Category: child welfare

The Death of Thomas Valva: Almost five years later, we still don’t know the truth

This blog was published on the website of Lives Cut Short on January 6, 2025.

On January 17, 2020, eight-year-old Thomas Valva died of hypothermia in the freezing garage at the home of his father and his father’s live-in fiancée. It soon came out that school staff had made multiple calls to the  state child abuse hotline during the 16 months before Thomas’ death, describing how he and his brother were starved, beaten and forced to sleep in a garage and urinate upon themselves. Almost four years after Thomas’ death, a Suffolk County grand jury issued a report explaining that it had been denied access to records from the child protection system (CPS) concerning ten investigations prior to his death because they were “unfounded.” At no point did the state or the county explain how they had missed this case of chronic abuse, share plans for ensuring the same errors would not occur in the future, or hold any employee accountable for leaving Thomas in the hands of his abusers.

In September 2017, during a bitter divorce battle between Michael Valva and Justyna Zubko-Valva, a judge gave Michael Valva temporary custody of Thomas and his two brothers. The boys joined a household that included their father, his fiancée, Angela Pollina, and her three daughters. As described in the grand jury report, Michael Valva removed six-year-old Thomas, and his older brother Anthony, from their specialized school in Manhattan and enrolled them in a Suffolk County elementary school. Both boys had been diagnosed with autism and were described as “high functioning.” 

Repeated calls for Help

According to the grand jury report, Thomas and his brother were the subject of at least ten reports to New York’s child maltreatment hotline between September 2018 and Thomas’ death in January 2020. All of these reports were “unfounded” by Suffolk County CPS ; “unfounded” means that the investigator found no credible evidence of  alleged abuse or maltreatment. But the New York Daily News obtained records of at least 20 calls by school staff about Thomas and Anthony during that period. We don’t know how many of these additional calls were investigated or screened out at the hotline as not warranting investigation. (Except where otherwise noted, all case details are based on the grand jury report.)

In January 2018, about four months after moving to their father’s home, Thomas and Anthony began to complain to school staff that they were hungry, reporting that they were denied breakfast as punishment. The staff alerted the CPS worker who was already investigating allegations against both parents, but it was not clear whether the boys’ hunger was addressed in the investigation.1  In September 2018, Thomas and Anthony returned to school looking very thin and both were now wearing pullups, despite having used the toilet without problem the previous year. School staff observed the children eating food from the trash and the floor. It was then that a school staff member made the first call to the state hotline that was documented in the grand jury report. The nine calls that followed during the next 14 months reported that the boys were hungry, had suspicious bruising including a black eye, were coming to school in urine-soiled clothing and shoes, and reported sleeping in an unheated garage, where they urinated upon themselves and were hosed down in the morning. 

School staff made four calls in March 2019 in a concerted effort to get a response.  But the effort seems to have backfired. When the staff called Suffolk County CPS to follow up, they were told that their multiple reports had “canceled each other out.” In April 2019, a staff member confronted a county CPS representative at the school. According to staff reports, the CPS representative responded that without broken bones, there was nothing they could do. The last report was made in November 2019 describing bruises on both children’s faces and their continuing complaints of hunger.

Thomas’ Death and the Response

On January 17, 2020, the Suffolk County Police Department learned that Thomas had been pronounced dead. The cause was determined to be hypothermia. Video surveillance from the garage the night before Thomas’ death shows Thomas and Anthony shivering in the garage. The low temperature that evening was 19 degrees Fahrenheit. At the time of his death, Thomas’ body temperature was recorded at 76 degrees. Michael Valva and Angela Pollina have been convicted of “depraved indifference murder” and sentenced to 25 years to life. Justyna Zubka-Valva has sued Suffolk County for $200 million in Thomas’ death.

In the wake of the tragedy, the grand jury was empaneled to identify any failures in CPS conduct and practices, determining whether anyone should be found criminally liable, and potentially making recommendations to improve CPS practices to ensure that future children would be better protected. When the grand jury finally issued its report in April, 2024, its central conclusion was that its ability to investigate the case was “severely hampered” by the law governing the disclosure of reports declared by CPS to be “unfounded.” Under that law, these records are sealed and can be provided only for very restricted purposes to a short list of people and agencies under specific circumstances. Thus the grand jury had no access to any information about any of the CPS investigations that occurred in response to calls from the school.2

We know that reviewers in both Suffolk County DSS and New York State’s OCFS did have access to the complete records of the case. New York law requires local departments of social services to investigate all fatalities from maltreatment. The state’s Office of Children and Family Services is required to review each local fatality investigation and issue its own report within six months of the local investigation. Unfortunately, neither the state and county legislatures, the grand jury nor the public had access to these two reviews. The local reviews are never released to the public. OCFS posts its fatality reviews on its website (with names and identifying information redacted), but only when it is determined that “disclosure would not harm the child’s siblings or other children in the household.” An earlier post by Lives Cut Short discusses this process and shows that about a quarter of these reports on child deaths in 2022 appear to be withheld on these grounds, including most of the cases that had been covered in the media. Not surprisingly, the grand jury confirmed that the OCFS report on Thomas’ death was withheld on these grounds. 

The Costs of Secrecy

The grand jury’s central recommendation was that the state’s law must be changed to expand access to this information–but only to grand juries and district attorneys prosecuting cases. Actually, a much broader change is needed. At a minimum, the “best interests” determination must be eliminated and all of the OCFS child fatality reviews, with appropriate redactions, must be shared with the public. As described in a Lives Cut Short report on state disclosure policies, several other states share such case reviews. These include Pennsylvania (which posts case reviews on all child maltreatment fatalities and near fatalities); Florida, Oregon and Washington (which post case reviews on the deaths of children in families with which the agency had contact within a year); and Colorado, (where cases are posted if the agency has dealt with the family in the past five years). In addition, Arizona and Wisconsin post summaries of all child maltreatment fatalities and near fatalities including a brief description of prior agency requirement. 

The public should have access to the full agency file involving its interactions with a family in which a child later dies of abuse or neglect. That includes records of all reports received and agency responses, including decisions not to investigate. These files should be redacted to remove the names of those who reported abuse and of other children in the family, though the names of Thomas’ brothers have long been known through media reports. Laws in Florida and Arizona require the release of redacted case files upon request in cases where a child dies of maltreatment. 

The limits of the grand jury’s recommendation may stem from its limited view of why the changes are needed. The grand jury stated that the privacy protections enshrined in the law “have had the unintended consequence of shielding an entire agency, its leadership, and its hundreds of employees, from criminal investigation and prosecution.” Accountability is certainly necessary. Newsday has reported that three Suffolk County CPS employees that “played key roles” in the investigations of Valva and Pollina were promoted after Thomas’ death. But we don’t need transparency just for the purposes of holding people accountable. Individuals are not always at fault in these cases, and even if they are, there may be systemic flaws as well. Knowing the entire case history is critical to enable legislators, advocates and the public to identify the flaws in the system that caused it to fail.

Without access to the full agency record, It is difficult to understand how so many reports over 14 months could have resulted in no findings of abuse or neglect. The number of reports, the serious nature of the concerns expressed, and the repetition of similar concerns regarding two boys, do make it difficult to understand how all of these reports were screened out or unfounded. Suffolk County officials provided a clue when they stated in a recent press conference that CPS staff may have been biased in favor of Michael Valva because he was a police officer. But other flaws in policy or practice, such as high caseloads, untrained or unqualified staff, an extremely parent-centered culture, or even criminal misconduct by CPS workers or supervisors, may have been present as well.

An Absurd Response to Thomas’ Death

On July 9, 2020, the Suffolk County Legislature enacted the CPS Transformation Act, which was designed to prevent future tragedies. It seems to have been based on a cursory external review by a legislative task force, which apparently did not have access to the internal DSS review. Four years later, Suffolk County officials announced “comprehensive changes” to CPS in response to Thomas Valva’s death. Strangely, several of the changes that were cited were completely irrelevant to the conditions that resulted in Thomas Valva’s death. These included changing the process of removing a child from a family by instituting “blind removals,” returning adult protective services to the Child and Family Services Division of DSS, and a new mobile “panic button” for employees who find themselves in danger.

The most bizarre of these reforms was the adoption of “blind removals” by Suffolk County. The blind removal process, pioneered in neighboring Nassau County, NY, was created in response to concerns about racial bias leading to the removal of Black children at a disproportionate rate compared to their share of the population. It requires each child removal to be approved by a panel that does not have access to demographic and identifying information on the child and family. The policy gained national attention due to a 2018 TED Talk citing numbers that were later shown to be wrong. The only academic study found no impact for the process; but New York State had already required all counties to develop a blind removal process by October 14, 2020.

County officials at the press conference attempted to connect blind removals with preventing future tragedies by stating that the policy “eliminates the type of “biased decision-making” that kept 8-year-old Thomas Valva in the custody of his police officer father before his death.” But Thomas was never found to be abused and therefore not considered for removal. Moreover, Suffolk County adopted blind removals in response to a state mandate, not Thomas’ death. 

Thomas Valva suffered and died because CPS ignored his cries for help and the repeated warnings of staff at his school. Almost five years after Thomas Valva’s death, the public still does not know why the system set up to protect abused and neglected children failed both him and his brother. In New York and around the country, we need transparency around child fatalities and near fatalities when public agencies were involved with the family and could have stepped in.  









  1. In February, 2018, Suffolk County CPS “indicated” (found some credible evidence of maltreatment) a case against Thomas’ mother for “inadequate guardianship” and against his father for “inadequate guardianship,” “excessive corporal punishment,” and other charges. These cases apparently stemmed from allegations that Thomas’ parents made against each other and are not further described in the grand jury report. 
    ↩︎
  2. It is possible that the grand jury was misinformed that ten reports were investigated and unfounded, The report cites only two visits from CPS workers to the school. Moreover, the grand jury’s report that a CPS worker said the four reports made in one week canceled each other out suggests that they were not investigated at all. If some of these reports were screened out or not investigated, the grand jury should have been informed of this fact and given information about why these reports were screened out.
    ↩︎

Seven children and all she needed was a van: large families and the blindness of the child welfare establishment

By Marie Cohen

Working in the field of child protection, it is sometimes hard to avoid the feeling of living in some type of alternate reality, where bizarre statements are accepted and obvious questions go unasked. A case in point was a hearing on the Family First Prevention Services Act (FFPSA) that took place on May 22, 2024 under the leadership of Senator Ron Wyden of Oregon, one of the original sponsors of the FFPSA. This hearing and the fundamental misunderstanding about FFPSA that it uncovered has already been discussed in a previous post on this blog. But today’s post focuses on one particularly jarring vignette–the story of a mother, her seven children, and a van–and what it means about how child welfare policy is made and discussed today.

David Reed, the Deputy Director of Child Welfare Services in Indiana, introduced the story of this family in his testimony. Reed was trying to illustrate how the provision of economic and concrete supports can make children safer–an application of the theory that much of what is called child neglect is actually only poverty, which has been questioned previously in this blog. Reed explained the Indiana Family Preservation Services (IFPS) model requires that “concrete support be provided to families when not doing so would result in children having to come into foster care.” He gave an example of how this worked in a specific case:

DCS was called about a neglect allegation involving a single mother who had seven children, all of whom were school-aged or younger. This mother worked but struggled financially. DCS was called because she was unable to take all seven of her children in rural Indiana to school and/or daycare at the same time so that she could go to work. She took them in “shifts” leaving some children home alone. This resulted in the neglect allegation and the opening of a DCS case. The provider delivering INFPS to this family recognized what this mom really needed to ensure that her children could all be transported together—a bigger vehicle—and used the concrete supports built into INFPS to purchase her a used minivan. That $3,000 van “solved’ the reason for DCS’ involvement and very likely prevented seven children from coming into foster care, which is exactly what most likely would have happened prior to INFPS.

There is something strange about this example. Is it really possible that this mother needed nothing but a van in order to parent her children adequately? The rarity of seven-child families and the association of such large families with family dysfunction, including abuse and neglect, raise doubts about this mother’s appropriateness as a poster child for the provision of material supports as a solution to child maltreatment.

The rarity of a seven-child family

Seven children is such unusual number that it raises questions about why this mother had so many children and how she managed to care for them. The National Center for Health Statistics has estimated that 28 percent of women aged 40-49 (near the end of their childbearing years) who had given birth to children had only one child, 40 percent had two children, 27 percent had three children, and only 13 percent had four or more children.1 It is likely that the proportion with seven or more children is a tiny fraction of that 13 percent–and that is a percentage of women aged 40-48. We don’t know this woman’s age, but the younger she is, the more of an outlier she is, and the more questions this story should raise about her needs.

The association of extremely large families with dysfunction

A family of seven is not just unusual; it is often a marker for family dysfunction and pathology. Despite the rarity of families with five or more children, anyone who has worked in child welfare or juvenile justice knows that children from extra-large families are overrepresented among their clients. These families frequently consist of mothers with children by multiple fathers, with both parents often suffering from mental illness and/or drug abuse, and domestic violence is commonly present. These mothers are often too disorganized or too influenced by drugs and alcohol to use contraception; moreover, they may consciously or unconsciously get pregnant to hold onto a new man. In its Study of the Root Causes of Juvenile Justice System Involvement,” the District of Columbia’s Criminal Justice Coordinating Council interviewed youth service providers with first-hand experience working with justice-involved and at-risk youth. Quotes from these interviews include:


A social service provider described one type of youth they see becoming justice involved, “You have those that the family may have multiple children and if mom has 13 kids and I’m the oldest and mom is high or dad is not involved, then they need to eat because they are looking at me. So, I need to be able to figure out how to get the next meal.

One interviewee who works with the juvenile justice system describedthe youth as coming from families with “Four, five, six, seven children” and growing up where there are “Three kids in a room, total bedlam all the time,” and as a result “They raise each other in the streets … because … a lot of times hanging out at home isn’t the pleasant environment.”

Research has consistently supported the association of larger families and closer birth spacing with higher rates of child abuse and neglect. In a groundbreaking 2024 article, Ahn et al report on their analysis of 20 years of data on almost 200,000 first-time mothers in California. They found a strong correlation between the number of children born to a mother and the likelihood that she would be reported to CPS in the next 20. The percentage of first-time mothers reported to CPS increased from 18.5 percent for mothers with one child to 25.4 percent for mothers with two children, 39.2 percent for mothers with three children, and 63.1 percent for mothers with four or more children.

Missing the Obvious?

Obviously not all large families are characterized by dysfunction and pathology. But common sense tells us that large family size can add to stress that in turn can lead to maltreatment. Moreover, having multiple children that one cannot afford may reflect other dysfunctions that may in turn be associated with child maltreatment. Yet somehow it never occurred to Senator Wyden or any of his colleagues at the hearing to ask whether this mother had any problems with mental health, drugs or domestic violence. Senator Wyden even mused aloud that federal law discriminates against large families, complaining that the child tax credit does not reimburse families based on the number of children they have! It appeared that he actually wanted to encourage unlimited childbearing regardless of the mother’s emotional or financial readiness.

And what about Mr. Reed, who actually provided this case as his only example of how material assistance can help resolve a child maltreatment report? According to the DCS website, Mr. Reed is a “licensed clinical social worker who has spent most of his career working with foster youth and children involved with the child welfare system.” One would think he had noticed that children from very large families were overrepresented among his clients. It is also worth noting, though slightly off-topic, that if this was the best example he could find, then his argument that many neglect cases can be solved with one-time material assistance appears to be in danger of collapsing for lack of support.

Perhaps one reason for Wyden’s and Reed’s blind spot is the current ideological tendency of what might be called the child welfare establishment, including the federal Administration on Children and Families, state leaders, and large and wealthy foundations and advocacy groups like Casey Family Programs. Many posts on this blog show how these groups’ focus on race and identity has restricted discussion about how to help prevent child abuse and neglect, among other problems. There seems to be a special taboo attached to any discussion about family size as it relates to child maltreatment, or any prescription for family planning as part of the solution. This taboo likely stems at least in part from our country’s shameful history of attempting to restrict childbearing by Black and poor women through means including forced sterilization and attempts to mandate that welfare recipients use an early injectable contraceptive called Norplant. But when efforts to be sensitive to past trauma to specific groups prevents the implementation of programs to improve the lives of at-risk children, it is time to set taboos aside.

What could be achieved by seeing extra-large families through clear eyes rather than a lens that is distorted by bias? Frontline workers faced with this type of client could look a little harder to see if the lack of a van was the real issue. Even if it was, requiring the mother to adopt one of today’s safe, long acting contraceptives in return for the gift of a van would hardly be unreasonable. In general, incorporating voluntary family planning, perhaps as a condition of receiving desired benefits, into family case plans might be a good start. Senator Wyden might not know this, but a new pregnancy for a mother who is trying to get her children back from foster care is one of the frequent setbacks observed by front-line workers.

The failure to regard unusually large numbers of children as a possible sign of pathology may reflect a genuine innocence about conditions in low-income urban and rural communities–conditions that are perfectly known to people in those communities and those who work there, but perhaps not to a US Senator like Wyden or his colleagues. A more cynical view is that self-imposed oblivion is needed to stay on the right side of advocacy groups and foundations that dominate the mainstream discourse on child welfare and provide funding to state and local agencies that are willing to toe the line. Whether it is ignorance or fear of losing the support of interest groups, national and local leaders’ disregard of the perils of repeated unplanned childbearing is hurting the very children these leaders claim they want to help.

  1. There is an error in the posted PDF of this report. The percentage of all women aged 40-49 who gave birth to three children was given as 2.4 percent instead of 22.4 percent. This was confirmed by an email to Marie Cohen from Brian Tsai, Public Affairs Specialist, Center for Disease Control and Prevention, November 21, 2024. ↩︎

Keeping the public in the dark about child fatalities and near fatalities: findings of a new report

At least 1,800 children die from abuse and neglect every year, and the total is probably considerably greater. Between a third and a half of these deaths may involve families that were already known to Child Protective Services (CPS) through previous reports of maltreatment. In addition, an unknown number of children are severely injured due to maltreatment every year. Legislators, advocates, and the public need timely information about the circumstances leading to these events so they can identify policy and practice changes necessary to protect children. Decades ago, Congress recognized this need and required states to have a policy allowing for disclosure of information and findings about these tragic events. But due to the weakness of the requirement and the federal government’s lack of enforcement, only a few states make meaningful disclosures in the wake of these horrific events, as documented in a new report.

Federal Law and Policy Regarding Disclosure

In 1996, Congress amended the Child Abuse Prevention and Treatment Act (CAPTA) to ensure that information from child fatalities and near fatalities that are caused by abuse or neglect can be used to correct systemic problems and prevent future occurrences. This provision —42 U.S.C. 5106a(b)(2)(A)(x)—requires that “every state’s plan for spending CAPTA funds contain “an assurance in the form of a certification by the Governor of the State that the State has in effect and is enforcing a State law, or has in effect and is operating a statewide program, relating to child abuse and neglect that includes . . . provisions which allow for public disclosure of the findings or information about the case of child abuse or neglect which has resulted in a child fatality or near fatality.”

This provision has many weaknesses, as described in more detail in a new report called Keeping the Public in the Dark: How Federal and State Laws and Policies Prevent Meaningful Disclosure about Child Maltreatment Fatalities and Near Fatalities, which was prepared for Lives Cut Short, a project to document and direct attention to child maltreatment fatalities. First, the provision requires only that the governor certify the existence of a disclosure requirement, not that it actually exist. Moreover, the language is so vague that it leaves all details to the individual jurisdictions. To make matters worse, the US Department of Health and Human Services (HHS) never wrote regulations to flesh out the vague statutory requirements. Instead, HHS provided guidance in the form of questions and answers in its Child Welfare Policy Manual (CWPM). The CWPM does not have the same force as federal regulations, but some states clearly pay attention to it and have mirrored it in their laws and policies.

Unfortunately the CWPM leaves many questions unanswered and even adds new ones. There are several federal confidentiality requirements embodied in different laws, and the CWPM does not explain the order of preference. Instead, different sections of the CWPM actually contradict each other, with one answer stating that the disclosure requirement trumps previously enacted confidentiality laws and several other answers reminding states to comply with existing confidentiality requirements. To make matters worse, revisions in 2012 introduced new opportunities to avoid disclosure, specifically letting states allow exceptions “in order to ensure the safety and well-being of the child, parents and family or when releasing the information would jeopardize a criminal investigation, interfere with the protection of those who report child abuse or neglect or harm the child or the child’s family.” The exception for “safety and well-being of the child, parents and family” completely undercuts the previous language in the CWPM.

The 2012 revision also included a list of the information and findings to be disclosed, which would have been extremely helpful had it not added a new opportunity to withhold certain information. Specifically, the CWPM (Section 2.1A.4, Question 8) prescribes that states must release:

“information describing any previous reports or child abuse or neglect investigations that are pertinent to the child abuse or neglect that led to the fatality or near fatality; the result of any such investigations; and the services provided by and actions of the State on behalf of the child that are pertinent to the child abuse or neglect that led to the fatality or near fatality.”

This language allows states to withhold information that is actually relevant to the question of whether and how a fatality or near fatality could have been prevented. For example, a state could decide a prior incident of neglect was irrelevant if the cause of death was abuse. But the same parent often perpetrates multiple types of maltreatment, especially chronically maltreating parents who have had multiple encounters with the child welfare system. A state’s decisive intervention in response to prior maltreatment may save a child from death or near-death by another form of maltreatment.

State Laws and Policies Regarding Disclosure

The report reviews state laws and policies governing disclosure of information and findings in cases where child maltreatment resulted in a child fatality or near fatality. The review shows that many state laws and policies fall far short of what is needed to ensure adequate public information about how child protections may have failed. The major findings include:

  • Despite the federal requirement, not every state has a policy for publicly disclosing findings or information about child fatalities and near fatalities. Out of the 50 states and the District of Columbia, four states appear to have no such policies. Another four states have a policy for fatalities but not near fatalities.
  • Among the 47 jurisdictions that do have laws or policies for disclosing maltreatment fatality and near-fatality information, only 35 require the release of findings and information about child maltreatment fatalities, and all but four of those require that of near fatalities as well. Twelve allow but do not require the release of findings and information about these incidents.
  • Many state laws and policies are vague, and many contain restrictions that violate the Congressional intent to make information about child maltreatment and agency operations publicly available.
  • Seventeen states have laws or policies that require releasing some information without request. These releases vary from a few basic facts on each incident to a comprehensive review of the victim’s family’s history with child welfare. Only nine issue notifications of fatalities or near fatalities that are suspected to be due to maltreatment.1 Without such notifications, the public may not even know an incident has occurred, so they certainly will not ask for information about it.

Recommendations

CAPTA should be amended to clarify the language regarding child fatalities and near fatalities due to maltreatment and establish parameters for states in interpreting the law. The new language should make clear that states must release findings and information about fatalities and near fatalities, and disclosure must be required rather than simply allowed. The law should prescribe the types of information that can be withheld and when disclosure can be postponed, and it should deny states the option of withholding other information or refusing to release information altogether. It should spell out the findings and information that must be released. It should clarify that the CAPTA language overrides other confidentiality provisions in federal law. It should also require that states notify the public of child fatalities and near fatalities that are reported to child abuse hotlines and accepted for investigation.

But recent attempts to reauthorize CAPTA have failed, and these changes seem unlikely in today’s ideological climate, where child safety often takes a back seat to other concerns. It is probably more realistic to focus on changes to state legislation. A good state disclosure policy, in compliance with CAPTA, should cover fatalities and near fatalities. It should be mandatory and contain no vague terms, conditions, or exceptions. Permitted redactions should be limited to the names of living children in the family and reporters of maltreatment and (temporarily) any information that would cause specific material harm to a criminal investigation. There should be no prohibition on sharing information deemed to be against the best interests of or harmful to the injured child or any other child in the household.

At a minimum, a disclosure policy should require prompt public notification of all fatalities and near fatalities reported to the hotline and accepted for investigation, along with a documented rationale for not investigating others. The notifications should include whether the family had past involvement with CPS and a brief summary of prior reports and responses by the agency. There should be no requirement that the historical information be “pertinent to the abuse or neglect that caused the fatality,” as suggested by the CWPM. Upon completion of the investigation, if it is determined that the fatality resulted from abuse or neglect, the department should be required to release a detailed summary of prior reports involving the family or household and of agency responses, including investigations, in-home cases, child removals, and family reunifications, The agency’s complete files on the perpetrators and their children, with certain identifying information redacted, should be available to any person upon request.

A study of the policies of 50 states and the District of Columbia toward disclosing information regarding child maltreatment fatalities and near fatalities shows that many fall drastically short of embodying Congress’s intent in adding Section 106(b)(2)(B)(x) to CAPTA. Most of these difficulties stem from the deficiencies of the language itself and the guidance provided in HHS’s CWPM. While changing CAPTA’s language would be the most efficient way to enable improvement around the country, it is more likely that legislators and child advocates at the state level will collaborate on legislation requiring full transparency around these deaths. We cannot make progress in preventing severe and life-threatening child maltreatment unless legislators, advocates, and the public can access comprehensive information about what led to these tragic events.

  1. Rhode Island provides notifications of suspected maltreatment only for fatalities and near fatalities only if the child was the subject of an open case; other notifications occur only after maltreatment is confirmed. ↩︎

GUEST POST: Torn Apart: How the Abolition Movement Destroys Foster Youth – And How Listening To Us Can Build A Safer World

by Patty Flores

I am grateful to be publishing this essay by a gifted and needed young voice in the child welfare space. Liliana “Patty” Flores, MSW is a clinician, researcher, advocate, educator, and motivational speaker. Her intersectionality and affiliation with marginalized identities such as being an undocumented Salvadoran female, LGBTQ+, foster youth, homeless, and cycling in and out of juvenile jails, have shaped the way she sees social issues. Patty was born in El Salvador and migrated to the U.S. at age 10. She spent half of her life in foster care, struggling with substance abuse. Patty turned 18 years old in jail. She eventually graduated high school and enrolled in college while still incarcerated. She now has an A.A. in Social and Behavioral Sciences, an A.S. in Administration of Justice from Pierce College, a B.A. in Sociology from UC Riverside, and a Master’s in Social Work from Smith College. Her goal is to empower those of similar backgrounds like herself. Read more about Patty and her work at www.defyinglabels.com. –Marie Cohen

Imagine going to school with bumps on your head and bruises on your back and legs from being repeatedly punched and kicked; this was my reality as a kid. Youth with lived experiences in foster care face countless challenges, even when the abuse finally stops – one way or another. For me, it stopped because at age 12 I reported it. I then found myself in foster care and having to navigate the complicated child welfare system, speaking little English and knowing nothing about how the child protection system (CPS) works in this country. Although my experience in care was hard for numerous reasons, including substance use, incarceration, homelessness, and being undocumented, I am alive only because this country has a system of protection in place for children and youth like me who have been victimized by their parents.

The movement to abolish the current child welfare system –spearheaded by the organization upEND and its co-founder, Alan Detlaff–has sparked useless controversy and divided the community of people who are concerned with child safety, permanency, and wellbeing. Former foster youth like me, who are pursuing college and graduate education,  are silenced in our classrooms. Also silenced are our allies, who are shamed for wanting to pursue a career in child welfare. The child welfare abolition movement originated from academics like Detlaff who have  no lived experience of foster care. Who are these ivory tower elites to tell anyone that foster care is unnecessary and should be eliminated when they’ve not lived through it themselves?

The child welfare abolitionists have chosen to ignore those of us with lived experience of child abuse and neglect who refuse to endorse their program of eliminating the child protection system. Are they too uncomfortable to talk about the cruel truth of being an abused or neglected child? Do they fear this conversation will thwart their efforts to abolish the system? It’s much easier to ignore the issues of child abuse and child deaths, to avoid engagement with survivors, and to see only the adult perpetrators as victims, than to recognize the reality of child abuse and neglect. It is also much easier to talk about tearing a system down than to grapple with the question of how to build one up that truly promotes child safety, permanency, and well-being. It is  harder to acknowledge the harms of child maltreatment and work together with us to find solutions that ensure our safety, stability, and well-being. Abolitionists are choosing the easy, less messy way out. They argue that foster care is not the answer. But for some of us, it is the only answer after experiencing abuse and neglect without extended family support.

I was born in El Salvador and am a descendant of the Pueblo Pipil, an indigenous group of people in El Salvador. I migrated to the United States as an unaccompanied minor at the age of ten. My background is rooted in a history of civil war and the struggle of oppressed indigenous people to overthrow those in power. In the United States, child welfare abolitionists often label themselves as “revolutionary” or claim to be engaging in “revolutionary” social work, but they are mistaken. True revolution occurs when the community rises up against oppression from those in power, not the other way around. These are the lessons I have learned from my revolutionary ancestors.

Child welfare abolitionists use the term to brand themselves as social justice warriors and  silence those with lived foster care experiences. They discuss child protection and  foster care among themselves, excluding the very people most affected.  It is  an abuse of power for the “abolitionists” to neglect the voices of those with lived experiences in foster care, while enhancing their own prestige within the elite ivory tower. 

Advocates for abolishing the child welfare system (or as they call it, the “family policing system”) argue that collective efforts and community involvement are the solution in cases of child abuse and neglect. Yet nearly five years have passed since the inauguration of upEND, and the child welfare abolition movement has not provided specifics about how this would look in practice. Nor have I heard Dettlaff or other child welfare abolitionists discuss the experiences of young people like me who endured abuse and neglect. Are they afraid of the harsh realities we’ve experienced? How can they even talk about the child welfare system when they refuse to acknowledge our existence?

I keep asking myself these questions: where was the community when I witnessed my mother being violently attacked, with a gun held to her head by my father? Where was the community when Gabriel Fernandez lost his life? Where was the community when Danieal Kelly was starved to death by her mother? Or much more recently, as four-year-old Jahmeik Modlin, slowly starved to death in an apartment stocked with food? Where is the community when children continue to lose their lives at the hands of their caregivers daily? When I’ve spoken to community members about their role in intervening when child maltreatment or violence on the streets occurs (a “solution” prescribed by the “abolitionists”), they’ve expressed fears of retaliation or concerns about getting themselves into dangerous situations where they could be attacked by the perpetrators.

The child welfare abolitionists have manipulated many young people, students, and activists into adopting oversimplified, Black and White narratives that erase other ethnic groups and the intersectionality children like me experience. To support their argument, they assert that the media is responsible for over-emphasizing cases of abuse and deaths, which they contend are infrequent. But when you grow up witnessing so much violence, abuse, and neglect firsthand, you don’t have to watch the stories on the news. In fact, I did not grow up watching any TV. I learned about all this violence because I lived it.

College and university professors who support abolition (and who have never worked in the system) consistently push the narrative that CPS serves only to break Black and Brown families apart. They rarely if ever acknowledge the suffering endured by the over half a million children and youth who are abused and neglected annually and the need for a system of child protection in this country. As a young person with lived experience in an abusive family, I felt compelled to speak up in the classroom. And I did, immediately standing out with my thick accent and visible head tattoos. Fortunately, many of my classmates, including peers with experience in foster care, supported me and together we pushed back against professors’ biases and prejudice. I felt powerless growing up, and I still feel powerless as I navigate the racist, sexist, and classist world of academia.

In Defying Labels: From Negative Credentials to Positive Credentials?, an article I wrote for a newsletter at UC Riverside, I explained that society often shifts blame to the child for revealing family secrets in cases of abuse and neglect. The last thing I want as an adult is to keep being torn down and silenced by those in positions of power – professors, researchers, policy analysts, lawyers, and others. The abolition movement is tearing foster youth apart. Why not actually listen to what we have to say? This is the only way toward a safer world for all.








How New York keeps the public in the dark about high-profile child abuse and neglect deaths

Image: WWNY

This essay was originally published on the website of Lives Cut Short, a project to document child maltreatment deaths in the United States since 2022, for which I serve as Senior Project Associate

Jahmeik Modlin was found in a skeletal condition in a Harlem apartment stocked with food. He died the next day, and his three older siblings were hospitalized with severe malnutrition. The family had been on the radar of the Administration for Children’s Services (ACS) since 2019, before Jahmeik was born. But the agency closed its last case with the family in 2022 after determining that the children were safe, a source told the New York Times. A spokeswoman for ACS declined to offer further information, citing state law designed to protect siblings of fatal abuse victims.

According to data states submit to the federal government, about 1800 children die of abuse and neglect every year, but this figure is widely recognized to be an undercount. Among those deaths, studies suggest that between a third and a half involve families who were already known to the child protection system (CPS) through previous reports.  Even in other cases where the family had no prior contact with CPS, other systems may have interacted with the child and perhaps could have intervened. Legislators, advocates and the public must have access to timely information about the circumstances leading up to child maltreatment fatalities so they can identify missed opportunities and policy and practice changes necessary to protect children. For that reason, Congress in 1996 added a provision in federal law that requires all states to provide assurances to the federal Department of Health and Human Services that they have provisions for disclosing findings and information regarding child fatalities and near fatalities from maltreatment.

Lives Cut Short surveyed state laws and policies governing access to information about child maltreatment fatalities and near fatalities. The resulting report, Keeping the Public in the Dark: How Federal and State Laws and Policies Prevent Meaningful Disclosure about Child Maltreatment Fatalities and Near Fatalities, shows that most states have such laws and practices but many of them are vague, and many have provisions that conflict with the purpose of ensuring public access to critical information. Among such provisions are those that prohibit releasing information that might harm surviving children in the families where a child was killed or seriously injured by maltreatment.

New York, at first glance, appears to be more transparent than most states in making information and findings about child maltreatment fatalities available to the public. The New York State Office of Children and Family Services (OCFS), which supervises local agencies such as ACS, is required to review all local investigations of child fatalities reported to the State Central Register and to publish a summary report within six months of the investigation. Disclosure of this information, however, occurs only if the state or local commissioner determines that it is not “contrary to the best interests of the child, the child’s siblings or other children in the household.”  While the law does not provide a comprehensive definition of “contrary to the best interests,” the OCFS website does explain that OCFS conducts what it calls a “best interests determination,” sometimes assisted by “experts” from the agency’s Statewide Child Fatality Review Team.  The process considers “whether publishing a fatality report is contrary to the best interests of a child’s siblings or other children in the household, what effects publication may have on the privacy of children and family, and any potentially detrimental effects publication may have on reuniting and providing services to a family.” 

To understand the impact of the “best interests” determination, one needs to know  the proportion of child fatalities for which New York withholds reports.  The identifying numbers that the state assigns to its child fatality reports provide a useful clue. All these numbers start with a two-letter abbreviation for the region (AL for Albany, BU for Buffalo, etc.), continue with the last two digits of the year, and end with a three-digit number, starting from 001. For example, the first Albany report for 2022 would be identified as AL-22-001. Assuming that all missing numbers represent reports withheld under the “best interests determination,” about one-quarter of reports on 2022 fatalities in New York State were withheld.

The Child Abuse and Neglect Deaths Integrated Database (CANDID), maintained by Lives Cut Short, allows us to determine which child deaths reported in the media had a corresponding fatality report released by New York OCFS. CANDID combines information on child maltreatment fatalities from media reports, official fatality reviews or reports, and other available sources. New York State’s fatality reports do not include names, but they do include the dates of death as well as details about the circumstances. Therefore, one can attempt to match media coverage with the OCFS review of the same fatality. But very few maltreatment deaths occurring in 2022 and covered by the media had an OCFS review released to the public. It appears that the reviews of high-profile deaths that received media coverage were withheld based on “best interest determinations.” 

These cases included:

  • The death of Bryleigh Klino, a profoundly disabled 17-year-old whose parents have been charged with endangering her welfare. Hospital employees observed numerous signs of abuse and neglect on Bryleigh’s body;
  • The drowning of six-month-old Dalilah Crespo, whose death was ruled a homicide;
  • The death from abusive head trauma of four-month-old Cairo Dixon-Sanchez, for which his father pleaded guilty;
  • The fentanyl poisoning death of 11-month-old Liam Sauve, who ingested 23 times the amount of fentanyl that could kill an adult and whose mother pleaded guilty for his death;
  • The death of three-month old Genevieve Comager, whose father was charged with shaking her to death;
  • The beating death of nine-year-old Shalom Guifarro, whose mother has been sentenced to 16 years for her killing;
  • The death of two-year-old Ermias Taylor-Santiago of a fentanyl overdose, which was ruled a homicide;
  • The death of blunt force trauma of Xavier Johnson, whose mother’s boyfriend was charged with beating him to death;
  • The fatal heroin overdose death of six-month-old Denny Robinson, found with a heroin bag in his mouth in a house that was connected with a major drug trafficking operation;
  • The drug and alcohol poisoning of 14-year-old Hailey Hasbrouck, allegedly by her father and his girlfriend, who allegedly gave her the “toxic cocktail;”
  • The “suspicious” death of seven-year-old Hunter DeGroat, found unresponsive in his home;
  • The death of two-year-old Aniyah Wyatt-Wright, allegedly punched to death by her father;
  • The murder of three-year-old Shaquan Butler, beaten to death in a Queens homeless shelter after being reunified with his parents after being removed from them by ACS.

It is probably not a coincidence that OCFS has elected not to release information on most of the egregious fatalities that were covered in the media. Many of the published state fatality reviews concern deaths due to unsafe sleep factors, accidental drownings, and other fatalities that do not result in criminal charges and are therefore never known to the public. It is possible that OCFS is trying to shield the surviving children in the cases listed above because readers may be able to identify them by putting together the reports and the media coverage—as we did. But these are the very cases for which the information is most urgently needed. The nature of these cases suggests the existence of serious and chronic conditions that might have resulted in previous reports and involvement with CPS. Any harm that public release of the report would cause when the incident has already been covered in the media is dubious.  
It’s hard to avoid wondering if the exclusion of these cases from disclosure protects the agency more than the children. And to avoid guessing that Jahmeik’s death will join the list of those cases for which reports are never published.

We cannot make progress in the prevention of severe and life-threatening child maltreatment unless legislators, advocates and the public have access to comprehensive information about what led up to these tragic events. Congress tried to provide this access through a provision in federal legislation, but states have couched this requirement in vague language or hedged it with qualifications that prevent the release of critical information—or any information at all in some cases—as in New York. Only Congress can fix the gaps in the federal law, but state legislatures can act in the meantime to ensure their disclosure laws serve the purpose of improving child welfare in their states. 

To learn about current law in your state, see the new report: Keeping the Public in the Dark: How Federal and State Laws and Policies Prevent Meaningful Disclosure about Child Maltreatment Fatalities and Near Fatalities. 


School shootings and fentanyl overdoses: the uncounted costs of neglecting maltreated children

Colin and Colt Gray: TMZ
Maylia Sotelo: Fox 11

A fourteen-year-old boy and a fifteen-year-old girl are charged as adults, one for a mass shooting and the other for selling a fentanyl tablet that killed an older teenager. These two young people had something in common–a long history of neglect (and sometimes abuse) by their parents and a failure to intervene by child welfare services despite multiple reports that children were in danger. Ignoring chronically maltreated children when they could have been saved and then locking them up for life is both inhumane and costly. We must intervene to help maltreated children before they are irrevocably damaged by years of abuse and neglect.

On September 4, 2024, fourteen-year-old Colt Gray shot and killed two teachers and two students at Apalachee High School in Winder, Georgia with an AR-15 style rifle given to him by his father. He has been charged as an adult and is awaiting trial. It did not take long for the media to uncover that Colt had grown up in a chronically abusive and neglectful home. As the Washington Post put it in a devastating article, “Colt’s parents, each addicted to drugs and alcohol, were perpetually inattentive, often cruel and sometimes entirely absent, according to family members, neighbors, investigators, police reports and court records.” In November 2022, Colt’s mother, Marcee Gray, left his father, Colin Gray, and moved to southern Georgia with her two younger children. It appears that DCFS had opened a case at some point because In October of 2023, a spot drug-test revealed Marcee’s renewed drug use. Colin Gray was ordered to retrieve the other children, or they would be placed in foster care. Shortly thereafter, it appears that the case was closed.

There is no information from media reports about whether DCFS evaluated Colin Gray for his fitness to take care of his three children or to monitor their well-being in his care before closing the child welfare case. Yet, relatives reported to the New York Post that Colin Gray relentlessly bullied his son, calling him names like “sissy” and “bitch.” The Washington Post reported that Colt first came to the attention of authorities at the age of 11, when his school flagged him for searching the internet for ideas on how to kill his father. In Colin Gray’s custody, Colt never attended eighth grade and was not even registered for school until February 2 of that year. That Christmas, Colin Gray gave Colt his own AR-15 style rifle, in an attempt to “toughen him up,” as relatives told the New York Post. By his fourteenth birthday in January, Colt’s grandmother reported that he was searching the internet for what was wrong with him; she offered to pay for therapy and take him there but his father never signed him up. In July of 2023, Marcee returned from rehab and Colin allowed her to move back in. Colt’s mental health deteriorated even further after his mother’s return, and he talked of hurting himself or others. He registered for high school two weeks late and rarely attended. “Colt was like the thrown-away child,” said his grandmother, who tried in vain to get his father and the school to help him. Five days after his father failed to take him to a crisis mental health center despite his grandmother’s plea, Colt brought his rifle to school and took four lives.

Also charged as an adult was 15-year-old Maylia Sotelo of Green Bay, Wisconsin, the subject of a devastating article by Lizzie Presser of Pro Publica.  Maylia’s home had been a “hangout for users and dealers.” Her three older sisters had all been kicked out or left due to their mother’s violence. Maylia’s had been referred to child protective services 20 times before she was finally removed from her home at the age of 14. In a pattern typical of chronic maltreatment, the reports concerned multiple types of neglect, sexual abuse, and physical abuse. Before Maylia turned one, CPS documents show that her mother overdosed on cocaine and Adderall with seven children in her home. When she was five years old, a caller reported that her mother was “high as a kite” and her boyfriend was violent. The next year, another report indicated that there was no food in the home and that the mother was using heroin in front of her children.

When Malia was seven, CPS substantiated a report that a man “opened his pants, pulled out his penis and masturbated” in front of one of Maylia’s sisters. That same year, a woman overdosed on crack in the house and Maylia’s mother “would not call rescue or the police because [she] did not want her children removed,” according to a social worker’s notes. And a school employee reported that Maylia missed half the school year. When Maylia was 14 and her mother became psychotic, Maylia and her sister were finally removed from the home and placed with relatives. But they were given no counseling or assistance with school, according to Pro Publica. Maylia had been smoking weed since fifth grade, then began selling it. By the beginning of tenth grade, she was selling “blues,” pills that were billed as percocet but actually contained filler and fentanyl. She sold a pill to an 18-year-old named Jack McDonough. When he died of an overdose, Maylia was arrested for first-degree reckless homicide.

It is obvious that both Colt Gray and Maylia Sotelo were chronically maltreated children who suffered from multiple types of maltreatment over a period of years. It is also obvious that the systems designed to protect them failed both of these young people. Both families clearly required intervention that did not come when it was needed, though we do not have enough details to make an informed critique of the system’s response. When the child welfare system finally intervened in Malia’s case, it may have been hard to change her trajectory, and it appears that she was left with relatives and received monitoring or services to address her traumatic history. In Colt’s case, the intervention may have also come too late to prevent serious psychological damage. And once they became involved, caseworkers appeared to be focused on his mother and ended the case with the placement of all three children with their father, a parent who had been equally neglectful and failed to take action to protect the children from his wife’s abuse.

Perhaps more intensive in-home services provided earlier could have helped Colt’s and Maylia’s parents address the issues that led them to abuse or neglect their children. If not, perhaps Maylia’s earlier removal from her toxic home, and Colin’s removal to a better environment than either of his parents could provide might have saved these children from the sad fate that awaited them. The approach that is currently in fashion – exemplified by the much touted Family First Prevention Services Act (FFPSA) of 2018 – prescribes the avoidance of foster care at almost any cost. It does, however, promise that parents receive support in parenting their children, whether it is mental health, drug treatment, or parenting training. Child welfare systems have long been providing such support to families in the form of in-home services, and FFPSA was supposed to provide the resources to improve these services. Unfortunately, FFPSA did not acknowledge or support the crucial role of frequent home visits to ensure the children are safe and that they can be removed into foster care if the parents do not cooperate with their plans for addressing their issues and improving their parenting.

Sadly, there is no evidence that increases in family support or child safety monitoring are forthcoming. States are proudly citing drops in their foster care caseloads, with no reporting on what is happening to the children left at home. States are not required to release data on the number of cases opened for in-home services, so we have no idea whether the abused and neglected children who are not being removed are getting any supervision or their parents receiving services. But as I have written, data from the states with the largest and third largest foster care caseloads indicates that the number of children receiving in-home services has not increased to make up for the drop in children removed to foster care; instead it has decreased along with foster care placements, resulting in a decline in the number of children being served overall.

Studies have documented the connection between child maltreatment and crime.1 Failing to intervene with at-risk children before they resort to crime and subsequently incarcerating them results in unnecessary human suffering, not to mention greater financial costs, than intervening early. If we do not want to remove more children, we must provide intensive services to parents and close monitoring of their children’s safety–and be ready to remove the children as soon as it becomes clear that parents are not going to change before the children are irreparably harmed. Such monitoring is key, because we really do not know what, if anything, works in preventing future maltreatment among parents who have maltreated their children.

This is not the first time that the failure of CPS has been noted in the wake of a heinous crime. I previously wrote about Lisa Montgomery, who was executed on January 12, 2021. She murdered a pregnant woman, cut out the baby, and took it home. It turned out that Lisa Montgomery had a long and horrific history of physical and sexual abuse throughout her childhood, including beatings and bizarre punishments by her mother, rape by her stepfather, and prostitution by both. Sadly, it seems that we have not made much progress since Lisa’s childhood, and current ideological trends run the risk of leaving even more children unprotected in the future.

Notes

  1. See Janet Currie and Erdal Tekin, Does Child Abuse Cause Crime? NBER Working Paper 12171, https://www.nber.org/digest/jan07/does-child-abuse-cause-crime and Todd I. Herrenkohl et al., Effects of Child Maltreatment, Cumulative Victimization Experiences, and Proximal Life Stress on Adult Crime and Antisocial Behavior, https://www.ojp.gov/pdffiles1/nij/grants/250506.pdf.

Reposting: Torn apart: A skewed portrait of child welfare in America

The MacArthur Foundation has announced its new class of Fellows, the recipients of what are commonly called the “Genius Awards.” Among the recipients is Dorothy Roberts, the self-styled popularizer of the term “racial disproportionality” and creator of the term “the family policing system.” According to the Director of the Program, “The 2024 MacArthur Fellows pursue rigorous inquiry with aspiration and purpose. They expose biases built into emerging technologies and social systems….” It’s hard to understand how this term can be applied to an author who wrote that the “family-policing system terrorizes Black families because that’s what it is designed to do ” despite also stating that child welfare systems excluded Black children from their inception until the second half of the twentieth century. The choice of Roberts only exposes the bias and lack of rigor–or alternatively the sheer ignorance– of the MacArthur Foundation. As an illustration, I am reposting my 2022 review of Roberts’ most recent book, Torn Apart: How the Child Welfare System Destroys Black Families–and How Abolition Can Build a Safer World.

In her 2009 book, Shattered Bonds: The Color of Child Welfare, Dorothy Roberts drew attention to the disproportional representation of Black children in foster care and child welfare in general and helped make “racial disproportionality” a buzzword in the child welfare world. In her new book, Torn Apart: How the Child Welfare System Destroys Black Families–And How Abolition Can Build a Safer World, Roberts revisits the issues addressed in Shattered Bonds and creates a new buzzword, renaming child welfare as the “family policing system.” Those who liked Shattered Bonds will likely love Torn Apart. But those who value accuracy in history or in data will find it to be sadly misguided, although it does make some valid points about flaws in the U.S. child welfare system.

Roberts starts with a horrific anecdote about a mother, Vanessa Peoples, who was doing everything right–she was married, going to nursing school, about to rent a townhouse and was even a cancer patient. But Peoples attracted the attention of both the police and child welfare and ended up hogtied and carted off to jail by police, placed on the child abuse registry, and subjected to months of monitoring by CPS after she lost sight of her toddler at a family picnic when a cousin was supposed to be watching him. But citing these extreme anecdotes as typical is very misleading. This particular story has been covered in numerous media outlets since it occurred in 2017 and continues to be cited regularly. One can counter every one of these horrific anecdotes with a story of a Black child who would have been saved if social workers had not believed and deferred to the parents. (See my commentary on the abuse homicides of Rashid Bryant and Julissia Batties, for example).

Roberts’ book restates many of the old myths that have been plaguing child welfare discussions as of late and that seem to have a life of their own, impervious to the facts. Perhaps the most common and pernicious is the myth that poverty is synonymous with neglect. Roberts embraces this misconception, suggesting that most neglect findings reflect parents who are too poor to provide adequate housing, clothing and food to their children. But parents who are found to have neglected their children typically have serious, chronic mental illness or substance use disorders that severely affect their parenting, and have refused or are unable to comply with a treatment plan. Many are chronically neglectful, resulting in children with cognitive and social deficits, attachment disorders, and emotional regulation problems. Commentator Dee Wilson argues based on his decades of experience in child welfare that “a large percentage of neglect cases which receive post-investigation services, or which result in foster placement, involve a combination of economic deprivation and psychological affliction…., which often lead to substance abuse as a method of self-medication.” Perhaps the strongest argument against the myth that poverty and neglect are one and the same is that most poor parents do not neglect their children.  They find a way to provide safe and consistent care, even without the resources they desperately need and deserve.

Roberts endorses another common myth–that children are worse off in foster care than they would be if they remained in their original homes. She argues that foster care is a “toxic state intervention that inflicts immediate and long-lasting damage on children, producing adverse outcomes for their health, education, income, housing, and relationships.” It is certainly true that foster youth tend to have bad outcomes in multiple domains, including education, health, mental health, education, housing and incarceration. But we also know that child abuse and neglect are associated with similar poor outcomes. Unfortunately, the research is not very helpful for resolving the question of whether these outcomes are caused by the original child maltreatment or by placement in foster care. We cannot, of course, ethically perform a controlled study in which we remove some children and leave a similar set of children at home. We must rely on studies that use various methodologies to disentangle these influences, but all of them have flaws. Roberts cites the study published in 2007 by Joseph Doyle, which compared children who were placed in foster care with children in similar situations who were not. Doyle found that children placed in foster care fared worse on every outcome than children who remained at home. [Update added October 2024: A newer study, reflecting current foster care policy and the more typical state of Michigan, found the opposite result.] But focusing on marginal cases* leaves out the children suffering the most severe and obvious maltreatment. In a recent paper, Doyle, along with Anthony Bald and other co-authors, states that both positive and negative effects have been found for different contexts, subgroups, and study designs.

There is one myth that Roberts does not endorse: the myth that disproportional representation of Black children in child welfare is due to racial bias in the child welfare system, rather than different levels of maltreatment in the two populations. After an extensive review of the debate on this issue, Roberts concludes that it focused on the wrong question. In her current opinion, it doesn’t matter if Black children are more likely to be taken into foster care because they are more often maltreated. “It isn’t enough,” she states, “to argue that Black children are in greater need of help. We should be asking why the government addresses their needs in such a violent way, (referring to the child removal). Roberts was clever to abandon the side that believes in bias rather than different need as the source of disparities. The evidence has become quite clear that Black-White disparities in maltreatment are sufficient to explain the disparity of their involvement in child welfare; for example Black children are three times as likely to die from abuse or neglect as White children. As Roberts suggests and as commentators widely agree, these disparities in abuse and neglect can be explained by the disparities in the rates of poverty and other maltreatment risk factors stemming from our country’s history of slavery and racism. Unfortunately, Roberts’ continued focus on these disparities in child welfare involvement will continue to be used by the many professionals who are working inside and outside child welfare systems all over the country to implement various bias reduction strategies, from implicit bias training to “blind removals.”

In Part III, entitled “Design,” Roberts attempts to trace the current child welfare system to the sale of enslaved children and a system of forced “apprenticeship” of formerly enslaved Black children under Jim Crow, whereby white planters seized custody of Black children from their parents as a source of forced labor.** As she puts it, “[t]hroughout its history US family policy has revolved around the racist belief that Black parents are unfit to raise their children. Beginning with chattel slavery and continuing through the Jim Crow, civil rights, and neoliberal eras, the white power structure has wielded this lie as a rationale to control Black communities, exploit Black labor, and quell Black rebellion by assaulting Black families.” In other passages she adds other groups to the list of victims, adding “Indigenous, immigrant and poor people to the list of communities that are being controlled by the “family policing system.” But most of her statements refer to Black victims only.

Roberts’ attempt to connect slavery and Jim Crow practices with child welfare systems highlights a major flaw of the book. She herself explains that due to racism the child welfare system served only White children when it emerged in the nineteenth century with the creation of child protection charities and the passage of state laws allowing maltreated children to be removed from their homes and placed in orphanages. Foster care was established in the middle of the century and also excluded Black children. The system did not begin serving Black children until after World War II, so it is difficult to understand how it could stem from slavery and Jim Crow practices. It seems much more plausible that the child welfare system arose from basically benevolent concerns about children being maltreated, and that with the rise of the civil rights movement, these concerns were eventually extended to Black children as well.

While Black children’s representation as a share of foster care and child welfare caseloads rose rapidly starting in the 1960’s, and Black children are much more likely to be touched by the system than White children, the system still involves more White than Black children. According to the latest figures, there were 175,870 White non-Hispanic children in foster care (or 44 percent of children in foster care) and 92,237 Black (non-Hispanic) children in foster care, or 23 percent of children in foster care. Moreover, the disparity between Black and White participation in child welfare and foster care as a percentage of the population seems to be decreasing.*** So the idea that this whole system exists to oppress the Black community and maintain white supremacy seems farfetched.

Roberts’ attempt to make Black children the focus of the book results in some awkward juxtapositions, like when she admits that though the Senate investigation of abuses by a for-profit foster care agency called MENTOR “highlighted cases involving white children, we should remember that Black children are more likely to experience these horrors in foster care—not only because Black children are thrown in foster care at higher rates, but also because government officials have historically cared less about their well-being.” A page later she states that the “child welfare system’s treatment of children in its custody is appalling but should come as no surprise. It is the predictable consequence of a system aimed at oppressing Black communities, not protecting Black children.” It is hard to understand how White children being maltreated in bad placements supports this narrative.

Fundamental to Roberts’ critique is her system is “not broken.” “Those in power have no interest in fundamentally changing a system that is benefiting them financially and politically, one that continues to serve their interests in disempowering Black communities, reinforcing a white supremacist power structure, and stifling calls for radical social change.” Even if one believes there is a white supremacist power structure, it is hard to see the direct connection between the abuses Roberts is highlighting and the disempowerment of Black communities; it seems more likely that the more abusive the system, the more protests it would generate. And at a time when the federal government and some of the wealthiest foundations and nongovernmental organizations are echoing much of Robert’s rhetoric, her reasoning seems particularly off-target.

Roberts makes some valid criticisms of the child welfare system. Her outrage at the terrible inadequacies of our foster care system is well-deserved. She is right that “The government should be able to show that foster care puts Black children [I’d say “all children”] on a different trajectory away from poverty, homelessness, juvenile detention, and prison and toward a brighter future.” Any society that removes children from their parents needs to be responsible for providing a nurturing environment that is much, much better than what they are removed from. And we are not doing that. As Roberts states, “The state forces children suffering from painful separations from their families into the hands of substitute caretakers…..who often have unstable connections, lack oversight and may be motivated strictly by the monetary rewards reaped from the arrangement.” As a foster care social worker in the District of Columbia, I was driven to despair at my inability to get my superiors to revoke the licenses of such foster parents; the need for “beds” was too great to exclude anyone was not actually guilty of abuse or severe neglect. Roberts is also right to be concerned the outsourcing of foster care to private for-profit organizations that may be more concerned with making money than protecting children, sometimes resulting in scandals like the one involving MENTOR Inc., which was found to hire unqualified foster parents and fail to remove them even after egregious violations like sexual assault.

Roberts also raises valid concerns about children being sent to residential facilities, often out of state, that resemble prisons rather than therapeutic facilities. But she ignores the need for more high-quality congregate care options for those children who have been so damaged by years of maltreatment that they cannot function in a foster home, no matter how nurturing. Instead, she repeats the usual litany of scandals involving deaths, injuries, fights and restraints, without noting the undersupply of truly therapeutic residential settings, resulting in children sleeping in office, cars, and hotels or remaining in hospital wards after they are ready for discharge. Ironically, she supports defunding the system, even if that would mean even worse situations for these children.

Roberts decries the fact that parents sometimes relinquish custody of their children in order to get needed residential care, arguing that “rather than providing mental health care directly to families, child welfare authorities require families to relinquish custody of children so they can be locked in residential treatment centers run by state and business partnerships.” That statement is completely backwards. The child welfare system does not provide mental health services but, like parents, it often struggles to secure them for its clients. Some parents are forced to turn to the child welfare system because their insurance will not pay for residential care for their children. That is not the fault of child welfare systems, which clearly do not want to take custody of these children. The underlying problem is the lack of adequate mental health care (including both outpatient and residential programs), which has destructive consequences for the foster care system. This is exacerbated by the lack of parity for mental health in health insurance programs. It’s hard to believe Robert is unaware of these well-known facts.

Roberts is correct that parents as well as children are shortchanged by inadequacies in our child welfare program, such as the “cookie cutter” service plans which often contain conflicting obligations that are difficult for struggling parents to meet. But she is wrong when she says that parents need only material support, not therapeutic services. But this error flows logically from her concept of neglect as simply a reflection of poverty. In fact, many of these parents need high-quality behavioral health services and drug treatment, which are often not available because of our nation’s mental health crisis, as well as the unwillingness of taxpayers and governments at all levels to adequately fund these services.

In her final chapter, Roberts concludes that, like the prison system, the child welfare system cannot be repaired because it exists to oppress Black people. “The only way to end the destruction caused by the child welfare system is to dismantle it while at the same time building a safer and more caring society that has no need to tear families apart.” In place of family policing, Roberts favors policies that improve children’s well-being, such as “a living wage and income support for parents, high-quality housing, nutrition, education, child care, health care; freedom from state and private violence; and a clean environment.” I agree with Roberts that aid to children must be expanded. The US is benighted when compared to many other Western countries that invest much more heavily in their children through income support, early childhood and K-12 education, healthcare, and housing. But family dysfunction occurs even if a family’s material needs are met. That is why every other developed nation has a child welfare system with the authority to investigate maltreatment allegations and assume custody of children when there are no other options. Moreover, some of the countries with the strongest safety nets for children also have higher percentages of children living in foster care than the United States.****

Torn Apart is a skewed portrait of the child welfare system. In it Roberts restates the common but easily discredited myths that poverty is synonymous with neglect and that foster care makes children worse off than they would have been if left at home. The underlying flaw in her account is the idea that this system exists to repress the Black community, even though it was established solely for the protection of White children. Roberts makes some valid criticisms of child welfare systems and how they shortchange the children and families they are supposed to help. But when she talks of dismantling child protection, she is proposing the abandonment of abused and neglected Black children in homes that are toxic to them, an abandonment that will perpetuate an intergenerational cycle of abuse and neglect. These children are our future; abandoning their well-being to prioritize that of their parents is a bad bargain with history.

*Doyle’s study included only those cases that would have resulted in foster placement by some investigators and not by others, leaving out the cases in which children were in such danger that all investigative social workers would agree that they should be placed.

**In various places, she also attributes it to different combinations of slavery and apprenticeship of Black children with the transfer of Native American children to boarding schools, the exclusion of Black children from charitable aid and the servitude of impoverished White children.

***A recent paper reports that disparities between Black and White children began to decrease in the twenty-first century in nearly every state, closing entirely in several Southern states.

****Unicef’s report, Children in Alternative Care, shows that Denmark has 982 children in “alternative care” per 100,000 and Sweden has 872 per 100,000, compared to 500 per 100,000 for the United States.

The fundamental misconception at the heart of the Family First Act

On May 22, 2024, the Senate Finance Committee (SFC) held a hearing entitled “The Family First Prevention Services Act [FFPSA]: Successes, Roadblocks, and Opportunities for Improvement.” The hearing focused on Part I of FFPSA, which is titled “Prevention Activities Under Title IV-E.” In his opening statement, Senator Ron Wyden, the prime author of the Act along with the late Orrin Hatch, recognized that FFPSA has so far not had the anticipated effect. “Six years on,” he acknowledged, “many states are still not taking advantage of the funding available to them.” He suggested that the problems were due to foot-dragging by the feds and states. But Wyden was wrong. The problem is not with the implementation of FFPSA but in the content of the bill itself. States have been hard-put to devise plans for implementing the new services because the bill was designed to fix a problem that did not exist–the alleged absence of child welfare services designed to help families stay together.

Sometime in the early years of the current century, a group of powerful advocates who thought that too many children were being placed in foster care came up with a proposal for change that they called “child welfare finance reform.” They thought the existence of a dedicated funding source for foster care and not for services to families that might keep children out of care impeded the provision of these services and might even provided an incentive to place children in foster care. A Google search for the earliest use of the term “child welfare finance reform” produced a 2010 report by the influential Casey Family Programs, entitled The Need for Federal Finance Reform. In that paper, Casey stated:

the major federal funding source for foster care, Title IV-E, primarily pays for maintaining eligible children in licensed foster care, rather than providing services for families before and after contact with the child welfare system. The fact that no IV-E funding can be used for prevention or post-reunification services has created a significant challenge to achieving better safety and permanency outcomes for children.

The idea of allowing Title IV-E to fund “prevention” or post-reunification services took hold. It was initially tested using waivers authorized between 2012 and 2014 to allow selected states to use Title IV-E funds to implement “evidence based practices” to prevent foster care placement. Despite the underwhelming results of these demonstration programs,1 FFPSA was introduced in 2016 in the House and Senate by the leadership of the House Ways and Means and Senate Finance Committees. The law was enacted in February 2018 as part of the federal Bipartisan Budget Act of 2018 (P.L. 115-123). It expanded the allowable uses of Title IV-E funding, formerly used to pay only for foster care, to include what the Act called “Prevention Services,” meaning services to prevent foster care.2 These services were defined to include mental health services, substance abuse treatment, and “in-home parenting skills training.”

In the recent hearing, Senator Wyden explained his view of the need for FFPSA and what it actually did.

Sometimes, in order to prevent the need for foster care, mom and dad might need a little help. Maybe a parent needs mental health care or substance use disorder treatment, or parenting training and support, or maybe the family needs to do family therapy. … So under Family First, we created new federal funding for those services.

Wyden’s formulation of the issue suggests that these mental health and parenting services and drug treatment were not available before FFPSA. But is simply not true. Mental health care, substance abuse treatment, and parenting training and support were all being provided with the help of federal funds — but just not through Title IV-E. States had other sources of federal reimbursement for these programs, such as Title IV-B, the Social Services Block Grant, and TANF. But above all, these services were funded by Medicaid, a federal entitlement program that receives the same federal match as Title IV-E. Because most parents involved with child welfare are covered by either Medicaid or (more rarely) private insurance, they could be referred to these services. These referrals were part of a set of child welfare services often called “in-home services,” “family preservation services,” “intact family services,” or “family maintenance services.” As the Child Welfare Information Gateway, an information clearinghouse of the U.S. Children’s Bureau, put it in a 2021 Issue Brief:

Most children involved with the child welfare system are not separated from their families but instead receive services while living at home. These child welfare “in-home services” are designed to strengthen and stabilize families that come to the attention of child protective services (CPS).

While FFPSA had taken effect when the issue brief was published, few states had implemented it and almost no money had been spent, so it is a testament to the prevalence of in-home services before any effects of FFPSA. In-home services were and are generally provided to families after an investigation found that the children are “at risk,” but not in immediate danger, which would require removal. A key element of in-home practice is safety assessment and management, which was given short shrift by the writers of FFPSA. Another key element was interventions for specific problems, like drug treatment, mental health services and age-specific parenting skills training–interventions which were mostly provided through referrals to other agencies.

I’m not saying that all families were getting all the services they needed. There is a longstanding undersupply of drug treatment and mental health services, as well as domestic violence services, which were inexplicably left out of FFPSA. Equally problematic is the poor quality of many of the services available, as many high-quality providers choose not to accept Medicaid due to low reimbursement rates and excessive paperwork. Federal reviews have found that child welfare agencies across the country have problems in accessing the services provided by other agencies, including long waiting lists, lack of quality providers, and lack of specialized services in rural areas. Perhaps the drafters of FFPSA assumed that it would allow state child welfare agencies to create their own supply of drug treatment, mental health and parenting programs strictly for child welfare clients.

But the use of Title IV-E funds authorized by FFPSA to add to the supply of services covered by Medicaid and other funders was soon blocked when Congress itself (with the involvement of the House Ways and Means Committee, which had also advanced FFPSA) decided that Title IV-E to be the “payer of last resort” for “Title IV-E prevention services.” This means that Title IV-E cannot be used to pay for any service that would have been paid for by another provider (like Medicaid) before FFPSA was passed. This change to Title IV-E of the Social Security Act was added on to a bill to address the opioid crisis that passed on October 24, 2018, apparently after members of Congress realized that FFPSA was unclear on what program paid first. It is hard to believe that the drafters of the bill did not anticipate this issue. since most of the other funding sources (like Medicaid and Title IV-B) are also under the jurisdiction of Senate Finance and House Ways and Means Committees. In any case, it is unclear why they did not move to amend FFPSA as soon as they recognized the problem.

Making matters worse, FFPSA required that all funded programs be “promising,” “supported,” or “well supported” as defined by a list of criteria set forth in the law, and that half of the funds be spent on programs that meet the more stringent criteria for being “supported” or “well supported.” This meant that some of the poorer and more rural states states as well as Indian tribes, were hard-put to find programs that existed in their states, were culturally appropriate and also met the criteria for being funded. Ironically, while FFPSA’s criteria for methodology are strict enough to rule out many programs, the bar for being considered “promising,” “supported” or “well-supported” is actually very low for any program that meet evaluation criteria. Many of the programs selected have few and small impacts, and common evidence-based services like Cognitive Behavioral Therapy and buphenorphine therapy for Opioid Use Disorder are not included in the list of practices that have been approved by the Title IV-E Prevention Services Clearinghouse. But that is a subject for another post.

The result of all this confusion and red tape was that the bill that was supposed to have a momentous impact, giving rise to an explosion of services for children at risk of being taken into foster care and their parents, has arrived with a whimper rather than a bang. ACF estimated that only 18,400 children in the entire country were served by Title IV-E prevention services programs in FY 2023, five years after it took effect, at a cost of $167 million. That’s hardly the massive impact that Wyden was expecting. It’s not hard to understand why the effect of FFPSA has been so underwhelming. States have been hard-put to find programs that meet the Act’s evidence requirements and are not already paid for by Medicaid.

What could Congress have done instead? They could have made changes to Medicaid to improve options for parents at risk of losing their children to foster care. Even if they preferred to change Title IV-E, they could have extended funding to case management, which the core service provided by child welfare and the backbone for all the other services that child welfare provides–case management. Case management is the only service that the child welfare system usually provides directly rather than through referrals and for which it actually pays. Child welfare social workers are above all case managers. It is the case manager who refers the parent to the other providers, motivates them to continue to participate, monitors their participation by communicating with the service provider, and most importantly, monitors the safety of the children in the home. One could say that in-home services is the main program that clients receive and encompasses other programs to which they may be referred.

The funding of case management through Title IV-E might have helped address an ominous development that is occurring in some large states–the simultaneous decline in both foster care and in-home cases. While, FFPSA was supposed to encourage states to substitute in-home services for foster care, there is evidence from some large states that endangered children are being left at home with no services or monitoring at all. (The evidence is limited because FFPSA does not require states to report on the number of cases that are opened for in-home services and how many children and adults are receiving such services.) The abandonment of these at-risk children may be due in part to the workforce crisis afflicting child welfare and other human services, which results in unmanageable caseloads and possibly pressure not to open cases. But the provision of matching funds for case management would help states provide higher salaries and better conditions, which might help increase the workforce.

It appears that Chairman Wyden still does not recognize the fundamental fallacy behind FFPSA’s “prevention services” and the problems it caused. In his opening statement at the hearing, he lamented that “last year, the federal government spent just $182 million on prevention services, while we spent over $4 billion on traditional foster care. Clearly, priorities are out of whack. The government can and must do better to get this funding out the door to states that ask for it.” But the bill’s drafters should look to their own responsibility before he blames “the government” for its implementation. It’s time to fix the flaws in FFPSA which stem from the fundamental misconception at its heart,

Notes

  1. An evaluation that incorporated the final state reports found that 80 percent of the interventions studied has mixed positive and “unexpected” findings. About one-fifth had statistically significant positive effects across all major outcomes on which they were evaluated…” ↩︎
  2. This title is somewhat deceptive as what is being prevented is placement in foster care, which is an intervention rather than a behavior. It is kind of strange to direct one intervention at another intervention provided by the same agency. If they want to prevent foster care, they can just not place kids in it! What they should have targeted for prevention is child abuse and neglect. ↩︎

A disappointing report from the Senate Finance Committee

A new report by the Senate Finance Committee concludes that children in residential treatment facilities routinely suffer harms like sexual and physical abuse, unsafe and unsanitary conditions, and lack of needed therapy. Further, it concludes that these harms are endemic to residential care itself. While the fact that some residential care facilities are substandard and cause harm to children is undisputed, the SFC’s study is poorly designed and should not be used as the basis of policy. It is based on facilities run by only four companies and cannot be used to make generalizations about residential care as a whole. Both the study design and the findings of the SFC report appear to stem from a preconceived conclusion and not on a desire to describe the actual landscape of residential care for America’s youth who need intensive behavioral health care.

On June 12, 2024, the Senate Finance Committee (SFC) released a report called Warehouses of Neglect: How Taxpayers are Funding Systemic Abuse in Youth Residential Treatment Centers. The report was based on an investigation of what it calls residential treatment facilities (RTF’s) operated by four large companies, “each owning facilities with a history of public abuse and neglect allegations and a substantial facility footprint.” It does not define RTF’s, but the term clearly refers to facilities that provide behavioral health services in a residential context to children with funding from programs under SFC jurisdiction, mainly Medicaid and foster care funds under Title IV-E of the Social Security Act. The four companies include three profit making corporations (United Health Services, Acadia Healthcare, and Vivant Behavioral Healthcare), and one nonprofit, Devereux Advanced Behavioral Health.

The report describes a pattern of poor conditions and abusive practices that the SFC staff observed by reviewing media articles and company documents, supplemented by interviews with senior leaders in the four companies and visits to several facilities not operated by these companies.1 These conditions and practices include sexual and physical abuse by staff; the inappropriate and often abusive use of restraints and seclusion; staff who are unqualified and inadequately trained staff or who routinely fail to discharge their duties, leading sometimes to tragic results; “non-homelike,” unsanitary and unsafe conditions; failure to provide the treatment that children need and that states are paying for; failure to maintain connections between children and their communities and to make adequate discharge plans; use of technology to monitor children that is more appropriate to detention facilities than therapeutic settings; and the absence of adequate oversight by state and federal authorities.

The report raises valid concerns about private businesses being involved in services to the most fragile young people. Several details stand out, all of them involving the company called Vivant and its CEO, John “Jay” Ripley. Ripley is the former CEO of Precision Tune Auto Care and and cofounder of BGR the Burger Joint. Ripley previously founded Sequel Youth and Family Services, which became known for the death of 16-year-old Cornelius Frederick while being restrained at a Michigan facility in 2020 and allegations of abuse and neglect at other Sequel facilities. In 2021, according to the report, Sequel closed half of its facilities and sold the other half, including 13 facilities that it sold to Vivant, Ripley’s new company. VIvant in turn hired many former Sequel executives and staff. In a video made by the University of Baltimore’s Merrick School of Business, Ripley explained that “you can make money in this business if you control staffing.” Ripley does not seem like the kind of person who should be running facilities dedicated to healing the most vulnerable young people.

The SFC report might have been a valuable document had it not tried to apply its findings to residential care in general. “Children suffer routine harm inside RTF’s,” the authors write. “These harms include sexual, physical, and emotional abuse, unsafe and unsanitary conditions, and inadequate provision of behavioral health treatment.” Leaving aside the ambiguity of the word “routine” (does that mean every resident or the majority of residents are harmed in such a way?), such a conclusion cannot be drawn from an investigation of treatment centers operated by four large companies. We have no idea what proportion of young people receiving publicly funded RTF care are in facilities operated by these four companies. Around the country, there are residential treatment facilities operated by many providers, including many freestanding facilities that are not part of large chains. Even within the companies reviewed, the report provides no data to document whether the problems exist only at certain facilities or throughout the chains. A facility’s functioning to a large extent reflects its leadership, and there may be well-run facilities among those operated by these companies.

Going even further, the SFC concludes that “the risk of harm to children in RTF’s is endemic to the operating model. The harms children in RTFs experienced are the direct, causal result of an operating model that incentivizes providers to optimize revenues and operating and profit margin. RTF providers offer minimal therapeutic treatment in deficient physical settings with lean staff composed of non-professionals, which maximizes per diem margins…” The report goes on to say that “[a]t its core, the RTF model typically optimizes profit over the wellbeing and safety of children.” But there is no “RTF operating model.” The understaffing and lack of professionals that are common among publicly funded residential providers more likely stem from the low reimbursement rates that that these programs receive, which in turn means that staff receive low pay as well, forcing the facilities to rely on poorly educated and trained staff.

Even more extremely, the report states that “In the best of circumstances, children at RTFs receive care from under-trained and overburdened staff, are given infrequent therapy, sometimes by non-professionals, and are exposed to unsanitary, unsafe, and non-homelike environments.” It is hard to understand how the SFC is capable of describing the best residential programs when its entire methodology consisted of seeking abuses in an extremely limited universe of residential programs.

In suggesting that residential treatment is a flawed model that should not exist, the SFC report ignores the important role of residential treatment facilities in the continuum of care for young people with mental illness. The Committee’s own invited witness, Elizabeth Manley of the University of Connecticut School of Social Work, testified about the need for these programs.

Residential treatment facilities have an important role in the provision of care for young people with complex behavioral health care needs when they have a clinical or behavioral health treatment need that cannot be met in a family and community setting due to the intensity of their treatment and supervision needs. In those instances, we need the care to be delivered in trauma-responsive environments that embrace parent and caregiver engagement throughout the treatment intervention and continually focus on best practice. These residential treatment facilities can have a significant benefit to the young person and their family.

The Child Welfare League (CWLA), in written testimony submitted to the SFC, added that residential services are “a small but important part of the full array of services” that must be available to meet children’s mental health needs.” CWLA went on to explain that there “are many providers and programs providing or striving to provide trauma-responsive, time-limited, effective residential care. They are informed by the emerging literature highlighting promising practices in residential interventions..” CWLA cited the Building Bridges Initiative, which is a national initiative working to identify and promote best practice and policy in residential interventions for youth. The initiative has produced a guide called Building Effective Short-Term Residential Interventions. According to this report, a new literature has developed in the last ten years or so which documents promising practices in residential intervention which are associated with positive benefits. These include “actively engaging youth and families, ensuring active school and community connection, and keeping residential intervention as short as possible.” The authors explain that “[c]utting-edge effective residential intervention now means providers are creatively working with youth and families in the home, in the community, and as briefly as possible – often for three months or less.” The guide was developed to help organizations make the transition to the new approach, with case histories of 12 programs that are making or have made this transition.

Ignoring this new literature, the SFC claims that “studies show that home and community-based approaches produce better treatment outcomes than placing children in RTFs, and are more cost-effective than RTF placements.” In the footnote to that sentence, the writers list only one study, which concerns only one type of facility, Psychiatric Residential Treatment Facilities, a particular model the provides the equivalent of in-patient psychiatric services outside a hospital setting to young people under 21 through an agreement with a State Medicaid agency. Moreover, that study does not conclude that community-based approaches produce better treatment programs. Instead, it concludes that “evidence is insufficient to assess which interventions are effective.” It is almost impossible to conduct a meaningful study comparing residential treatment to community-based approaches, since the children who are sent to RTF’s are generally much more troubled or impaired than the children who are not, and it would be hard to control for such differences without doing a randomized controlled trial. That’s why there are few if any studies that shed light on this issue.

It is hard to avoid the conclusion that both the study design and the findings of the SFC reflect the Committee’s desire to show that residential care is harmful to young people. The SFC’s anti-residential bias is displayed in numerous passages throughout the report. One particularly inaccurate statement claims that “In some cases….., child welfare agencies place children in state custody without diagnoses in RTFs because they have nowhere else to place them.” As evidence, the report cites a 2013 report that showed 28.8 percent of children in “congregate care” had no clinical diagnoses. But congregate care (a term used to designate any placement that is not a foster home) is a more general term than RTF’s. The earlier report included many other types of facilities including cottage-style homes (often on the site of former orphanages and often providing high-quality family-style care) that are not intended for children with serious behavioral health needs, as well as emergency shelters that some states operate to house children before they are placed in a foster home. Given the relatively high cost of RTF’s, it would be very strange if states placed children in them for lack of another option.

Much more common is the opposite scenario: agencies placing children in foster homes unprepared to care for them, resulting in placement instability, or even letting them sleep in hotels or offices, for lack of residential treatment facilities. Articles about this problem appear frequently, including a recent report from the Midwest Newsroom (a collaboration between NPR and Midwest member stations) on the insufficient capacity of residential care for girls in Missouri and Iowa. The article starts with the story of a young woman who was placed in a residential treatment program called Missouri Girls Town after a traumatic childhood, placement in foster care and a disrupted adoption by a parent who could not handle her rebellious adolescence. This young woman credits Missouri Girls Town with completely changing the trajectory of her life. Sadly, this nonprofit program, which relies on private donations to supplement what it gets from government agencies, was designed to accommodate up to 50 girls but can only take 12 because of “staffing and funding challenges.” Stories like this have been appearing from around the country for years. There is not enough residential treatment for the young people in foster care who need it. Facilities have been shutting down due to failure of state reimbursement rates to keep up with operating costs, as well as the increasing unpopularity of residential care among state officials and legislators.

Despite the major flaws in the SFC’s analysis, there is little to object to in its recommendations. It’s hard to argue against recommendations that Congress act to improve conditions in congregate care facilities, that the companies reviewed raise their standards, and that states invest in community-based services for children with behavioral health needs and improve oversight over RTF’s. The need to invest in community-based services is particularly important because it might enable some children to be helped before their problems become so severe that they need residential care. It might even prevent some placements in foster care that occur when parents can no longer care for behaviorally challenging their children at home. But the findings of the report remain dangerous even if the recommendations are benign; they can be used to support attempts to defund residential care entirely, which would be disastrous for our most vulnerable young people and their families.

The SFC report confounds a group of residential treatment facilities poorly run by four large corporations with the entire field of residential treatment for youth with serious behavioral health care needs. The report presents a distorted picture of a field that already contains excellent, life-changing programs and where passionate and dedicated leaders are already providing or working toward trauma-informed, short-term, and effective residential services for these most vulnerable young people.

  1. Visits to five facilities that were not operated by the four providers being investigated were used to document physical conditions in the facilities, as well as their efforts to provide education to the residents. The finding of “non-homelike,” unsanitary and unsafe conditions was based on the visited facilities rather than on the four companies that were investigated. ↩︎

As foster care removals plummet, where’s the promised help for families?

Year after year, states and the federal government continue to release annual data showing a decline in the number of children in foster care, congratulating themselves on keeping families together. They seem to have forgotten that reductions in foster care were supposed to be accompanied by increased services so that children could be safely maintained at home. Unfortunately, there seems to be little to no interest on the part of the federal Children’s Bureau, Members of Congress, advocates, or the media in whether such services are actually being provided.

The newest report from the Adoption and Foster Care Analysis and Reporting System (AFCARS) showed that the number of children in foster care dropped to 368,530 on September in 2022–a drop of 5.8 percent over the previous year 15.6 percent since 2018. “We are encouraged by the continued decrease in the number of children entering foster care and staying in foster care and we will continue working with our state, tribal and territorial partners to ensure an emphasis on family well-being and safe family reunification,” said Jeff Hild, the Principal Deputy Assistant Secretary of the Administration on Children and Families (ACF) in a press release heralding the new numbers. ACF gave credit to the Family First Prevention Services Act (FFPSA), which “helped change the conversation to be about prevention of foster care placements and preservation of families.” 

It seems premature to celebrate the shrinkage of the foster care rolls as a triumph without knowing what is happening to the children remaining at home who would have been removed in a different year. How many of these children are living with abuse or neglect that will leave lasting scars or impair their development, if not endanger their lives? Supporters of the Family First Prevention Services Act (FFPSA), which passed in 2018, said that declining foster care counts would result from providing support to parents who needed help to address the problems (like substance abuse, mental illness and poor parenting skills) that led to their maltreatment of their children.

After an allegation of abuse or neglect is substantiated, an agency can place a child in foster care or open a case for in-home services, among other options.1 FFPSA made it possible to use the same federal funds for foster care and in-home services, allowing children to stay at home safely while their parents addressed the issues that put them at risk. A major purpose of FFPSA was to enable states to use federal funds that were formerly available only for foster care to pay for parenting support, mental health, and drug treatment that would enable children to stay safely with their families. The rationale for this change was that allowing foster care funds to be used for such services was necessary to enable states to keep kids out of foster care.

However, FFPSA has not made massive federal resources available for such services. ACF estimates that only 18,400 children in the entire country were served by Title IV-E prevention services programs in FY 2023, at a cost of $167 million. But perhaps states are using their own funds to pay for these services? After all, foster care is more expensive than services provided to families in their homes. Both require case management, but instead of the cost of room and board for foster youth, providing in-home services usually involve referring parents to mental health and drug treatment services often funded by Medicaid or paying for parenting support programs that cost less than foster care. (Of course the supporters of FFPSA ignored this basic fact and claimed the legislation would revolutionize child welfare!). States were already providing these services before FFPSA and they could have increased them without the promised federal funding.

But believe it or not, nobody knows if more children and their families are receiving in-home services as the foster care rolls decline, since the federal government doesn’t ask states for this information. While states were already required to report the number of children entering foster care, leaving it, and in care at a point in time, FFPSA did not add a requirement to provide the same data on services provided to children and families in their homes, now that they were also covered by federal Title IV-E funds.2 Hoping some states might track this data of their own accord, I searched the data publications and dashboards on the websites of the ten states with the largest number of children in foster care according to the most recent AFCARS report,3 but I was able to obtain this data for only California and Texas.

California has by far more children in foster care than any other state, 45,924 children at the end of September, 2022, which was 12.4 percent of the national total. Fortunately, there is extraordinarily good data from the California Child Welfare Indicators Project (CCWIP), a collaboration between University of California at Berkeley and the California Department of Social Services. The CCWIP dashboards include data on the number of entries into foster care and the opening of Family Maintenance cases, as in-home cases are called in California. Entries into foster care declined precipitously from April 2019 to March 2020 and continued declining, though more slowly, through March 2024. Family Maintenance case openings also declined continuously throughout the period. Thus, there was no increase in Family Maintenance case openings to compensate for the decline in removals. Or put in a different way, the total number of cases opened for child welfare services dropped from 46,264 at the beginning of the period to 29,969 at the end–a drop of 35 percent. Rather than a shift from foster care to in-home services, there has been a shrinkage of children reached by child welfare services overall.

Source: California Child Welfare Indicators Project, Entries, https://ccwip.berkeley.edu/childwelfare/reports/Entries/MTSG/r/ab636/l and Case Openings, https://ccwip.berkeley.edu/childwelfare/reports/CaseOpenings/MTSG/r/ab636/l.

Texas has the third largest state foster care caseload, after Florida. The Texas data are a bit more confusing. The number of children entering foster care dropped from 16,028 in 2021 to 9,623 in 2022, an incredible 40 percent, while the number of children entering in-home services declined steeply as well, resulting in a 35.7 percent drop in all case openings. Both drops may well have been related to a new Texas law that took effect on September 1, 2021 and changed the definition of neglect to an action or lack of action that puts a child in “immediate danger” of harm, rather than “substantial risk” of harm as the previous language read. The bill also put restrictions on child removals, requiring that children can be removed only from parents who display “blatant disregard” for their actions, or whose inaction “results in harm to the child or creates an immediate danger to the child’s physical health or safety.” Interestingly, in 2022, foster care entries actually rose slightly in Texas, while family preservation entries sprung back to where they were in FY2021, resulting a substantial increase in total case openings that year. Nevertheless, the overall trend over time was a decrease in foster care entries, family preservation case openings and the total number of children receiving help through open in-home or out-of home cases. That total dropped from 72,181 to 48,619 over five years–a drop of 32.6 percent–almost the same as the drop in California’s child welfare case openings.

Source: Texas Department of Family and Protective Services, CPS Conservatorship, Removals, https://www.dfps.texas.gov/About_DFPS/Data_Book/Child_Protective_Services/Conservatorship/Removals.asp, and CPS Family Preservation, Children Entering Services, https://www.dfps.texas.gov/About_DFPS/Data_Book/Child_Protective_Services/Family_Preservation/Children_Entering_Services.asp

Florida, the state with the second largest number of children in foster care, reports on the numbers of children entering foster care but not on the number entering in-home cases. One can, however, compare the number of children in foster care at a point in time with the number of children and young adults receiving in-home services. Both numbers have been decreasing and the number of children receiving in-home services has been consistently about half of the number of children in foster care. But these numbers don’t tell us whether declining entries to foster care have been offset by increasing entries to in-home services. In general, foster care cases last longer than in-home cases. Not knowing the average length of stays in foster care and in-home cases, and how they have changed over time, one cannot tell whether in-home case openings have made up for the reduced number of entries into foster care.

The Florida data show why point-in-time data cannot be used to answer the question of whether the decline in foster care entries has been accompanied by a rise in in-home case openings. Unfortunately, none of the other eight states with the highest caseloads provide this data on their websites. Illinois and Indiana provide point-in-time data on foster care and in-home participants. The other five states with the largest caseloads–Ohio, New York, Pennsylvania, Arizona, and North Carolina–display no data on in-home case participants at all.

If California and Texas are typical, states have not been increasing their provision of in-home services to make up for declines in foster care. Instead, the total number of abused and neglected children being helped by in-home or out-of-home services (or foster care) has declined by as much as a third in five years. But we cannot assume that California and Texas represent the entire nation. It is unfortunate that the writers of FFPSA did not requiring states to include data on in-home case openings and total caseloads, given that the legislation allowed federal funds to be used for this purpose. States have not begun tracking and reporting on this data on their own, and are triumphantly proclaiming the drop in foster care without even reporting on whether in-home services are being provided instead. When Congress considers desperately-needed fixes to FFPSA, a requirement that states report in-home case data analogous to the foster care data in the AFCARS system should be included in the new legislation.

Notes

  1. Other options include referring a family to a community provider or even doing nothing nothing if the abuse or neglect was assumed to be a one-time event unlikely to occur. The family may also refuse in-home services, and the agency would then have to decide whether to file a court petition to require such services ↩︎
  2. States must provide to National Child Abuse and Neglect Data System (NCANDS) information on how many children receive “postresponse services,” meaning services after a child protection investigation. But unfortunately, “postresponse services” includes foster care and provides a duplicated count, counting children every time they are the subject of an investigation, so it is not useful in telling us how many children receive in-home services. ↩︎
  3. State foster care data can be accessed from https://www.acf.hhs.gov/cb/report/trends-foster-care-adoption. According to the latest information, the ten states with the largest number of children in foster care on September 30, 2022 were California, Florida, Texas, Illinois, Ohio, New York, Missouri, Pennsyhlvania, Arizona, and Indiana. ↩︎