visits to try to motivate Ms. Kelly, hardly glancing into Daniael’s darkened room.
Gelles explains that U.S. law and tradition grants parents broad discretion in how to rear their children. This bias towards parents was accentuated after the passage of the Adoption Assistance and Child Welfare Act of 1980, which required that agencies make reasonable efforts to maintain a child at home and to reunify those who are placed in foster care.
Gelles argues that “the most important step in child welfare system reform is that agencies and the workforce understand that the child is the most important client in the child welfare system. Making the child the client means that the safety and well-being of the child is the primary concern and goal of the child welfare system. Moreover, and equally important, decisions regarding children must be made by considering a child’s sense of time.”
Gelles could not have said it better. Making the child the client, and restoring child safety as the preeminent goal in child welfare, is indeed the first step in any meaningful reform. Adhering to a child’s sense of time, even if that means limiting the amount of time it takes to kick a drug habit or treat mental illness, is an important aspect of a child-centered child welfare practice.
Gelles goes on to explain the central dilemma in child welfare. We have to decide whether we are more interested in reducing false negatives or false positives. A false negative is a case such as that of Daniael Kelly, who died because social workers missed the actual maltreatment that was going on. In order to avoid more Daniael Kellys, he argues, we must tolerate a larger number of false positives: children removed from homes where they were not in danger.
While Gelles is right about the tension between false positives and false negatives, I think he may be too pessimistic. He dismisses the claim that underfunding results in some of these tragedies, but I disagree. There is almost universal agreement from around the country that workers are overwhelmed. (That was certainly true for me as a foster care worker in the District of Columbia, which has some of the lowest caseloads in the country.)
If these systems were adequately funded, they could hire more qualified workers and give them lower caseloads. More qualified and less overwhelmed social workers could spend more time with families and make better decisions.
Moreover, if we develop better methods for assessing risk, we may reduce the number of false positives we have to incur in order to identify the children who are truly in danger. Indeed, Gelles’ second major recommendation is that social workers must be given better tools – namely predictive analytics tools to assess risk of future abuse and neglect – to help them make better decisions.
But Gelles is right when he points out that predictive analytics might not reduce child maltreatment fatalities. That’s because only about half of fatalities occur among children who are known to the system. He demonstrates that even an algorithm that was 99 percent accurate would create over 10 false positives for each of the fatalities that it actually predicted.
Unfortunately, Gelles does not devote any space to how we could prevent those fatalities, as well as other cases of abuse and neglect that are never reported. Most experts agree on the need for primary prevention programs like home visitation that seek to prevent abuse and neglect before they occur. Perhaps this is outside the scope of the book, because it is outside the child welfare system. But it needed to be mentioned.
Gelles’ third “center of gravity” is funding structure, and his argument is that the current structure creates a “perverse incentive to keep children in foster care.” As a result, he recommends turning Title IV-E into a block grant.
This “perverse incentive” narrative has become accepted in the child welfare community. The only problem is that it is not true. Most of the funding streams states can use for child welfare services – including Temporary Assistance for Needy Families, Medicaid, Social Services Block Grant and Title IV-B – can be used to support children outside foster care.
Moreover, only half of children taken into foster care are eligible for IV-E reimbursement due to the archaic 1996 provision linking IV-E eligibility to eligibility for welfare. Given these facts, it is highly unlikely that states are putting children in foster care for financial reasons.
Gelles’ strong advocacy for turning Title IV-E into a block grant based on its past spending is unfortunate and contradicts his call for a more child-centered system. With capped block grants, a state facing a crisis, like the current opioid crisis that is causing caseloads to rise in many states, or simply an increase in population, might find itself without funding to remove children from unsafe homes.
Gelles’ last set of recommendations centers around the children who age out of foster care. He calls for a “Transition Account” available to every youth who ages out of foster care. The account would be usable for education expenses, vocational training and housing.
A transition account might be a good idea. However, I’m surprised that Gelles makes no proposals for improving foster care quality, instead attempting to atone for its inadequacy once children leave. If more youths in foster care had loving foster parents who worked closely with schools and mental health providers or lived in excellent boarding schools where top-quality education was connected with therapy, sports and arts, many more might graduate from foster care with jobs and careers.
Moreover, many emancipated foster youths are part of a much larger population of disconnected youths, who fail to make the transition from school to work. We need new policies that keep youth in school and connect education to work activities. Youth apprenticeships and career-based high schools are among the programs that are gaining in popularity.
Out of Harm’s Way provides a lot of good information and food for thought. Gelles’ call for a child-centered system is the strongest and most effective part of his book. Perhaps the weakest is his contention that we could fix the system without more funding. If we continue to skimp on addressing child maltreatment, we will continue to pay far more to address its consequences, including crime, mental illness and intergenerational poverty.
This column was published in the Chronicle of Social Change on April 24, 2017. 

The Other Missing Children: Those Fleeing Abusive and Neglectful Homes

Last week I wrote a column about the missing children who have run away from District of Columbia foster homes. Youth Services Insider estimated that foster youth account for about 10 percent of missing children reports and a larger fraction of the current pool of missing children in the District of Columbia.
But we must not forget that the majority of runaway youth are fleeing their own homes, not foster care. Many of these children are fleeing abusive or neglectful homes.
Federal data suggests that nationwide over 20 percent of the youths who run away or are thrown out of their homes reported being physically or sexually abused at home in the prior year or fearing abuse upon returning home. Many of these children have been betrayed by a system that failed to protect them, leaving running away as their only option.
Stacey Patton, whose new book I reviewed in my previous column, has a powerful new piece in the Washington Post entitled: “Want to keep black kids from running away from home? Stop hitting them.
In her column and her riveting memoir, That Mean Old Yesterday, Patton describes her own experience running away from her adoptive mother, who beat her with switches, belts, extension cords and anything else she could lay her hands on, leaving lifelong physical and emotional scars.
Corporal punishment, abuse and neglect are hardly problems confined to the black community. But Patton speaks specifically to black parents who argue that their children will go to jail if they are not “whupped,” an argument she conclusively demolishes in her book. 
While Patton is speaking to black parents and churches, I hope that all professionals who deal with families will heed her message as it applies to children of any color and ethnicity. Patton recommends more parent education on child development so that parents don’t have unrealistic expectations, as well as on non-violent discipline practices.
In addition to churches, pediatricians’ offices are a perfect place for such education. Pediatricians should be asking parents how they discipline their children, then providing them with research-based evidence on the consequences of, and alternatives to, corporal punishment.
But we need to remember that there are times when the abuse has deeper causes than false beliefs about corporal punishment.  I don’t think any additional education would have changed Patton’s adoptive mother’s sadistic disciplinary methods. Her extreme harshness likely stemmed from untreated mental illness to which past trauma was probably a contributor. This is not a kind of mental illness that could be erased by even a year of therapy ordered by a family court judge.
As Patton described in her memoir, she was almost sent home after her attempt to escape. She obtained a last minute reprieve when a psychiatrist finally understood the extent of the physical and mental damage and the climate of fear in which she had been living for most of her life.
The prevailing view in child welfare, over the last decade at least, has been that removal from home by CPS is a traumatic event that is almost never justified. When I went through training as a Child Protective Services caseworker at D.C.’s Child and Family Services Agency (CFSA), one of the first things I was told is that I was not there to save children. Yet, being rescued from her violent home saved Stacey Patton.
I disagree with CFSA. Saving our children is what all child-serving professionals should be about. Of course we should save children from sex trafficking and other forms of exploitation. But as Patton tells us, let’s spare some concern for the much larger group of children who are not safe in their own homes.
This column was published in the Chronicle of Social Change on April 14, 2017. 

Foster Care Quality: A Missing Piece of the Story of Missing Girls

John Kelly’s article, The Foster Care Aspect of the D.C. Missing Girls Story, draws an important connection between  recent uproar about missing girls in the District, many of whom turned out to be runaways, and the city’s foster care system. One of the runaways told WUSA9 that she left because her foster mother was mistreating her. She added: ”We should not feel safer on our own roaming the streets than we do with the people that the government is paying to [to keep us in their homes].”
Unfortunately, poor care by the people who are paid to take care of our most vulnerable children is all too prevalent in the District of Columbia. While a handful of outstanding foster parents filled me with awe, it was bad foster parents who finally drove me to leave my job after five years as a foster care social worker in the District. Trying to parent most of the youth in my caseload because their foster parents did not do so finally wore me down.
Things that I did that the foster parents were supposed to do included: take my clients to the doctor, the dentist, and the therapist. Talk to their teachers. Pick them up from school when they were sick. Wait with them for hours at the emergency room.
One foster parent I worked with had never (in a whole year) been to the school of one of her foster children for a meeting, back to school night, or to see her in a performance. The teenager  was never able to attend an evening activity at her school because the foster parent would not take her. The foster parent even refused to pick up the child when she was throwing up.
Another foster parent refused to go to a meeting with the child’s teacher and therapist to improve the child’s school performance. She said, and I quote, “If I cared, I would go, but I don’t care.”
A third foster parent knew that her two foster children were getting on a public bus to get to school. But she had no idea what bus they were taking, where their schools were, or that the 15-year-old was letting the 6-year-old get off the bus and find her way to school on her own.
Many of these children have undergone severe trauma and yet they are receiving less nurturing  than required by a child with no traumatic history or special needs.
Anyone with experience with District of Columbia foster homes knows that some people foster for the money. Foster parents receive a stipend to cover clothing, transportation, personal allowances and other expenses. However, many siphon off part of the money to meet their own needs.
Children in these homes have only one school uniform, and the foster parent make require them to pay for necessities out of their personal allowance. Many young people have weekend visits with their birth parents but  the foster parents pocket the subsidy for those weekends and even longer periods while the birth parents struggle to pay for their visiting children.
I have known several fabulous foster parents, most of whom spend more than they receive in order to give their foster children the best. These parents are not motivated by money. Most of them are providing foster care because they love children and want to have a positive impact on their futures.
Unfortunately, we don’t have enough of these great foster parents. That’s why we don’t fire the bad ones.
Like the District of Columbia, jurisdictions around the country struggle to find enough foster parents, let alone enough good ones, to meet the need. Frequent stories about abuse or severe neglect are one of the results of this situation.
Perhaps we need to find alternatives. These might include foster care communities that provide housing to dedicated potential foster parents, or  top-notch boarding schools for foster youth along the lines of the Crossnore School in North Carolina. Perhaps with more nurturing, truly homelike placements, fewer foster youth would run away.  
This column was published in the Chronicle of Social Change on April 7, 2017.

Author Ties ‘Whupping’ of Black Kids to the Days of Slavery in ‘Spare the Kids’

An important new book, “Spare the Kids: Why Whupping Children Won’t Save Black America,” is drawing considerable attention. The author, Morgan State University journalism professor Stacey Patton, is a survivor of childhood “whuppings” that left her with lifelong physical and mental scars and a history of foster care.
Patton argues that the use of “whupping” by black parents is a legacy of slavery. She found no evidence that West African civilizations employed the type of “ritualistic physical punishment” that is practiced by some black parents today.
White slaveowners, argues Patton, introduced their slaves to the concept. Enslaved parents used the practice to train their children to be docile workers and respectful to their masters, to protect them from whippings or worse.
Dr. Stacey Patton, author of ‘Spare the Kids.’ Photo: sparethekids.com
With the end of slavery, Patton states that “whupping was used as a survival tactic to teach black children proper racial etiquette so they would not risk being beaten or lynched by whites.” Even today, black parents justify whupping their children as the only way to prevent them from being shot or locked up.
Yet, Patton explains, the research indicates that hitting often promotes the very behaviors and negative outcomes it is supposed to prevent; ”namely, disobedience, aggression, dishonesty, antisocial behaviors, mental health problems, poor educational achievement, low-self-esteem, early puberty, risky sex, and a host of other issues.”
Patton documents that many black leaders continue to support hitting children. Our first black president expressed nostalgia for the days when any adult could publicly “whup” a black child, she notes, and received thunderous applause from the NAACP. 
She excoriates black parents uploading videos to social media showing themselves “screaming at, shaming and hitting their kids.” Some of these videos are posted on Patton’s website, and they are truly chilling.
But wait, a reader might say … white people use corporal punishment too. Patton acknowledges this, but argues that the rate is higher among black parents. The evidence she cites is not very strong, in my opinion, and she acknowledges that “corporal punishment is not a black thing. Between 70 and 80 percent of all Americans hit their children.”
But Patton has chosen to focus on “how whupping children became so deeply embedded in [African-American] culture as good parenting.” And given the evidence she cites, that focus is a valid and deeply needed one.
Patton draws a direct link between corporal punishment and child abuse, but her discussion of federal data on this issue is rather weak. She reports that federal statistics “consistently show that black children are mistreated and killed by their family members at significantly higher rates than children of any other group.” But the majority of these maltreated children were found to be neglected rather than abused.
And these data don’t show actual maltreatment, only what has been reported and identified as such by child welfare systems. Some cases of maltreatment are never reported or substantiated by child welfare systems.  
Patton failed to mention some better evidence for her claim that black children are abused at a higher rate than other kids. The most recent in a series of national studies which attempt to find maltreatment cases that are not reported or adjudicated estimated that African-American children were more than twice as likely as white children to suffer physical abuse.
Setting aside quibbles over data, Patton’s emphasis on protecting black children is a refreshing contrast to the “racial disproportionality” movement that has gained currency in this century. Starting in the early 2000s, a group of wealthy foundations and allies called the Alliance for Racial Equity in Child Welfare promoted the notion that a racist child welfare system is behind the disproportionate representation of African-American families in the child welfare system.
As evidence has accumulated that contradicts this view, the alliance has quietly suspended its work, and has not published anything since March 2015. But many agencies, commentators and others continue to advocate equalizing black children’s representation in the system with that of other groups, with possible danger to black children who may be left in violent homes without support or supervision.
Patton takes a much more complex view of the role of racism.  Yes, racism is behind the disparities in child welfare. But the mechanism is not as simple as racist social workers removing too many black kids from their families.
Dr. Patton’s past as an abused child, as well as her deep and critical thinking, help explain her willingness to dig deeper. Her focus is on protecting children, not on protecting parents at children’s expense. I  hope her book gets the large readership it deserves.
This column was published in the Chronicle of Social Change on April 4, 2017.

Protect Homeschooled Children from Maltreatment

On October 24, 2016, 16-year-old Natalie Finn died of starvation in Des Moines, Iowa. She was found wearing an adult diaper and lying on the linoleum floor of her bare bedroom.
The body of seven-year-old Adrian Jones was found on November 25, 2015 in a barn in Kansas City, Kansas. Adrian was kept in a shower stall, beaten, starved, and eventually killed and his body fed to pigs. Six other children were removed from the home.
Three days before her ninth birthday, a little girl was wheeled into a Kentucky hospital in a catatonic state, with a body temperature of 86, and covered with bruises. She had been tortured nearly to death over by her father and stepmother.
All of these children had something in common: They were homeschooled.
About 1.8 million children, or 3.4 percent of the school-aged population, were homeschooled in America in 2012, the most recent year for which data are available. Clearly most of their parents are not abusive and want to provide the best education for their children, often at great personal sacrifice.
Nevertheless, the Coalition for Responsible Home Education (CRHE) has collected nearly 400 cases of severe or fatal child abuse in homeschool settings. Many of the families had a history of past child abuse reports and child welfare involvement, according to CRHE Executive Director Rachel Coleman’s testimony before Iowa’s Government Oversight Committee. All too often, she said, the homeschooling began after the closure of a child welfare case.
We rely on teachers and school staff to report their concerns about children with injuries or disclosures about abuse and neglect. “When homeschooling occurs in an abusive home,” Coleman testified, “the ordinary safeguards in place to protect school-aged children disappear.”
CRHE has three recommendations to protect home-schooled children from abuse:
  • Forbid homeschooling by parents who have been previously convicted of any offense that would disqualify them from teaching or volunteering in a public school. Only two states bar homeschooling based on criminal offenses, but according to CRHE, neither enforces them in a meaningful way.
  • Bar homeschooling in households where any adult has had a child removed from the home due to substantiated abuse allegations. Also monitor homeschooling families who have a history of child abuse reports or open CPS cases.
  • Require that homeschooled students have contact with mandatory reporters several times each year.
This can save children’s lives. In 2011, an Ohio 11-year-old asked her online charter teacher to call 911. The police found that she and her two siblings were being beaten with belts and tied naked to their beds with chains and the  girls were being raped by their stepfather. The children were removed from the home.
After the death of Natalie Finn, followed by the escape of Malaiya Knapp from her abusive home, Iowa Senator Matt McCoy introduced a bill to require quarterly checks for homeschooled children.
After the Kentucky case mentioned above, Senate Democratic Leader Ray Jones introducedlegislation to bar parents with a substantiated incident abuse or neglect to withdraw a child from school without court approval.
The Iowa bill did not make it out of committee, and the Kentucky Judiciary Committee refused to consider McCoy’s bill.
Homeschooling advocates have a powerful lobby – according to a recent article in the Washington Post Magazine, The Home School Legal Defense Association is one of Washington’s most effective lobbying groups  – and the current political climate in their favor. On the state level, home-schooling interests seem to be powerful as well.
It is hard to understand why responsible homeschooling parents and their advocates would protect that small number among them who are using homeschooling as a pretext to isolate and maltreat their children. I asked Coleman for her thoughts on the matter.
“Many homeschooling parents (though not all) see oversight of homeschooling as a violation of their parental rights,” she said in an e-mail. “At the same time, these parents frequently argue that abuse is not a homeschool problem–that when abuse does occur in homeschool settings, it’s because child services dropped the ball. [But they ignore the reality] that abusive parents use homeschooling to conceal their abuse.”
I hope that the vast majority of loving homeschool parents will tell their legislators and lobbyist to support sensible controls that protect children from suffering and even death at the hands of their parents.
This column was published in the Chronicle of Social Change on March 23, 2017.

Education Instability a Symptom of Bigger Foster Care Problem

Of the myriad issues in child welfare, The Chronicle has recently chosen to devote five articles to one issue: California’s failure to implement federal provisions regarding educational stability for foster youth.
Heimpel is talking about California’s failure to meet a December 2016 deadline to explain how it will comply with a new provision in the Every Student Succeeds Act requiring them to transport foster children to their original schools whenever it is in their best interest.
As a foster care social worker in the District of Columbia, I acquired firsthand experience in the difficulties of imposing an educational stability mandate. During my tenure, the District dropped its policy of immediately re-enrolling foster children in the school closest to the foster home and began making efforts to keep them at their original schools.
For many children, this new policy was a much needed dose of stability at a time of traumatic disruption. The comfort of seeing familiar teachers and friends cannot be overstated. As a social worker, I was happy to know that the student’s teacher or social worker would keep a special eye out for them or let me know of any problems.
But the new policy had some consequences that were not as beneficial, especially for the half of D.C. foster kids living in Maryland foster homes. Young people spending over two hours a day in vans and unable to participate in sports or extracurriculars because they would miss their ride. Kids getting to school too early or hanging around school for an hour since the driver had to transport other children to other schools.  
Foster parents who never visited the child’s school because it is an hour away during rush hour or they “don’t drive in the city.” Foster youth unable to make friends in the neighborhood because they went to school in an entirely different jurisdiction.
Being able to participate in activities and see friends is part of another goal that has also been enshrined in federal education policy. It is called “normalcy,” and the Preventing Sex Trafficking and Strengthening Families Act of 2014 requires that states develop standards to ensure that foster children have these opportunities. That same act mandated that child welfare agencies collaborate with education agencies to keep kids in their school of origin, the child welfare side of the mandate discussed in this article.
If normalcy conflicts with school stability in the District of  Columbia, how much more difficult must it be to reconcile these goals in a county as large as Los Angeles, with an area of 4,751 square miles, 81 school districts, a famous traffic problem and one in five foster youths placed outside the county, as the Chronicle reported in 2015? 
It’s not that I am opposed to requiring that foster children be enabled to stay in their school of origin if it is in their best interests. It’s just that when foster homes are not near that school, the question of what is in the child’s best interests is not often an easy one to answer.
Until the day that we can place every foster child in a home that is within a few miles of the birth family (and that might require building foster home communities in those areas, as I have written before), it will be difficult to ensure school stability for foster children without compromising other values such as normalcy.
It is much easier for Congress to impose an unfunded mandate than to address the roots of the educational stability problem: a lack of foster homes in or near the communities from which children are removed. And it’s easier for the media to expose a jurisdiction’s failure to implement a policy than to report on the complex reality that makes it so hard to implement.
This column was published in the Chronicle of Social Change on March 7, 2017.