Category: child welfare

Reform, not abolish, child welfare: A science-informed path

By Antonio R. Garcia, Jill Duerr Berrick, Melissa Jonson-Reid, Richard P. Barth, John R. Gyourko, Patricia Kohl, Johanna K.P. Greeson, Brett Drake, and Victoria Cook

A note from Child Welfare Monitor (CWM): CWM welcomes submissions from authors who represent points of view that are more evidence-based and child-centered than what is typically presented by leading media outlets and other child welfare publications. We are privileged to share this commentary from an illustrious group of child welfare scholars from schools of social work and social policy around the country. While this essay does not mirror the views of CWM in every detail, we share the authors’ basic premise regarding the need to reform, rather than abolish, the child welfare system.

Over the past couple of years, while teaching classes, presenting lectures, or offering invited talks and workshops, students and participants have inquired about the need to abolish the child welfare system. Some have questioned whether they should continue their pursuit of a career in this field. They are aware of the growing calls by abolition advocates, particularly UpEND and JMac for Families, to completely eradicate child welfare services, despite offering no evidence as to its likely impact on child safety or permanency.

Abolition advocates have successfully convinced a few scholars, an unknown number of students, and a surprising number of community members and decision-makers that child protective services must be eliminated. Acting on briefs supplied only by activist groups, the United Nations has even called for all major child welfare laws in the United States to be repealed or replaced. 

Why?  The narrative built by the abolitionists includes two major parts: First, classist and racist bias largely determines who has contact with the child welfare system, with poor children as well as Black and Native American children being routinely and unnecessarily harassed.  The resounding narrative–largely offered by lawyers, not child welfare scientists–is that the interventions and intentions of child welfare services and its staff are inherently racist (e.g., Roberts, 2022).  Some child maltreatment scholars (e.g., Briggs et al., 2023) have even gone so far as to reiterate Roberts’ claim that the modern child welfare system (CWS) was intentionally designed as a mechanism of racial oppression. This conclusion flies in the face of history as documented child welfare historians (e.g., Myers, 2004). Purveyors of this narrative ignore efforts like those of pioneering African American women pursuing the development of child welfare facilities for African American children who were routinely insufficiently served by family and community (Peebles-Wilkins, 1996); they fail to mention the work of the Children’s Defense Fund, and a diverse coalition of policymakers, who helped to shape the modern CWS through their work to expand family preservation and support services. Nor do they acknowledge that the Title IVE program was, in part, explicitly developed to extend equal protections to Black children (Hutchinson & Sudia, 2002).

Second, those who denigrate child welfare services argue that CWS interventions do more net harm than good, and for that reason should be abolished.  Child welfare services are said to sever familial connections (Roberts, 2022), and unjustifiably surveil children and families (Gruber, 2023). To that end, they argue that the best way to protect children and families is to abolish the current system and replace it with family and community-based responses (Kelly, 2021). This proposed alternative to CPS is remarkable for the degree to which it is vague and undefined.  Nothing approaching a concrete plan for such a system has ever been suggested to our knowledge.  Given the historical lessons of relegating unwanted or abused children to orphanages, orphan trains, indenture, or detention centers, it is difficult to point to an example of American communities fully embracing the care of children whose parents are unable to care for them.

The abolition movement sidelines any past record of successful reforms of child welfare or hope for future evidence-based or incremental change. Anxious, perhaps, that reforms have been uneven or too slow, the proponents of abolition do not suggest improving the complex and intricate web of local, state, and national child welfare policies that have been developed over the last 40 years.  Critically, their proposals have no evidence base. Instead, they rely on ideology that disregards the best available evidence (Barth et al., 2020).

The degree to which the abolition narrative is taken seriously is troubling.  Child safety is contingent upon training qualified professionals to respond to signs of abuse and neglect – and ensuring institutions have the resources to recruit and support them. Tuition is covered for many social work students if they agree to “repay” their time by working for the state’s child welfare system after graduation. The premise is to promote and retain a highly educated, culturally responsive child welfare workforce and prepare them to rely upon critical thinking skills and the best available evidence to promote child safety and permanency. With many states facing unheard-of staff shortages following the pandemic, the additional decrease in interest in the field is distressing. 

In our paper, The Stark Implications of Abolishing Child Welfare: An Alternative Path Toward Support and Safety, we offer an alternative path – a reformist position that focuses on four key elements of child welfare that must be maintained and improved to keep children safe:

1) receiving and responding to community signals about risk or harm to children;

(2) assessment of need coupled with a proportionate response;

(3) rights protections to ensure fairness and equity when placement outside the family is required; and

(4) procedures for accountability and quality improvement.

Without these key elements, we contend that children will be left in peril.  Many community members will not know how to respond to signs of risk and harm to children.  The progress we have made in the last few decades toward developing, implementing, and evaluating prevention and early intervention services to address trauma and promote healing will be disrupted. Supports for foster parents, kin, and child welfare staff will be disbanded. The elimination of court oversight will eliminate rights protections for parents, children, and extended family.  Racial inequities in economic hardship will make it more challenging for communities of colorto develop responses, which will likely yield an even larger gap in unmet needs for children of color.

Still, many in our field are challenged by having to choose between abolition and reform. At the core of this debate, we are contending with the interplay of science, practice, ideological beliefs, and conflicting values. What types of evidence are or should be used to guide our decision-making? How do we best balance the support of families with a child’s need for safety without defending the status quo? Said another way, we see no reasonable likelihood that abolishing child welfare services would result in a world where families are better supported to provide care that is not injurious to their children and children are better protected from the harsh realities of child abuse, including fatalities.

The debate offers an opportunity to examine current practice and whether it advances the needs of vulnerable children and families. We underscore in our paper that current services and funding are inadequate. To that end, we delineate alternative pathways to abolition providing some practical, evidence-informed recommendations, including but not limited to the following:

  • Create a robust family support and prevention infrastructure outside of Child Protective Services (CPS);
  • Reduce poverty and financial hardships through universal basic income supports and targeted economic supports for families in great need;
  • Resume the child welfare waivers program to expand and test innovations in case finding and response to family needs; and
  • Continue to improve alternative systems for reporting less serious concerns and connecting families to existing resources to reduce the number of families who are subject to unwarranted CPS investigations.

As discussed in our paper, we believe implementing these recommendations offers a holistic roadmap for (1) improving outcomes for all children and families and (2) mitigating racial inequities in exposure to economic hardship and access to services and programs.

Although many jurisdictions have a long way to go in fully aligning practices with our valued principles, the child welfare system, on the whole, has made much headway. We have made progress toward reducing foster care entries, enhancing permanency, supporting youth who must emancipate from care, and developing alternative response paths for less severe cases.  The number of children in foster care is now lower by more than 175,000 children than it was in 1991, despite population growth (US DHHS, 2022; US DHHS, 2000).

We have made advances in the development and implementation of evidence-based, and culturally appropriate parenting programs, and there are innovative approaches to screening and collaboration with other systems such as family drug courts and other models that are  being adopted around the country. Research indicates that families are better served by caring and competent child welfare staff. At a minimum, this means we need trained child welfare professionals to determine if abuse or neglect are occurring and how best to provide services to mitigate risk factors. If removal to foster care is required, trained social work and legal professionals need to be engaged in reunification services and the determination if it’s safe for children to go home.

Finally, it is critical that these efforts are continuously evaluated. Abolition would end the now-routine national reporting of the number of victims of child maltreatment, and their characteristics (i.e., NCANDS; Children’s Bureau, 2023). We would not know if new family- and community-based approaches were helpful or harmful, particularly for the families of color for whom both reformists and abolitionists are concerned. State-level systems that track the provision of services and outcomes would also end, meaning that trends in family needs and gaps in response systems would likely go undetected. We would also lack data to influence policy to end harmful practices and expand funding for effective prevention and intervention services.

As we note, “it is difficult to imagine how eradicating the only structures that exist to address this issue [child maltreatment] would result in any outcome other than jeopardizing the safety and well-being of children as well as reducing accountability to the families that CWS [the child welfare system] serves.”

This is a contentious moment in the journey to create opportunities and healing for all children and families. We hope our message conveys a sense of urgency to engage in critical, evidence-informed practice and policy – and to reflect upon how values, biases, and morals can impact decision-making.  The famous words of Nelson Mandela may be instructive: “There can be no keener revelation of a society’s soul than the way in which it treats its children.” In efforts to enhance practice and policy, we need child welfare professionals to gain the skills, cultural humility, self-efficacy, and motivation to ensure children live lives free of violence and abuse. Policymakers need to stay grounded in the pathway that has led to significant improvements in child welfare services and rely on research-based reforms. Our children deserve nothing less.

References

Barth, R. P., Jonson-Reid, M., Greeson, J. K. P., Drake, B., Berrick, J. D., Garcia, A. R., Shaw, T., & Gyourko, J. R. (2020). Outcomes following child welfare services: What are they and do they differ for Black children?. Journal of Public Child Welfare, 14(5), 477-499. https://doi.org/10.1080/15548732.2020.1814541

Briggs, E., Hanson, R., Klika, J. B., LeBlanc, S., Maddux, J., Merritt, D., … & Barboza, G. (2023). Addressing systemic racism in the American Professional Society on the Abuse of Children publications. Child maltreatment, 28(4), 550-555.

Children’s Bureau. (2023). National Child Abuse and Neglect Data System (NCANDS). U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families. https://www.acf.hhs.gov/cb/data-research/ncands

Gruber, T. (2023). Beyond mandated reporting: Debunking assumptions to support children and families. Abolitionist Perspectives in Social Work, 1(1). https://doi.org/10.52713/apsw.v1i1.12

Hutchinson, J.R. (2002).  Failed child welfare policy: Family preservation and the orphaning of child welfare. Washington DC: Child Welfare League of America.

Kelly, L. (2021). Abolition or reform: Confronting the symbiotic relationship between ‘child welfare’ and the carceral state. Stanford Journal of Civil Rights & Civil Liberties, 17(2), 255–320. https://heinonline.org/HOL/P?h=hein.journals/stjcrcl17&i=271

Myers, J. E. B. (2008). A short history of child protection in America. Family Law Quarterly, 42(3), 449–463. https://www.jstor.org/stable/25740668

Peebles-Wilkins, W. (1996). Janie Porter Barrett and the Virginia Industrial School for Colored Girls: Community response to the needs of African American children. In E Smith and L Merkel-Holguin (Eds.), A history of child welfare. Washington, DC: Child Welfare League of America.

Roberts, D. (2022). Torn apart: How the child welfare system destroys Black families, and how abolition can build a safer world. Basic Books.

U.S. DHHS. (2022). The AFCARS Report. Washington, D.C.: Administration for Children and Families.

U.S. DHHS. (2000). The AFCARS Report. Washington D.C.: Administration for Children and Families.

We are not here to save children: abuse and neglect deaths after contact with child welfare services in the District of Columbia, 2019-2021

To my readers: This blog summarizes a report that is the culmination of nine months of work. It is part of my advocacy for children in the District of Columbia, which I share in my blog, Child Welfare Monitor DC. But I think this post and the underlying report will be of interest to child advocates, policymakers and researchers around the country because the findings and issues discussed are widely applicable.

“We are not here to save children.” That is what I was told on the first day of my training as a child protective services worker at the District of Columbia’s Child and Family Services Agency (CFSA). And indeed, the District is on the cutting edge of the current movement in child welfare around the country that considers child protective services as a “family policing system” that unnecessarily harasses and separates families, especially families of color. The problem with this perspective is that some families do not provide a safe environment for children to grow and develop. In some of these families, children die. That is what happened to the 16 children whose cases are discussed in a new report, which is summarized in this post. And indeed, analysis of the limited information provided suggests that CFSA did not take advantage of the opportunities it had to protect children even after long histories of CFSA involvement in their families. As a result, three children were beaten to death, three more were poisoned by opioids, and others died of burns, a car accident, and unknown causes when the deaths might have been preventable if the agency had been more protective.

When a child dies of abuse or neglect after that child’s family has been on the radar of the agency designed to protect children, it is important for the public to know whether and how this death could have been avoided. The essential question is whether the agency could have prevented the death by doing something differently. Did staff miss any red flags, and therefore fail to take action when necessary? If the death was preventable, what factors must be remedied in order to prevent such failures in the future? It is not enough for the agency itself to have access to this information, or to have an internal team review it. Agencies can fail to learn from their mistakes when they are blinded by ideology, self-interest or just inertia.

For those reasons, federal law requires every state to have a law or program 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.” In compliance with this requirement, DC Code requires the Mayor or the Director of CFSA, upon written request or on their own initiative, to provide findings and information related to “[t]he death of a child where the Chief Medical Examiner cannot rule out child abuse, neglect, or maltreatment as contributing to the cause of death.” In March 2023, we requested such findings and information for all the fatalities that met the criteria and were reviewed by CFSA’s internal fatality review team between 2019 and 2021. It took more than six months of meetings and emails to receive the information that is presented in this report. We agreed to restrict our request to cases reviewed in 2019, 2020 and 2021 and to withdraw our request for information on near-fatalities, which CFSA only began tracking in October, 2022.

Not surprisingly, CFSA interpreted the disclosure requirements in a way that restricted the information provided as much as possible. If a medical examiner did not rule the manner of death to be an abuse or neglect homicide or “undetermined,” no information was provided. Therefore, the agency did not release any information on cases where the manner of death was labeled as accidental, even if it found a parent responsible for the death or removed the children. The “accidental” deaths for which information was not provided included one child who died after he was left in a baby swing for two hours, which most ordinary people would consider to be neglect. The death of seven-week-old Kyon Jones, whose mother told police that she threw his body in a dumpster after she rolled over him while high on PCP, was not included because his body was never found and therefore it did not meet the criteria for release of the information–even though CFSA removed the surviving children from their mother.*

In addition to omitting some cases in which neglect or abuse played a role, CFSA heavily redacted the information it did provide, with many pages and large portions of others blacked out. CFSA refused to provide the names of the children, parents and caregivers, providing a rather convoluted interpretation of DC Code, which clearly requires the release of this information. (See the full report for more information about their reasoning). In three cases, the child’s identity was clear from media coverage of the case, and we used the child’s name. A major source of redactions was the exclusion of “personal or private information unrelated to the child fatality.” It appears that CFSA’s legal team interpreted this term much more broadly than a social worker or researcher would, because they redacted almost all information about parents’ history of criminal activity, substance abuse, mental illness, and domestic violence–which are obviously relevant to many of the fatalities we are discussing.

On investigations, it is unfortunate that DC Code requires that the agency release only ”a description of the conduct of the most recent investigation or assessment” rather than all investigations regarding the family in question. It appears that the agency interpreted “the most recent investigation” as the fatality investigation itself rather than the most recent investigation before the fatality, but the law ought to require a description of all previous investigations. The agency also disregarded language that requires it to provide “the basis for any finding of either abuse or neglect.”

For most cases, we received very little information aside from a list of the previous referrals (reports to the CPS hotline) including only the date of the report, the allegation category and the disposition; an account of in-home and foster care case activities for the families that had such cases; and an account of the investigation of the fatality itself. The information about the parents was heavily redacted, and almost the entire history of agency involvement was blacked out in most cases. Despite the limited information provided, the redacted summaries included some new information, some of which was startling and disturbing. The report is based on the 16 case summaries provided by CFSA, occasionally supplemented with information from the agency’s annual fatality reports, which are available to the public. These cases affected 15 families, as one family had two fatalities in one year. Unless otherwise noted, the information is based on the case summaries. The full report, from which this blog is excerpted, contains summaries of each case.

Cause and Manner of Death

CFSA classifies child deaths by cause and manner. “Cause of death” is the specific disease or injury that led to the death. Manner of death refers to the circumstances that caused the death, and falls into five categories: natural, accidental, suicide, homicide, and undetermined. Of the 16 cases for which information was provided by CFSA, three (19 percent) were abuse homicides, six (37 percent) were neglect homicides, and seven (44 percent) were undetermined in manner. The latter were the cases for which CFSA provided information because the Medical Examiner was unable to rule out child abuse or neglect homicide as the manner of death.

The most common causes of death were blunt-force trauma and opioid poisoning, each claiming the lives of three children, as shown in figure below. The remaining children died from a variety of causes, including drowning, asphyxia, thermal and scald injuries, injuries from a car accident, and unknown causes.

Abuse deaths: Blunt Force Trauma

Three of the children died of blunt force trauma–one of the two most common causes of death in the sample. The murders of two of these children – Makenzie Anderson and Gabriel Eason – – became known to the horrified public through press coverage of their deaths in February and April of 2020. Each of them died from head trauma inflicted by a parent or stepparent. Makenzie suffered from multiple contusions to the face and head, skull fractures, and other injuries, and her mother pleaded guilty to manslaughter, receiving a ten-year prison term with seven years suspended on the condition that she obtain mental health treatment and have no unsupervised contact with children. Gabriel’s autopsy found abrasions and contusions to the head, face and torso; contusions to the heart and thymus gland; liver and kidney laceration; new and healing fractured ribs; and a brain hematoma. His stepfather was sentenced to 12 years and eight months in prison and his mother, who did not seek medical help for Gabriel or his critically-injured three-year-old brother, was sentenced to four years of probation and three years of supervised release.

But there was a third homicide by blunt force trauma. A three-year-old girl died of trauma to the abdomen in the home of an aunt where she was placed by CFSA after being removed from her drug-addicted mother. Her injuries included contusions to the forehead and abdomen, a lacerated liver, and blood in the abdominal cavity. No charges were filed against either the aunt or her boyfriend, and the case received almost no public attention.

Neglect deaths: Opioid Poisoning and other causes

Three children (a three-year-old girl, a three-year-old boy, and a three-month-old girl) died of synthetic opioid toxicity, with fentanyl implicated in all three deaths. (One of the children had also ingested a controlled substance called eutylone.) There is no information about how the children might have ingested the drugs, but all lived with parents who were known or alleged to abuse substances. These deaths never became known to the public, which is not surprising since it appears that none of the parents were arrested or charged.

A 17-month-old boy died of “complications of thermal and scald injuries,” and his mother told the investigator that she had no idea how it happened or how he ended up face-down in the bathtub several hours later. A seven-year-old died of injuries from a car accident. His mother was a long-time substance abuser and was arrested for Driving Under the Influence (DUI) in the accident. She was driving from Florida to Washington and her children were not sitting in car seats or belted in. A five-month-old boy died of asphyxia by drowning after being left alone in the bathtub with a one-year-old sibling while their mother searched for her car keys.

Deaths for Which the Manner was Undetermined

Two deaths has known causes but the manner – whether abuse or neglect or something else – was not determined. A twelve-year-old girl with asthma died of an untreated bacterial infection and pneumonia but also had enough bruising from two separate beatings in the previous two days to support a CFSA substantiation of the mother for physical abuse. It is unclear why this was not considered a medical neglect homicide. A ten-month-old girl died of asphyxia but the manner of death was undetermined. Her mother had left her in the care of her father and returned to find her unresponsive.

The cause as well as the manner of death was unknown or undetermined in five cases. These included an 18-month-old boy with a subdural hematoma, which could have been caused by abuse or a fall, an 11-month-old girl whose mother reported leaving her unsupervised on her stomach with a bottle in her mouth for about 40 minutes, a nine-month-old boy put to bed with a bottle and found face-down on a pillow; a two-month-old girl who died while sleeping with her mother, and a three-month-old girl found unresponsive by her parents one morning. Unsafe sleep practices may have contributed to some of these deaths, but other unsafe sleep fatalities were categorized as accidents, for which case summaries were not provided.

Demographics

A quarter of the children who died were younger than six months old and half of them were one-year-old or younger. Another quarter were two or three. This is not surprising as young children are more vulnerable and similar results are found nationally. But older children were not invulnerable to abuse or neglect, including the seven-year-old who died in a car accident and the 12-year-old who died of an untreated bacterial infection and pneumonia.

Fifteen of the decedents were African American and one was classified as “African-biracial.” According to the latest data from Kids Count, 54 percent of children in the District of Columbia are Black. So Black children were overrepresented among the children who died of maltreatment or possible maltreatment. The overrepresentation of Black children among children who died points to Black children’s particular need for protection. And it suggests that current emphasis in the District and around the country on reducing the involvement of Black families in child welfare may cause more suffering and more deaths among Black children.  

The prevalence of large families among those that lost a child due to abuse or neglect is striking. More than two thirds of the mothers of children who died by maltreatment had four or more children. The average mother in the group had 4.6 children, often with more than one father.

Histories of System Involvement

All the families had been the subject of at least one report to the CFSA hotline before the fatality, or else they would not be included in this report. But many of the families that lost a child had experienced a large number of reports prior to the fatality. Among the 16 fatalities included in this report, only six occurred in families that were the subject of five reports or fewer in the last five years. Five occurred in families that had between six and 10 reports, three occurred in families with 10 to 15 reports, and one family had 24 reports. Three of the families had actually experienced a previous child fatality–a shocking statistic considering the rarity of child fatalities overall.

The families of the two children – Makenzie Anderson and Gabriel Eason – whose abuse homicides shocked the District of Columbia in February and April 2020 were both known to CFSA before the deaths, and the last report to the hotline came five months before the fatalities of both children. Makenzie Anderson’s family was reported to the hotline eight times within five years of her death. The last report alleged exposure to unsafe living conditions, inadequate supervision, and substance abuse by a parent, caregiver, or guardian. All those allegations were unfounded (not confirmed) by CFSA. Gabriel Eason’s family was the subject of 17 prior calls to the hotline since 2012, including 12 in the five years preceding Gabriel’s death. The most recent report was for unexplained physical injury in October 2019 and was also unfounded by CFSA.

Substance abuse by the parent or caregiver was the most frequent allegation CFSA received regarding the families in the five years before the deaths, with 30 substance abuse allegations collectively accumulated by the families of the 16 dead children during that period. Another  eight reports concerned positive toxicity of a newborn, a reflection of parental substance abuse. Substance abuse by the parents was observed or alleged in the families of all but four of the victims included in this report. Inadequate supervision was the second most common allegation, with 25 allegations concerning the 15 families. Almost as common was educational neglect, referring to children with excessive school absences, with 24 allegations received in the five years preceding the fatality. Ten of the 15 families had at least one report for educational neglect before the child’s death. Another major theme was exposure to domestic violence, with 17 allegations received by the families. Domestic violence was mentioned in nine of the 16 case histories as the subject of an allegation or in notes from social workers or police.

Most of these families could be described as “chronically neglectful.” According to the Child Welfare Information Gateway, “Chronic child neglect occurs when a caregiver repeatedly fails to meet a child’s basic physical, developmental, and/or emotional needs. Chronic neglect can have long-term, negative consequences for child health and well-being.” Working with chronically neglectful families is especially difficult and requires special training and skills, which many CFSA social workers may lack. Perhaps that is one reason why they struggled so hard to engage some of these families. Four of the children died while an in-home case was open. Three out of four of the in-home case narratives from CFSA portray caregivers who evaded offers of help from CFSA and other providers and refused to cooperate with efforts to monitor conditions in their homes.

System Failures

The information received suggests several areas where failures in policy and practice by CFSA and other agencies may have allowed these deaths to happen. These areas include:

  • Screened out and unsubstantiated reports: Research points to the difficulty of determining correctly whether a child has been maltreated, as well as the absence of significant differences in subsequent outcomes between children with a substantiated allegation of maltreatment and those with an unfounded allegation. Without information on how hotline and investigation decisions were made, we cannot assess the agency’s performance in these areas. But the fact that most previous reports for families with a subsequent death were screened out or unfounded is concerning.
  • Flawed management of in-home cases: Four of the deaths reviewed here happened while an in-home case was open for the family. In three of these cases, workers struggled to complete face-to-face visits with the families because parents evaded these visits. Social workers and supervisors could have filed a petition to involve the court, an option known as “community papering.” But they did not exercise this option–or they started too late, as in the case of the child who died after a meeting was finally scheduled to discuss community papering the case. The meeting was cancelled after the agency received word of the child’s death.
  • Too many chances: The mother of the seven-year-old killed in the 2020 car accident had been given numerous chances to recover from drug addiction and had relapsed many times over 18 years of involvement with CSFA. The family of the 17-month-old who died of complications of thermal and scald injuries had 24 referrals to CFSA between 2016 and 2021. Three in-home cases were opened and closed, but the children were not removed until the little boy died.
  • A fragmented health care system: In its findings on Gabriel Eason’s death, CFSA pointed out that Gabriel was taken to different medical providers for his various injuries. Because they use different information systems, the providers could not see records of the earlier injuries.

The reaction of CFSA and the criminal justice system after the fatalities obviously did not contribute to the fatalities themselves but may illustrate a pattern that contributes to future deaths. Specifically, CFSA’s tendency to place siblings informally after fatalities and the police and US District Attorney’s failure to charge parents raise concerns.

  • Informal placements after fatalities: CFSA, and child welfare agencies around the country, have been criticized for relying on informal placements with family members, rather than formally removing the children, placing them with the relatives, and opening a case to monitor their safety and well-being. In at least four of the 16 cases reviewed here, CFSA did not officially remove the siblings of the children who died but instead relied on informal placements with fathers or other relatives to keep them safe. Nothing was done to assure that the children were not returned to the home from which they had been removed as soon as the investigations closed, or to verify that the parents or caregivers had rectified the conditions leading to the child deaths.
  • Failures by the criminal justice system: The failure to bring charges against some of the parents and caregivers described here is quite concerning, particularly in the case of the three-year-old who died of blunt-force trauma and the infant and two three-year-olds who died of opioid poisoning. There has been considerable criticism of the US Attorney’s office in the District (which handles adult criminal prosecutions) for its low rate of opting to charge people for crimes. We do not know if the problem is the Metropolitan Police Department’s failure to bring the cases to the US Attorney or the latter’s failure to pursue them.

Recommendations

Without seeing the full case studies that were available to CFSA’s internal review committee, we cannot make detailed recommendations about how to avoid child maltreatment fatalities for children known to CFSA. The minimal recommendations that CFSA’s internal review team made show the need for the City Council, advocates and the public to have access to these complete case studies: in its 2021 report the agency made no recommendations other than those dealing with the fatality review process! Therefore, our first recommendation is to the City Council, urging it to require that CFSA release comprehensive case histories on all proven or suspected child maltreatment fatalities. Our next blog post will discuss the legislative changes that are needed.

The lack of information on how screening and investigation decisions in particular were made precludes specific recommendations. Perhaps a new audit of the hotline is in order. Some changes to hotline screening policy might be advisable, especially around educational neglect. School absences should be investigated regardless of the age of the child (requiring a change in the law) and their academic performance. And perhaps investigative workers could benefit from better training in forensic interviewing techniques that might help them better evaluate parents’ and childrens’ statements for veracity and perceive more subtle signs of abuse or neglect.

The case narratives make clear that in-home social workers struggled to complete home visits to the families of the children who later died. The agency must change its policy to encourage “community papering,” making court involvement routine after a certain number of missed visits or other instances of noncooperation. CFSA might also want to consider strengthening its in-home practice, perhaps by reinstating the Chronic Neglect Units, which were eliminated barely a year after they were implemented. These units would employ specially-trained social workers with lower caseloads and longer time periods to work with families.

Despite the current ideology favoring family preservation and reunification at all costs, the agency must also recognize that sometimes it must give up on a parent and find a safe, permanent alternative for the children. Giving parents multiple chances with successive children over many years belies the true purpose of child welfare services – to protect children.

Not all needed changes fall in CFSA’s bailiwick. Reforms in the criminal justice system are also necessary to ensure that parents who killed one child cannot harm more children. Couples who refuse to cooperate with prosecutors, and parents who expose children to opioids due to their own abuse or drug dealing must also be charged. Other jurisdictions do it, and the District must do it as well.

DC Health and medical providers also have a crucial role to play in making children safer. Encouraging the adoption of a comprehensive medical information platform across the region to prevent families from using different doctors to hide abuse and neglect would be a welcome step. A campaign by DC Health to educate young women on how an early pregnancy, especially when followed quickly by others, compromises their future and that of their children, is a crucial necessity. It must be accompanied by improved access to long-acting reversible contraceptive methods.

In summary, even with the very minimal information we received, some conclusions emerge. CFSA’s extreme deference to parents and guardians emerges clearly through the redactions in these narratives. This is in direct contrast to the picture that is being painted by the foundations, advocacy groups and public agencies dominating the child welfare conversation. Their accounts portray interventionist child welfare agencies that remove children rather than giving their families the help they need and want.  We are seeing the opposite here: families who evade offers of help from the agency and providers and refuse to cooperate with efforts to monitor conditions in the home. The goal of such parents often appears to be to avoid surveillance by outsiders rather than to improve their ability to care for their children. And CFSA workers often seem unwilling or unable to intervene in a way that will protect these children.

‘The tragic deaths of children whose families are known to CFSA are the tip of a much larger iceberg. For every child who dies of abuse or neglect, an unknown number of others are living in fear or pain from abuse, suffering chronic neglect that will cause lifelong intellectual an emotional damage, or lacking the loving attention necessary for optimal mental, emotional and physical development. Sadly, it is only the children who die whose cases can be used to learn lessons to prevent similar tragedies in the future. This information must be public, so that the public can push for a system that protects all children who are not receiving the parental care they need to survive and thrive.

*The case, which received media coverage, was included and easily identifiable in

Diverse opinions not accepted: Censorship by a contractor of the U.S. Children’s Bureau

Instances of censorship and restrictions of free speech from both ends of the political spectrum have drawn increasing concern as the country’s polarization has increased. I have been very grateful that a digest of child welfare news and opinion articles funded by the federal government has for years been sharing my work–which often takes aim at the ideology prevailing in child welfare. But last July, the government contractor that prepares these digests declined to share one of my opinion pieces–while continuing to share other commentaries with a different perspective. My attempt to get an explanation has resulted in a series of bizarre communications that only heighten my fears that a government-funded organization is censoring the views that it shares.

Child Welfare in the News (CWN), a daily email sponsored by the US Children’s Bureau, has contributed significantly to Child Welfare Monitor‘s growth from its creation in 2016. CWN is an “email subscription service that provides a daily collection of news stories and opinion pieces from across the country and around the world.” It is an activity of the Child Welfare Information Gateway (CWIG), which is part of the Children’s Bureau and is managed by a consulting firm called ICF. For several years, I have been sharing links to Child Welfare Monitor commentaries with the ICF librarians who put together CWN and they have in turn provided links to these pieces, along with excerpts, in their daily mailings. At least until last July.

On July 24, 2023, I published The Misuse of Lived Experience in Child Welfare. The gist of the piece was that while all lived experiences are valid and valuable, their use can be problematic when experiences that support a particular perspective are highlighted and those that contradict it are not, or when evidence from data and research are ignored in favor of curated narratives. When I shared the blog post with the CWN staff as usual, I received a message saying “We’ll get back to you in a few days with a response on this article.” This was unexpected. When I checked for an update on July 31, an ICF librarian responded that “we are still working to review this article, and expect to have a response soon.” I emailed again on September 7 and heard that “We’ve not yet received a response or decision on this article.”

I replied asking to whom my commentary had been submitted and why, what the review criteria would be, and when I could expect a response. Receiving no answer, I wrote on September 14 to the Communications Director of the Administration on Children and Families, parent agency of the Children’s Bureau. I also submitted a Freedom of Information Act request asking for any emails that contain my name or that of Child Welfare Monitor.

On September 22, I received a response from Kai Guterman, the “Senior Manager of Knowledge Management” at ICF, which included the following:  “As you know from your past submissions, The Child Welfare Information Gateway is a service of the Children’s Bureau and as such, as part of our standard process our team reviews all requests submitted. Upon our review, this request was not selected for posting as it contains personal fundraising links.” I was totally baffled by this response. I was not aware of any “personal fundraising links” in my piece, but an alert reader informed me after I published this blog that the photo I used of the family of Vanessa Peoples (the mother whose bad experience with CPS was cited by Dorothy Roberts in her book), came from a GoFundMe page set up to help her and her family. Not realizing that at the time I replied, asking Mr. Guterman to describe these links so I could remove them and allow the post to be shared by CWN. Thirteen days later I received the following response:

Thank you for following up and agreeing to exclude the fundraising link. 

We have conducted a review of the Misuse of “Lived Experience” in Child Welfare blog submission request.  While we appreciate your submission, it has been determined that it will not be included in the Child Welfare in the News since this specific blog post has a strong emphasis on storytelling, calls out individuals [sic] names, makes personal opinion statements about individuals, and focuses on editorial and opinion-based content. 

As you consider future submissions, please review how much editorial or opinion-based content is included and ensure the content is not driven by or connected with fundraising purposes.   

Email from Kai Guterman, Senior Manager of Knowledge Management, ICF, October 5, 2023

This message from Mr. Guterman was even more confusing than the previous one. It is certainly true that my blog post names several individuals, including the writer Dorothy Roberts and several people who have shared their lived experience with the child welfare system in writing and/or in oral testimony, and I included links to all of their writings. But not many news or opinion articles shared by CWN fail to name individuals. And my post does not make any “personal opinion statements” about these individuals other than summarizing or quoting their views and saying that other types of experiences also exist. The “strong emphasis on storytelling,” leaves me totally baffled. Indeed, the major point of the essay was to question the use of individual stories to make policy. Is it possible that Mr. Guterman missed the point of my blog or did not read it at all? Moreover, removing articles that tell stories would probably exclude more than half the content that is currently included in CWN–pretty much every news story and many opinion pieces as well.

And finally, Mr. Guterman asserts that my piece “focuses on editorial and opinion-based content.” Yes, most of my blog posts are opinion pieces and are labeled as such in the CWN emails, along with opinion pieces by other authors. Since I published my lived experience blog, the newsletter has shared numerous opinion pieces. At least four of these commentaries were by a writer named Richard Wexler. From beginning to end, Wexler’s essays “focus on editorial and opinion-based content,” as Mr. Guterman put it. Here is one example from Child abuse: the surge that wasn’t, a commentary from August 17, 2023 that was shared by CWN.”The American family policing system, a more accurate term than “child welfare” system, is built on ‘health terrorism’ – misrepresenting the true nature and scope of a problem in the name of ‘raising awareness.'” Some of Wexler’s pieces “have a strong emphasis on storytelling.” For example, in Child Well-Being Doesn’t Require Family Policing, also shared by CWN, Wexler devotes seven paragraphs to the story of one family that he says was victimized by a false accusation of child abuse.

As far as “calling out individuals,” CWN shared a piece by Wexler entitled Attn: New Hampshire “Child Advocate – there are horrendous institutions in your state too.” In that commentary, Wexler “calls out” the New Hampshire Child Advocate by name, telling readers that she was “understandably proud of herself” for getting two New Hampshire teenagers out of an abusive institution. But she “took matters too far” when she said according to a local news station that she and her staffers could finally get a good night’s sleep after removing the two teenagers from the institution. But nobody should be getting a good night’s sleep as long as “children are institutionalized,” according to Wexler. “And [the Child Advocate], of all people, should know it” because last year her predecessor issued a report exposing abuse at a New Hampshire institution. He goes on to label as “disheartening” her proposal to form a commission to address the issue of residential care.

It is noteworthy that Wexler’s pieces tend to endorse the prevailing ideology about child welfare, albeit often in an extreme way, while mine tend to challenge it. But Wexler is not the only author of opinion pieces that tell stories and mention individuals and nevertheless are shared by CWN. In addition to commentaries by Wexler, the newsletter has shared opinion pieces with titles like “The Child Welfare System Is Failing Children, Separating Black and Brown Families,” and “What To Do When Children’s Services Comes to the Door,” which also endorse the prevailing view. But my essay has been rejected, ostensibly for the same characteristics that these pieces display. Could it be that the creators of CWN are discriminating based on viewpoint?

As Mr. Guterman mentioned, ICF produces CWN under contract for the Children’s Bureau, which has wholeheartedly endorsed the prevailing view of child welfare promoted by a group of well-heeled foundations and nonprofits, consulting firms and influential commentators. This narrative portrays a racist child welfare system that disproportionately investigates, intervenes with and separates Black children and families. It disregards the evidence that the need for protection is also much greater among Black children, suggesting that they are more likely underrepresented in relation to their need. The dominant viewpoint asserts that foster care is harmful and rarely necessary and that “prevention services” including financial aid can eliminate the need for most child removals. It holds that children should almost never be placed in non-family placements such as group homes or residential treatment centers. Proponents of this perspective hailed the Family First Act, which has failed to add significant preventive services while catastrophically reducing the availability of placements for the most troubled and traumatized young people, resulting in an explosion in the number of youths staying in offices, hotels and other inappropriate placements.

In my censored commentary, I provided examples of how the child welfare establishment and its preferred authors tend to share only the lived experiences that support their views, while ignoring experiences that support different viewpoints. And I gave examples of foster care alumni who have shared experiences of foster care and group homes that contradict the ones that have been repeatedly highlighted. Instead of choosing only the personal stories that support preferred views, I suggested that it is more useful to survey large samples of foster care youths or alumni. And I reported that such surveys result in much more positive views of foster care and group homes than those of the individuals who have been highlighted.

Over the years, Child Welfare Monitor has consistently expressed views that sharply question those of the child welfare establishment. But the CWN staff has never declined to share a piece because of its content. The website description of CWN states that the inclusion of a link “does not imply endorsement of any view expressed in a story and may not reflect the opinions of Child Welfare Information Gateway, the Children’s Bureau, or either organization’s staff.” So they clearly do not need to vet submissions for viewpoint.

The reason for the sudden change in practice (without notification or a change in the website language) remains a mystery, but one might speculate that it has something to do with a decreased tolerance for diverse views. But ICF or the Children’s Bureau would be violating the spirit and possibly the letter of the First Amendment if it were purposely excluding from a government publication content that does not fit the prevailing view. The Supreme Court has ruled that the government cannot discriminate against speech based on viewpoint, stating that: “When the government targets not subject matter but particular views taken by speakers on a subject, the violation of the First Amendment is all the more blatant. Viewpoint discrimination is thus an egregious form of content discrimination. The government must abstain from regulating speech when the specific motivating ideology or the opinion or perspective of the speaker is the rationale for the restriction.”

The possibility of viewpoint discrimination by the federal government or its contractor is deeply disturbing. But ICF’s dishonesty is also concerning. I was told for weeks that the article was still under review. When I persisted, I was told that my piece was censored because of “personal fundraising links” that I could not identify. When I asked to be shown the links so I could remove them, I was then given an entirely different explanation. And the new explanation was equally absurd, citing issues with my blog that either did not exist or were common to many other pieces shared in CWN. So there must be another reason they have not given me, and discrimination based on viewpoint is the only one that comes to mind.

It is unfortunate that my attempt to tell the truth about child welfare has finally come up against the increased intolerance for diverse views, even in a government-funded clearinghouse. Unless I find an organization that wants to take my case to court, it is unlikely that “The Misuse of Lived Experience” will be published in Child Welfare in the News. I’ll have to rely my readers to share my writing with their colleagues. Please share this blog and my censored post and urge people to follow Child Welfare Monitor. We cannot let the censors win.

The misuse of “lived experience” in child welfare

Vanessa Peoples: Gofundme, https://www.gofundme.com/f/nb2wut-help-vanessa-get-back-on-her-feet

“Those closest to the problem have the answers to solving it. Every child welfare policy and project should prioritize incorporating the expertise, perspectives and experiences of the people whose lives have been directly impacted by the system. We call this ‘centering lived experience.'” There is a lot of truth in these words from an organization called Think of Us and a lot of good in the current focus in child welfare and other fields on considering the actual experience of people affected by systems when developing new policies and practices for these systems. But the emphasis on lived experience has potential pitfalls. When experiences that support a particular perspective are highlighted and those that contradict it are not, and when evidence from data and research are ignored in favor of narratives that may be outliers, there is a risk of adopting policies and practices that hurt, rather than help, children and families.

As described in a brilliant article by Naomi Schaefer Riley and Sarah Font, it is “individuals and groups with a platform” like foundations, government agencies, and journalists, that “select ​the people with lived experience to serve on advisory boards, testify to Congress, give media interviews, or otherwise disseminate their story.” The “lived experiences” that are selected tend to support the views of what I call the “child welfare establishment,” which includes federal, and many state and local child welfare agency leaders; foundations and nonprofits; consulting firms; and influential commentators and writers. They tend to believe that foster care is harmful and rarely necessary, and that on the rare occasions when children are youth must be placed in foster care, they should almost never be placed in “congregate care” placements such as group homes or residential treatment centers.

Let us start with the idea that foster care is rarely necessary, and the child protective services (or the “family policing system” as author Dorothy Roberts and others put it) removes children from loving parents who just need a little bit of help, thus harming rather than helping children. The story of Vanessa Peoples illustrated this thesis so well that it was shared by numerous media outlets before being picked up by Dorothy Roberts to begin her book, Torn Apart, about how the child welfare system “destroys Black families.” Peoples was a mother of three small children who was apparently 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 in June 17 when a cousin was supposed to be watching him.

From the information provided by Roberts and others, it sounds like Peoples’ was the victim of a hyperactive agency and police department, but it is also possible that critical details were omitted from the narrative. Moreover, Roberts did not include any narratives from people with a very different experience, like this one from Kiana Deane writing in The Imprint: “For me, meth became the pernicious thief that stole my home, my sense of belonging and, at times, my well-being. Being placed in a foster home saved me. Though foster parenting is not for everyone, I couldn’t imagine a world without the protection of the foster care system.” The Kiana Deanes are not asked to testify before Congress, highlighted in books by trending authors, or interviewed by the mainstream media for stories on foster care. (But kudos to The Imprint, which has published many narratives from youths who are grateful that they were placed in foster care.)

Then there’s the issue of group homes versus foster family homes. We all “know” that group homes and residential treatment centers are houses of horror because that is the only thing we ever hear. In the two hearings it held on the Family First Act, the Senate Finance Committee heard from only one person with “lived experience” in a group home, and that was Lexie Gruber, who told Senators about the locked food cabinets, punitive disciplinary system, over-medication, and the lack of emotional support that characterized her group home experience in Connecticut. But Senators did not hear from anyone like Imani Young, who wrote in The Imprint: “Eventually, OCFS (the Office of Children and Family Services) brought me to a wonderful placement called St. Christopher’s. …While in the NY child welfare system, I wanted to feel safe, comfortable, respected and not neglected, and St. Christopher’s made me feel all of THOSE above. They taught me independent living skills, helped me manage my money, got the counseling I needed, and taught me that there’s more to life.”  

Other than the selective presentation of lived experiences to be highlighted, another problem with using individual narratives to develop policy is that each person presents their own version of their story, which may leave out crucial details. It is rare for a journalist, author, or Congressional committee to check up on the accuracy of a story that supports the broader narrative they are seeking to portray. Vanessa Peoples’ wanted to portray herself as an innocent victim who did nothing to merit the intervention of CPS, and Roberts had no interest in finding inaccuracies in her story. Lexie Gruber, too, was intent on making the case against group care. She did not talk about the support that she must have gotten from the group home in order to get into college, or any other positive aspects of the care she received.

When the media, congressional committees or advocacy groups select only one set of lived experiences to highlight, real harm can result. Take the passage of the flawed Family First Prevention Services Act (FFPSA) in 2018 after only two hearings with a “curated” group of invited speakers who were clearly chosen to support passage of the bill. Lexie Gruber was the only former foster youth who spoke at the hearing on group homes and other congregate care placements, which was titled No Place to Grow Up: How to Safely Reduce Reliance on Foster Care Group Homes. When it was finally passed in 2018, FFPSA contained drastic restrictions on federal reimbursements for group homes and other residential placements. I wrote in a recent post about how those restrictions have contributed to a placement crisis around the country, with the most troubled foster youth spending weeks or months in offices, hotels, jails, hospitals and other inappropriate and harmful settings. I don’t claim that hearing from Lexie Gruber caused Congress to impose drastic restrictions on group homes, but it was certainly used to support that action.

Don’t get me wrong. Every individual’s story has value. Such stories allow us to visualize the reality behind dry data and statistics. But, to make policy, we need to know whether a story we hear is an outlier or representative of the average experience. It’s not that outliers don’t matter; we need to have protections to ensure that the worst possible outcomes (like the killing of 16-year-old Cornelius Fredericks in a residential treatment center run by Sequel Youth and Family Services) don’t occur. But making policy assuming the outliers represent the majority can lead to disastrous outcomes, like the congregate care provisions of FFPSA.

In contrast to individual narratives, surveying a representative sample of people with lived experience in a particular setting or system can provide information that is useful for policy purposes. Such information is not guaranteed to be accurate; survey response rates are often suboptimal and those who do respond may differ systematically from those who don’t. Nevertheless, such surveys are a much more accurate way of assessing lived experience than relying on individual anecdotes.

And it happens that in child welfare, surveys of older foster care youth and alumni present a much more positive picture than what has been presented by the child welfare establishment and the media. In four studies of former foster care youth reviewed by Barth et al, majorities said that they were lucky to have been placed in care. Most recently, the CalYOUTH study followed a cohort of 727 youth who were in foster care at age 17, with personal interviews every other year until they were 23 years old. At 23, 68.4 percent of the 621 respondents said that they were lucky to have been placed in foster care. And 57.4 percent were “generally satisfied” with their experience in foster care.

There are few studies of youth perspectives on residential care, but a recently published study in a leading child welfare journal reports on the experience of 450 youths placed in 127 licensed residential care programs in Florida between 2018 and 2019. The youths responded to a validated quality assessment that asked them to rate their facilities on elements of service quality in seven domains based on evidence and current best practice standards. Overall, youth provided high ratings of their residential programs on all seven domains. The mean ratings indicated that youths felt their facilities were “mostly to completely” meeting the standards across all domains.1

This does not mean that there are no children who could have stayed safely with their families and not been placed in foster care had the right help been provided. Nor does it mean that there are no terrible group homes. The current placement crisis (to which FFPSA has contributed) means that more youths will be placed in neglectful or even abusive homes or facilities than if this crisis did not exist. But when advocates of one point of view choose to share only those experiences that support their viewpoint, the use of lived experience to support particular policy proposals can lead to policy choices that are harmful to the people they are intended to help.

Note

  1. But not all surveys are based on large, scientifically-chosen samples. For example, the nonprofit,Think of Us, which has the aim of “centering lived experience,” published a report called Away from Home: Youth Experiences of Institutional Placements in Foster Care. That report is based on the responses of 78 young people residing in what it called “institutional placements, which included group homes, homes for pregnant and parenting teens, and therapeutic residential treatment facilities around the country. Among the conclusions of the report were that institutional placements were prisonlike (“carceral”), punitive and traumatic for their residents and failed to meet child welfare mandates to provide safety and wellbeing. The methodology section, relegated to an Appendix, reveals that the 78 participants were recruited through an “open call for participation through youth advisory boards and community partners.” Assuming that these are advisory boards and community partners of Think of Us, and knowing that the nonprofit and its CEO are associated with the dominant viewpoint on group care, one has to wonder whether the recruitment process produced an unbiased sample.

Shiny, happy and homeschooled: the Duggar family and the need to regulate homeschooling

After its premiere on June 2 on Amazon Prime Video, Shiny Happy People: Duggar Family Secrets, reached more viewers in its first nine days than any other Amazon docuseries. The series exposes the fundamental moral corruption underlying the Duggar family, the subject of TLC’s long-running reality series, 19 Kids and Counting, as well a spinoff entitled Counting On. The Amazon series reveals the Duggar family involvement with a fundamentalist Christian movement that endorsed physical child abuse, sanctioned educational neglect, and created a culture of sexual abuse of women and girls. One issue that was not discussed in the series is the key role that unregulated homeschooling plays in allowing the abuse and exploitation of children like the Duggars to occur and persist.

For someone who was hardly aware of the Duggars and their reality-shows empire, Shiny Happy People was a revelation. I learned that the Duggers were the poster children for an organization called the Institute in Basic Life Principles (IBLP), which was formed in the 1960s by a minister named Bill Gothard in reaction to the civil rights, women’s rights, and student protest movements, and to the cultural changes of the period. The first principle of IBLP was “Authority.” Just as God was the ultimate authority over mankind, so did IBLP preach the father’s ultimate authority over his family. Girls remained under the authority of their fathers until they transitioned by arranged marriage to the authority of their husbands.

To reinforce its authority, IBLP preached (and the Duggars used) physical punishment starting from infancy. As babies, the Duggar children were subjected to “blanket training,” promoted by the book To Train Up a Child, which is popular in Christian homeschooling circles. Babies are shown a desirable object, told not to touch it, and hit every time they reach for it. The point is to teach obedience. The survivors interviewed for the series spoke of receiving physical punishment for just about any transgression, no matter how minor.

In 1984, IBLP published a home-schooling curriculum consisting of “wisdom booklets” based on the Bible, which was marketed as an academic curriculum but according to survivors contained little if any actual education. Children learned that all fossils were created by God at the same time and that the rhythm of rock music could be traced to satanic ritual; girls were taught to identify what items of female clothing are provocative and should be avoided. It’s not surprising that many survivors spoke of struggling financially after leaving home without preparation for further education or work beyond the minimum wage level.

The children of IBLP families were brought up with frightening visions of hell and taught to constantly examine their own thoughts for evidence of sin, especially the sin of lust. This practice may have backfired. Survivors interviewed for the series reported that IBLP families were rife with sexual abuse. It was eldest son Josh Duggar’s admitted abuse of his sisters among other girls that put an end to the long running series, 19 Children and Counting. It was replaced by a new series called Counting On, which focused on some of the family’s daughters, but that show in turn was suspended after Josh Duggar was arrested for receipt and possession of child pornography. He is now serving 12.5 years in prison.

IBLP is not the only Christian home schooling movement that promotes physical punishment and educational neglect. The Revolt of the Christian Home-Schoolers, a brilliant article by Peter Jamison in the Washington Post, tells the story of Christina and Aaron Beall, who were brought up in families that were both active in a religious community led by Gary Cox, an evangelical pastor and pioneer of Maryland’s home-schooling movement. (Cox’s son later ran for Governor of Maryland and lost in a landslide to Wes Moore.) Christina and Aaron could not bear to watch their children grow up the way they did – in fear of being beaten several times a week. They rejected corporal punishment for their four children and eventually decided to send them to public school.

Christina and Aaron’s children were lucky. But states’ policies toward homeschooling provide little protection for those who need it, like the Duggar children. The Amazon series did not address the policy context of the abuses suffered by the Duggars and all the other children brought up in IBLP and similar movements, or how future children in these environments could be protected. As Eve Ettinger, the oldest of nine children homeschooled in a fundamentalist Christian home, explains in Salon Magazine, it is the failure of states to meaningfully regulate homeschooling that allows abuse and neglect to take place in these homes.

Before continuing, it is important to note that It is not just fundamentalist Christians who homeschool. Homeschoolers include Black parents who wish to avoid racism in the public schools, parents of elite athletes or musicians whose schedule does not allow for attendance at regular schools, and other parents who simply want to have more input into their children’s education than the public schools allow. And most of these parents are no doubt well-meaning and provide an excellent education. But when homeschooling parents abuse or neglect their children, the protections provided to other students are not available.

According to the Coalition for Responsible Home Education (CRHE), an advocacy group started by homeschool alumni, 11 states require nothing of homeschooling parents, not even notification to the school district when they begin homeschooling. Another 16 states require only that parents who intend to homeschool give notice to state or local officials. The remaining states have some combination of requirements for subjects covered, hours of schooling, academic assessments, parent qualifications, or other provisions. Only nine states require academic assessments that are meaningful because they must be submitted to the government or require a certain level of achievement. Only 11 states require any qualifications (usually a high school degree or GED) for parents who want to homeschool their children, and only two states conduct background checks for parents who want to homeschool their children. Of those two states, Pennsylvania prohibits homeschooling if a parent or other adult in the household has been convicted of any of a range of offenses. Arkansas prohibits homeschooling if a registered sex offender lives in the household, but parents may petition the sentencing court to have this restriction waived. No state provides for monitoring of parents who begin to homeschool during or after a child protective services investigation, or for those with histories of child welfare involvement. Such provisions have been introduced in several states but have failed to become law due to opposition from the homeschool lobby. Shockingly, no state requires that a state employee or contractor ever set eyes on the child once homeschooling is approved.1

The lack of meaningful standards and monitoring of home education opens the door for educational neglect by parents who reject the importance of anything but a biblical education. Such educational neglect was described eloquently by many survivors in the Amazon series, who reported that their learning outside of religious principles was minimal and that they spent most of their time doing chores and caring for their younger siblings. Such children “graduate” from home schools without the knowledge and skills necessary to thrive in American society. A 2013 article in the Washington Post described one Virginia student’s struggle to fill the gaps in his home education. This determined young man needed several years of remedial education and other courses at the local community college before he could fulfill his dream of attending a four-year-college.

Even worse, the lack of contact with educational staff isolates homeschooled children from adults outside their families, churches, and fundamentalist homeschooling circles, leaving them particularly vulnerable to long-term maltreatment. Teachers and other school staff have traditionally been the most common reporters of child abuse and neglect.2 When a child is being abused or neglected at home, it is teachers and others at school who see the bruises or the hunger. If the child does not go to school, that extra set of eyes is missing; there remains only the hope that a doctor or other professional (if the child is lucky enough to see one) will notice something is wrong. The importance of educators as mandatory reporters was illustrated in a chilling manner by the Connecticut Office of the Child Advocate, which found that of children withdrawn from public schools to be homeschooled between 2013 and 2016, 36 percent had at least one prior accepted report for suspected abuse or neglect to the Department of Children’s Services, and the majority of these families had multiple prior reports for suspected maltreatment. So it is not surprising that a disproportionate number of the horrific abuse deaths that make the news (such as the Hart children, Natalie Finn in Iowa, Matthew Tirado in Connecticut and Adrian Jones in Kansas), involved parents who hid their abuse behind the guise of homeschooling, even though schooling rarely took place in these homes.

Before the 1980’s, homeschooling was not even addressed in state laws. The first achievement of the new homeschooling movement was the legalization of homeschooling in the 1980s and early 1990s in every state, as described by Milton Gaither in his history of American homeschooling. This came about thanks to the work of the Home School Legal Defense Association (HSLADA) and allied groups. Since that time, HSLADA and state-level homeschool lobbies have often been successful in getting legislatures to strike requirements that were included in the original legislation. For example In Virginia, homeschool groups succeeded in removing the requirement that homeschooling parents have a bachelor’s degree, replacing it with the lower requirement of a high school degree or GED. In Arizona, the requirements that parents pass a proficiency exam and that students take annual standardized tests were both removed, and the new requirement that parents have a high school diploma or GED was later removed. In Iowa, homeschooling was completely deregulated in 2013.

Homeschool lobbies have also been successful at thwarting attempts to add regulations to protect children, some of which were inspired by egregious instances of abuse. After the 13 Turpin children and young adults were found imprisoned (some chained to their beds) and emaciated in their home in California, a horrified public learned that their parents had elected to homeschool as an individual private school, an option available in that state. California Assemblyman Jose Medina introduced a bill that would require a fire inspection for all private schools, regardless of size.3 Due to a massive outcry from the homeschooling community, the inspection requirement was eliminated, leaving a bill that required nothing but identification of homeschooling families by name and address. When the eviscerated bill was scheduled for a hearing, hundreds or perhaps thousands of homeschooling families poured into the capitol building, testifying for three hours. No committee member even moved to approve the bill, and it died that day.

The Covid-19 pandemic resulted in a jump in homeschooling enrollment which has not yet subsided. There has been an estimated 30 percent rise in homeschooling enrollment since the beginning of the 2019 school year. This increasing trend makes the need for regulation of homeschooling more urgent. CRHE’s recommendations for protection of at-risk children include prohibiting homeschooling by parents who have committed offenses that would disqualify them from teaching school, requiring that students be assessed annually by trained mandatory reporters, and flagging certain at-risk children (such as those in families with a history of child protective services involvement) for additional protections and support. CRHE also recommends requiring a high school degree or GED for the primary homeschooling parent, instruction in the same subjects as public schools, maintenance of academic records, and assessments of annual progress with interventions in case of inadequate progress, among other recommendations.

With Shiny Happy People, Amazon Prime exposed the abuse and neglect hiding behind the happy facade that the Duggar family presented through its reality shows. But unfortunately the series did not let watchers know how we can protect today’s homeschooled children from such maltreatment by increasing regulation and oversight. I wish the series had ended by urging viewers to contact their state legislators and urge them to mandate reasonable regulation and oversight for homeschooling, so that no more children will be victimized.

Notes

  1. Presentation by James Dwyer, Homeschooling Summit, Harvard University, June 2021. See https://childwelfaremonitor.org/2021/07/06/homeschooling-harvard-conference-highlights-need-for-regulation/
  2. In Federal Fiscal Years 2020 and 2021, teachers lost their top ranking as maltreatment reporters to legal and law enforcement personnel due to Covid-19 school closures. It is my guess that they will gain it back in 2022.
  3. There actually already was a fire inspection requirement for schools with 6 or more children, but there was no record that the Turpin home had been inspected.

Residential care in child welfare: An international perspective

In my last post, Family First at five: Not much to celebrate, I discussed how the Family First Prevention Services Act (FFPSA) made it more difficult to provide residential care (often pejoratively called “congregate care” by the Act’s supporters) for the most troubled foster youth while doing little to ensure the development of alternatives. The result has not been surprising–an exacerbated placement crisis, with foster youth around the nation sleeping in hotels, offices, jails and other inappropriate settings. An important new book provides an international perspective on residential care. It shows that the U.S. ranks very low in the percentage of foster youth that are in residential care, casting doubt on the advisability of trying to further reduce residential placements. The obvious conclusion is that we would do better to increase the quality of residential care by raising standards for staff.

The new book, Revitalizing Residential Care for Children and Youth, is a compilation of research on residential care in 16 high and middle-income countries, edited by James K. Whittaker, Lisa Holmes, Jorge F. Del Valle, and Sigrid James, who are professors at universities in the US, England, Spain, and Germany, respectively.1 The editors define “residential care” as “any group setting where children spend the night,” encompassing settings that vary in size and function and that operate under the auspices of child welfare, juvenile corrections, or mental health. The 16 countries are viewed through a common template, making comparisons possible. However, there are problems with such comparisons. As explained in the second chapter, countries differ in the terms they use for different types of care and how they define these terms, among other things. The editors’ definition of “residential care” does not ensure that the same facilities are being counted across nations. A small group home with paid staff might be classed as “foster care” in some countries, and some facilities (like those for youth offenders) might be counted in the residential totals for some countries and not others.

Keeping in mind the impossibility of obtaining data that is totally comparable across countries, there appears to be a striking variation between nations in the utilization of residential care for youths who are in out-of-home placements. The editors defined the residential care utilization rate as the proportion of out-of-home care dedicated to residential care rather than family foster care or other types of out-of-home placements. This percentage ranged from seven percent in Ireland and Australia to 97 percent in Portugal, as shown in Figure 29.1, which is reproduced below. The United States had the third lowest residential care utilization rate, with ten percent of children in out-of-home placements being in residential settings. Moreover, the number of children in U.S. residential care fell by about 25 percent between 2015 and 2019. According to the editors, it appears that countries in the low-utilization category have made legislative changes (like FFPSA and California’s Continuum of Care Reform in the US) that have led to drastic reductions in residential care. But the countries with medium utilization rates (between 30 and 55 percent) seem to be focused on improving residential care by strengthening the elements believed to be associated with quality care rather than reducing the utilization of residential care.2

Source: James Whittaker et al, Revitalizing Residential Care for Children and Youth, page 430.

The authors also found great variability in the education and training requirements for residential care staff. These range from no minimum qualification in the United States, Canada and Australia, to high school level (Israel, Argentina and Portugal), to rigorous multiyear vocational training and/or university education in the other countries. A number of countries use both vocationally trained and university educated staff. For example, in Germany, about 70 percent of residential care staff hold a 3.5 to five-year vocational degree as educators (or in fewer cases two years as assistants) and 30 percent have Bachelors’ degrees in social work or “social pedagogy.”3

The editors found that it is countries with lower educational requirements for staff that have turned against residential care and have sought a drastic reduction of its use. Among those countries was, no surprise, the United States, along with Australia and England. In contrast, countries with a high qualification requirement have higher utilization of residential care. This correlation is not surprising. There is no doubt, say the volume’s editors, that “the quality of the services is directly related, in any field, to the qualifications, training and experience of the professionals who provide them.” In child welfare, they argue, “[I]t is difficult to carry out the work without a qualification based on the learning of very diverse theories related to child development, the clinical expressions of trauma, listening and helping techniques, the framework of family relationships, and ecological theories.” The editors suggest the existence of a vicious cycle, where low staff qualifications may led to poor quality and outcomes, which in turn lead to reduced funding, making it harder to recruit well-qualified staff.

Unfortunately, available data do not tell us what proportion of children and youth in residential care in each country are there for time-limited treatment for behavioral issues with a plan to “step down” to a family setting. Available data suggest that a majority or large minority of children and youth in residential care in the middle-utilization countries have a mental health diagnosis, which does necessarily mean that they are in a time-limited therapeutic setting. Most likely, the residential care population in the middle-utilization countries is a combination of youths with issues that require treatment in residential care and those who could be in family foster care if available As one of the editors notes in the introductory chapter, “residential care across the globe …does not seem to be limited to the narrow treatment-oriented and time-limited setting it is generally reduced to in several Anglo-American nations. In fact, in many countries,…., children and youth still spend years in residential care programs.”

The assumption that family foster care is always the better choice unless a child cannot function in such a setting may be unique to the English-speaking countries. Small, family style group homes, whether freestanding or part of a campus of such homes, may be difficult to distinguish from foster homes, especially if they use a house-parent model. In fact, the authors say, some countries classify “a small “family group” home, staffed by paid staff” as a foster home. I have argued in the past that high-quality family-like group homes may be better for children than mediocre or poor-quality foster homes and are especially appropriate for siblings. Indeed, as discussed in the book, France has 28 children’s villages, which are family-like units especially for siblings.

The evidence shared by Whittaker et al. has important implications for the United States. Given our low position on the scale of residential care utilization, one might logically conclude that further lowering the number of children in residential care would be unrealistic. In the two countries with lower residential utilization rates than the United States, Ireland and Australia, news accounts document an urgent need for more foster parents, with young people being separated from siblings, moving from one emergency placement to another for lack of a suitable home, and spending nights at hotels. Instead of trying to bring the residential share of foster care even lower, the U.S. might be better advised to follow the example of countries like Germany and Finland, which are focusing on improving residential care programs rather than eliminating them.

Cross-national comparisons are valuable in many policy areas, and the absence of such comparisons in child welfare debates is particularly unfortunate. Reading this book brings home the lack of international comparisons informing Congress when it passed the FFPSA. As far as I know, the supporters of FFPSA’s drastic restrictions on residential care never referred to other countries’ use of residential options; that’s not surprising as such comparisons may have led to uncomfortable questions about the premise that too many foster children and youth were in residential care.

Some members of Congress who supported the residential restrictions in FFPSA may have been more concerned about budgets than ideological objections to residential care. Improving residential care costs money, while cutting it may appear to help balance budgets. FFPSA was designed to be budget-neutral, so that restrictions for funding of residential care were required in order to offset the increase in spending for services to families. And it apparently did not matter to Congress if those costs were by necessity picked up by states that had no other options: the federal government would see the savings.

Perhaps the federal coffers have benefited from the restrictions on federal funding for residential care, especially because federal spending for the “prevention services” side of Family First has been negligible. But it is hard to believe that states have gained financially from the new law. Spending as much as $2,000 a night for a hotel room complete with staffing and security for foster youth, as Washington State is reportedly doing, cannot possibly be a better use of funds than improving and expanding residential care. And the effects on children and youth are disastrous. One can only hope that state leaders will be brave and smart enough to take the first steps in the direction of revitalizing residential care to be a nurturing and therapeutic environment for children and youth and a field that is a source of pride for its practitioners.

Revitalizing Residential Care for Children and Youth should be required reading for anyone involved in making policy or drafting legislation regarding foster care. But it is probably too much to hope that the anti-residential crusaders will choose to read this important book. They find it more comfortable to continue believing that cutting funds for these programs without providing an alternative will save money and help children at the same time.

Notes

  1. The countries studied include Argentina, Australia, Canada, Denmark, England, Finland, France, Germany, Ireland, Israel, Italy, the Netherlands, Portugal, Scotlad, Spain, and the United States.
  2. Portugal, with 97 percent of its out-of-home youth in residential care, is in violation of its own law establishing residential care as the last option for out-of-home care. It appears that the country has not developed the supply of foster parents needed to shift the system toward home-based care. Argentina, with 86 percent of children separated from their families living in residential care, is only in the early stages of developing family-based foster care. In Israel, a system of residential facilities or “youth villages” developed as a means of social integration of immigrant groups, starting with survivors of the Holocaust. This system of residential care operates under the MInistry of Education. A separate child welfare system developed later under the Ministry of Labor, Social Affairs and Social Services, to serve the needs of maltreated children, and 63 percent of the children in this system are also in youth villages.
  3. According to the editors, “[s]ocial pedagogy is grounded in a holistic understanding of the person and espouses participation, democratic processes, self-determination, and social and moral education within the context of everyday life as guiding values and principles for practice. Individualization (n contrast to standardization) and professional decision-making are further hallmarks of this approach.”

Family First at five: Not much to celebrate

Photo by Ivan Samkov on Pexels.com

When the Family First Prevention Services Act (FFPSA) passed as part of the Bipartisan Budget Act of 2018, it was hailed by many as a revolutionary step in the history of U.S. child welfare. Five years after the Act took effect, child welfare leaders have been weighing in with statements like this one from Rebecca Jones Gaston, Commissioner of the Administration on Children, Youth and Families: “Following its passage five years ago, the Family First Prevention Services Act has transformed our approach to child welfare and benefited families across the many states that have used it to provide concrete support and services.”1 But for those closer to ground-level and less invested in demonstrating the act’s success, there’s not much to celebrate.

FFPSA had two major goals: to keep children out of foster care altogether through services to families and to keep more of those who do have to enter care in family homes. In terms of the first goal, the law’s impacts on services to families have been almost negligible. And in its effort to keep foster children in families, FFPSA has exacerbated the critical shortage of appropriate placements for our most troubled youth, many of whom may need placements in larger settings. In this post, I examine these two goals and their outcomes in greater detail.

FFPSA’s Part I made it possible to allocate funds under Title IV-E of the Social Security Act, previously directed mainly to foster care, to services aimed at keeping children out of care. The law allowed spending on mental health, substance abuse prevention and treatment, and in-home parenting services, “when the need of the child, such a parent, or such a caregiver for the services or programs are directly related to the safety, permanency, or well-being of the child or to preventing the child from entering foster care.”

As I explained in my 2019 post, Family First Act: a False Narrative, a Lack of Review, a Bad Law, Part I was based largely on the false premise that current law, by allowing TItle IV-E funds to pay for foster care and not for services to prevent it, incentivized states to remove children rather than keep families together. While it is true that IV-E funds were not available to pay for services to children and families in their homes, that does not mean that no money was available to help keep families together or that states had an incentive to place children in foster care. In fact, states had long been using Medicaid and other funds for services to prevent placement of children in foster care. In Federal Fiscal Year 2017, according to federal data, out of the children who received services after a CPS investigation or alternative response, only 201,680 were placed in foster care, while 1,332,254 (or more than five times as many children) received in-home services such as case management, family support, and family preservation services.2

Disregarding the role that other funding already played in child welfare, the framers of FFPSA required that Title IV-E would be the “payer of last resort,” so that any services already paid for by Medicaid could not be paid for by Family First. By doing this, they ensured that states with a generous Medicaid programs would be hard-pressed to find any service already existing in the state on which to spend their TItle IV-E money. If not for this provision, such states might have chosen to supplement Medicaid funding for some of these services. Perhaps some states would have allowed Title IV-E funds to be used to pay high-quality providers who do not accept Medicaid funding due to the program’s low reimbursement rates and high paperwork burden. (During my time as a foster care social worker in the District of Columbia, we had contracts with high-quality providers who did not accept Medicaid in order to provide therapy for our most complex clients).

The choice to fund only parenting, mental health and drug treatment services by the framers was another design flaw of FFPSA. The absence of a domestic violence service among the funded services is striking. It is universally acknowledged that drug abuse, mental illness and domestic violence are the “big three” factors that result in foster care placement. But for some reason, the words “domestic violence” are nowhere to be found in FFPSA. Perhaps even more striking is the failure to include one of the most promising services to prevent foster care–high-quality child care. As I have written, not only does quality early care and education prevent foster care placement through multiple pathways, but it also provides an extra set of eyes on the child in case of continued abuse or neglect–greatly needed if FFPSA is to achieve its goal of keeping children both safe and out of foster care. Think of what a difference Congress could have made by providing matching funds to provide quality child care to all families with in-home cases!

Perhaps the most unfortunate feature of FFPSA’s Part I is the requirement that all funds must be spent on “promising, supported or well-supported practices,” with 50 percent of the total spent spent on “well-supported practices” — a percentage that increases after 2026. The law imposes strict requirements for designating a program as promising, supported or well-supported. It set up a clearinghouse to assess the data on existing programs and approve those that met the criteria. As Dee Wilson points out in one of his essential commentaries, the law gets it exactly backwards. We have very little evidence about what works to prevent foster care placement. What we need is to invest in innovative approaches to doing this safely. But FFPSA prevents the use of TItle IV-E funds for this purpose.

Thanks to the various restrictions imposed by FFPSA, the clearinghouse is woefully incomplete. For example, Cognitive Behavioral Therapy (CBT), the therapy of choice for depression and anxiety, which has not been approved nor is it on the list of programs to be examined by the clearinghouse. (“Trauma-Focused CBT,” a newer and much narrower and short-term model, has been approved.) No residential drug treatment program has been approved or is even slated to be considered. The requirement that the practice have a manual may be at fault for the failure to include CBT and residential drug treatment programs, but I’d like to hear from readers who may be better-informed. Buphenorphine therapy for opioid use disorder, which is often preferred to methadone therapy (which is approved by the clearinghouse)because it does not require daily clinic visits, has not been approved and is not slated for consideration, according to the Clearinghouse.. Of course, these popular programs are often funded by Medicaid anyway, so they would be ruled out by the last resort provision as well.

With all these restrictions on Title IV-E spending, it is not surprising that states have been hard-put to find useful ways to spend Title IV-E funds to keep families together. In an important article, Sean Hughes and Naomi Schaefer Riley cited the latest available federal data showing that just 6,200 children across the entire country received an FFPSA-funded service in FFY 2021, costing a grand total of $29 million. That is truly underwhelming given that about 600,000 children were found to be victims of maltreatment in FFY 2021.

The other major purpose of FFPSA was outlined in Part IV, entitled “Ensuring the Necessity of a Placement that is not in a Foster Family Home.” The purpose of this part was to keep more children out of “congregate care,” a term used to designate settings other than foster homes, such as group homes and residential treatment centers. FFPSA made it more difficult to place a child in a congregate placement by imposing conditions on Title IV-E reimbusement for such placements, and by limiting reimbursement after two weeks to facilities that qualify as “Quality Residential Treatment Programs (QRTP’s), a new category defined by the act. QRTP’s must meet strict criteria that many facilities that were caring for foster youth at the time of FFPSA’s passage could not meet without major changes. The act also (perhaps inadvertently) further restricted the number of congregate care beds available to foster youth by creating a conflict with a Medicaid provision called the “Institutions for Mental Diseases (IMD) exclusion” that prevents Medicaid paying the cost of care for children who are placed in facilities with more than 16 beds.“

Like Part I, Part IV of FFPSA was in large part based on a false narrative. The myth this time was that every child does better in a family rather than in a more institutional setting. But as I described here, there are many foster youths who cannot function in an ordinary foster home, at least until after a stay in a high-quality residential treatment program or group home. These are the same young people who bounce from home to home and end up in hotels, offices, jails, and other inappropriate settings, but FFPSA made no provision for them.

Even if too many children had been placed in residential care without sufficient clinical justification (which is probably the case in at least some states), it would not be responsible to shut down congregate care placements before ensuring that appropriate foster homes were available for all the children being displaced. But just as the deinstitution movement of the 1960s closed mental hospitals before putting alternatives in place, FFPSA disregarded the question of where children would go when congregate settings disappeared.

As I described here, FFPSA exacerbated trends that were already underway. Group homes and residential treatment centers were already shutting down due to growing publicity about abusive incidents at some facilities, failure of reimbursement rates to keep up with costs, and resignation of staff due to poor pay and working conditions. Tragically, this reduction in residential capacity coincided with increased demand for care due to the youth mental health crisis and increasing levels of need in the foster care population due at least in part to delays in removing children from abusive and neglectful homes. The restrictions put in place by FFPSA added to the problem. As Hughes and Schaefer Riley put it, “If you want to understand why foster children across the country are being housed in a range of inappropriate temporary settings, including county and state offices, hospitals, hotels and shelters, FFPSA is a significant factor.” 

The trends just mentioned have contributed to a foster care placement crisis that has if anything worsened since I described it last October. In Illinois, the Department of Children and Family Services (DCFS) is being sued by the Cook County Public Guardian for allowing foster children to remain locked up in juvenile detention even after they’ve been ordered released. In Maryland, a disability rights group has just filed suit against the Department of Human Services and other agencies for keeping foster children in hospitals and restrictive institutions beyond medical necessity for weeks, months, or even as long as a year. In a must-read article, Dee Wilson documents a 370 percent increase in hotel/office stays in his state of Washington since 2018 despite a federal court order to stop the practice. At an average cost of up $2,000 per night (including the cost of paying two social workers and a security guard), overnight hotel placements cannot possibly be cheaper than group homes or residential treatment centers. Similar problems are reported around the country, differing only in which inappropriate settings each state is relying on.

As is often the case, California paved the way for FFPSA by passing its Continuum of Care Reform, designed to curb the use of congregate placements, in 2015. A new article in the Los Angeles Times recounts the results. The number of children living in congregate care has dropped from 3,655 to 1,727 since implementation of the law, but the state has failed to find the foster homes to replace the congregate care settings. As a result, Los Angeles County has placed more than 200 foster youths in hotels, sometimes for months. County officials report that two social workers have been assaulted by foster youths in separate incidents this year at hotels. Moreover, it appears that care at the existing congregate facilities has grown worse as larger numbers of troubled youths are placed together in fewer facilities. The results of California’s reform and of FFPSA were predictable and indeed predicted by some commentators (including this writer), but these predictions were ignored.

As Dee Wilson puts it, “The implementation of Family First legislation has accelerated the demise of residential care, which has decreased 25% nationally during the past five years. It has been the goal of the federal Children’s Bureau and influential foundations to reduce the use of residential care (which has a bad reputation among advocates and most scholars) and they have succeeded; but without developing — or sometimes even proposing – viable alternatives.”

Anyone who chooses to celebrate the “revolution” wrought by FFPSA is living in a dream world. It’s time for Congress to recognize and correct the many errors it made in passing the law. At a minimum, Congress should add funding for early care and education and domestic violence programs to the models that can receive funding under Title IV-E, loosen the standards for evidence-based practices, modify the last-resort provision to allow payment for services to providers who do not accept Medicaid, eliminate some of the restrictions on congregate care, and provide incentives for states to boost their capacity of quality residential programs. Until such changes are made, there will be nothing to celebrate.

.

  1. Alexia Suarez (asuarez@wearerally.com), [YOU’RE INVITED] Expert panel on the Family First Prevention Services Act. Email message, May 15, 2023.
  2. These are duplicated counts as children are counted again each time they are the subject of an investigation and receive post-response services.

What is the cause of racial disparity in child welfare?

There is no doubt that Black children and families are reported to child abuse hotlines, investigated, and removed from their homes more than White children. But many leading voices in child welfare today have made the dubious assumption that racial bias in reporting and child protective services is the underlying reason for these disparities. Unfortunately, based on this assumption, they propose policy solutions that risk destroying existing protections for Black children or even for all abused and neglected children. A star-studded group of researchers has collaborated on a paper that ought to put this presumption to bed for good. I hope that this brilliant paper is able to change the minds of some who have unquestionably adopted the fashionable theory that is being promoted by the child welfare establishment.

There is no dispute that Black children are reported to authorities, investigated for abuse or neglect, and placed in foster care at a higher rate than White children. The federal publication, Child Maltreatment 2021, reports that Black children are nearly twice as likely as White children to be the subject of a screened-in report and almost twice as likely to be substantiated as a victim of child abuse or neglect. In 2020, Black children were 14 percent of the child population but 20 percent of the children entering foster care. Kim et al estimated that 53 percent of Black children will experience a CPS investigation by the age of 18, compared with 28 percent for Whites. But are these disparities greater than what would be expected given the higher rates of poverty and other social problems among Black children? That’s the question that a group of 13 researchers addressed in a recent article on racial and ethnic differences in child protective services reporting, substantiation and placement, published in the leading child welfare journal, Child Maltreatment. The authors include most of the top researchers in the field, such as lead author Brett Drake and his co-authors Richard Barth, Sarah Font, Emily Putnam-Hornstein, Jill Duerr-Berrick, and Melissa Jonson-Reid–an accumulation of starpower rarely seen collaborating on a single article.

Previous studies cited in the paper have already concluded that when adjusting for income and family context, Black children were actually reported to CPS at similar or slightly lower rates than White children and that Black children who are the subject of investigations were no more likely to be substantiated or placed in foster care than White children. Despite these results, the belief that racial disparities are due to anti-Black bias in reporting and child protective services (CPS) decisionmaking has been asserted as established fact in publications by the federal government, numerous child welfare groups, the American Bar Association, the American Civil Liberties Union and Human Rights Watch, and many media outlets. A report by a leading legal advocacy group and the Columbia Law School Human Rights Institute urged the UN to investigate the American child welfare system for racial discrimination. After conducting its own review, a UN Committee recommended that the United States “take all appropriate measures to eliminate racial discrimination in the child welfare system, including by amending or repealing laws, policies and practices that have a disparate impact on families of racial and ethnic minorities.” Rather than advocating for reform of child welfare systems, some individuals and organizations, such as upEND, press for the extreme step of abolishing the entire child welfare system.

The new paper provides a needed antidote to the certainty that racial bias is the principal source of racial disproportionalities in reporting, substantiations, and foster care placements, and provide compelling evidence against it. The authors use universal national data to ask two questions:

  1. Are Black-White and Hispanic-White disparities in CPS reporting lower than, similar to, or higher than disparities in non-CPS measures of social risk and child harm?
  2. Once referred and accepted for investigation, do Black or Hispanic children experience substantiation and removal into foster care at rates lower, similar or higher than White children?

The authors focused on Black, White and Hispanic populations. Native American populations, which are also disproportionately involved in child welfare, are difficult to study because many are served by tribal child welfare systems and may not be reflected in the national data that the authors use. The authors used CPS data from the National Child Abuse and Neglect Data System (NCANDS), which gathers information from all 50 states, the District of Columbia, and Puerto Rico about reports of child abuse and neglect and their handling by child welfare agencies. Data from certain states and years had to be eliminated because of data quality problems and missing data. The elimination of all data from New York and Pennsylvania is unfortunate, but it is unlikely that these omissions changed the overall trends. Data for income and other indicators of risk and harm came from the Census Bureau, the Kids Count Data Center, National Vital Statistics records, and the Centers for Disease Control.

Question One: Reporting Disparities

The authors posit that the “expected rate” of Child Protective Services (CPS) involvement for a particular group of children should be “the rate at which children in that population experience child abuse, neglect, or imminent risk thereof.” But the authors explain that we cannot actually observe the incidents of abuse or neglect, as they are not always reported to authorities. And when reports are made, the system may not always make the correct decision when it decides whether or not to “substantiate” or confirm the allegations made by the reporter. To estimate the “expected rate” of being reported to CPS, Drake and colleagues used several categories of risk and harm that are known to be highly correlated with the risk of child abuse and neglect. Indicators of “social risk” included the numbers of children in poverty, children in single parent families, teen birth rate, and adults without a high school degree. To indicate harm to children, the authors used “very low birthweight,” “very preterm births,” infant mortality, homicide injury, and “unintentional death.”

Drake and his colleagues calculated “disparity ratios (DR’s),” by dividing the incidence of social risk or harm for Black or Hispanic children by the rates for White children by year. They found that the DR’s for all the measures of risk, and all of the measures of harm except accidental deaths, were greater than the DR’s for CPS reports. In other words, there was a greater disparity in risk and harm to Black children than there was in CPS reporting. Thus, given their likelihood of being abused or neglected, Black children appear to be reported to CPS less than are White children.

The tables below illustrate the incidence of risk, harm and CPS reports for Black children compared to White children. While Black children were reported to CPS at a rate close to twice the rate of White children throughout the period studied, their poverty rate was three times that of White children in 2019, the proportion of Black children in single-parent households was 2.5 times as as that of Whites, and the disparity in the rate of single-parent households and adults without a high school degree was almost as great. In terms of harm, Black children were four times as likely to be a homicide victim in 2019, nearly three times as likely to have a very low birth weight, and more than twice as likely to die of maltreatment, in 2019.

Disparities in Substantiation and Removal

To address disparities in substantiation and removal following investigation, Drake and coauthors compared the raw data and also ran regressions to adjust for demographic factors that might affect placement, such as poverty. They found that in both adjusted and unadusted estimates, Black children, once investigated, have been less likely to be substantiated and placed in foster care in more recent years. Before 2011, Black children were slightly more likely to be substantiated and placed in foster care than White children before the trend reversed. The unadjusted estimates are shown below.

When they compared Hispanic children to White children, the authors found a very different pattern. While Hispanic children face much more exposure to social risks like poverty than White children, they experience harm and CPS reporting at about the same rate as White children. This pattern is consistent with what is known as the “Hispanic paradox.” This term describes a well-documented phenomenon in the child welfare and medical literatures wherein Hispanic children and families have indicators of well-being similar to their White non-Hispanic counterparts, despite having much higher indicators on risk factors like poverty. For Hispanic children, there were slightly greater unadjusted rates of substantiation and placement than for White children, but these differences disappeared when statistical controls were added.

Conclusions and Implications

The authors draw two primary conclusions from their research. First, “Black-White CPS reporting disparities were consistently lower than Black-White disparities in external indicators of social risk and child harm.” Black children were exposed to more risk and experienced harm at greater rates than White children, and these disparities were consistently greater than the disparities in reporting. If either group is overreported in relationship to their risk it is White children. It is still possible, the authors point out, that all children are overreported to CPS in relation to external indicators of risk and harm. But “if there is systemic overreporting, it is not specific to Black children and thus, unlikely to be driven by racial animus.” They also found no evidence that once investigated, Black children were disproportionately substantiated or placed in foster care.

Second, the authors found continued evidence for the “Hispanic paradox” in CPS reporting compared to observed risk exposure. Although Hispanic children face substantially greater social risks than White children, they experience harm and CPS reporting at about the same rate as White children. This supports the well-documented pattern whereby more recently immigrated Hispanic families, despite having higher risk factors, tend to have indicators of well-being similar to Whites.

In the authors’ own words:

It is indisputable that despite progress in certain areas, the United States has not overcome the legacy of slavery, segregation and Jim Crow. This legacy lingers most clearly in the patterns of segregation that emerge in many of our metro areas…To assert that these patterns, and the poverty and chronic stress they perpetuate, would have no impact on behavioral and psychosocial functioning among the individuals and families in those neighorhoods is to reject decades of scientific consensus on human development. Indeed, this history and its unresolved legacy is essential to understanding why Hispanic families face similar individual socioeconomic disadvatage but appear to have sigificantly lower rates of CPS involvment than Black children.

If I have one quibble with the authors of this brilliant and essential article, it is their lack of attention to the possile psychological impacts of intergenerational trauma from the history of slavery, Jim Crow, and racial hatred and violence. As the child of Holocaust survivors, I can attest that the six years of trauma that my parents suffered after the Nazis invaded Poland has affected me and even my daughter. For families in which nearly every generation going back almost 400 years suffered the trauma imposed by living within slavery, Jim Crow, or a culture of virulent and violent racism that continues in some form today, it would be surprising if there was no current mental health impact on the generation that is parenting children today. Such a impact might include elevated levels of mental illness as well as self-medication through drugs and alcohol, both of which are associated with child maltreatment.

In the section on Implications, the authors assert the need to address the factors that underlie the differing rates of risk and harm to Black children, outside the CPS system itself–factors such as poverty and racial segregation. The belief that abolition of child protections would in and of itself help Black children, the authors point out, relies not only the assumption that CPS is racially discriminatory, which this paper has debunked. It also relies on the assumption that CPS provides no protection to children. Certainly there is room for improvement in our child protection systems, particularly in the quality of care they provide to children removed from their homes. Yet, foster youth testimonies such as “being placed in a foster home saved me,” or “Using my voice is the reason I am no longer in a household that is broken,” as well as the silent testimony of the more than two thousand children who die of abuse and neglect every year,1 are a testament to the untruth of this statement.

The authors suggest three courses of action for the future. First, we should acknowledge and address the true drivers of racial inequity among families, such as multigenerational poverty, underresourced schools, and lack of access to quality substance abuse and mental health treatment programs. Second, despite their results, we must acknowledge that racial bias may exist in certain localities and be prepared to address it. And third, “there is clearly room to consider restructuring child and family policy generally to include a focus on providing preventive services, including material assistance, to families. (See my discussion of universal yet targeted programs to prevent child maltreatment.)

The authors go on to state that “It is possible that a narrow focus on reducing Black children’s CPS involvement without addressing the pronounced inequities documented by the external indicators will result in systematic and disproportionate unresponsiveness to abuse and neglect experienced by Black children.” And indeed, there are already reports that professionals are already more reluctant to report Black children and CPS employees are more reluctant to substantiate or remove them.2 Or to put it more bluntly, the standards for parenting Black children will be lowered, and the level of maltreatment that Black children are expected to endure before getting help will be raised. Ironically, this calls to mind some manifestations of racism that have been cited by scholars and advocates, such as treating Black children as if they are older than their actual age, and thinking that Blacks have a higher pain threshhold than Whites. Of course if the child welfare abolitionists have their way, the entire system will be abolished, destroying protections for all children. That is unlikely to happen, but what is more likely is a weakening or repeal of critical laws like the Child Abuse Prevention and Treatment Act or the Adoption and Safe Families Act, which are both currently under attack, to eliminate or weaken provisions like mandatory reporting.

Sadly, few leaders on either side of our increasingly polarized political scene will be open-minded enough to read, understand and accept the conclusions of this important paper. While the progressive mainstream (and even many others in the child welfare establishment) has blindly accepted the notion that racial bias is the primary driver of child welfare disparities, conservatives remain obsessed with reducing the size of government and cutting taxes, refusing to recognize the need for massive spending, even a domestic Marshall Plan, to rectify the result of centuries of slavery and anti-Black racism in America.

Notes

  1. States reported 1,820 child maltreatment fatalities to NCANDS in 2021. But experts cied by the National Commission to Eliminate Child Abuse and Neglect Fatalities (p. 9) estimate that the actual number is at least twice as many as that reported to NCANDS.
  2. See, for example, Safe Passage for Children of Minnesota, Minnesota Child Fatalities from Maltreatment, 2014-2022. The report authors found evidence that raised the question of whether Minnesota child welfare agencies may have tended to leave Black children in more high-risk situations for longer periods of time than children of other races and ethnicities. See also Stacey Patton, The Neglect Of 4 Texas Brothers Proves That The Village It Takes To Raise A Black Child Is The Same Village That Stands By And Watches Them Die, Madamenoire, November 2, 2021. She states that “To reduce the number of Black children entering into foster care as a result of abuse, child welfare professionals are increasingly “screening out” calls for suspected child abuse.  There haven’t been any state or national level studies to show whether disproportionately higher numbers of calls of Black child abuse are being screened out to avoid claims of racial discrimination.  However, in my work as a child advocate, I keep hearing stories of non-Black child welfare professionals who don’t report abuse because they either don’t want to be accused of racism, or they just accept that beating kids is an intrinsic part of Back culture.”

The Minnesota Child Maltreatment Fatalities Report: Essential reading for child advocates everywhere

A shattering new report from a Minnesota child advocacy group demonstrates that many of the more than 160 deaths of children from abuse and neglect over an eight-year period ending last May were preventable. These deaths, the report concludes, can be attributed to “a child welfare philosophy which gave such a high priority to the interests of parents and other adults in households, as well as to the goals of family preservation and reunification, that child safety and well-being were regularly compromised.” This report is essential reading for child advocates everywhere, because this philosophy reigns around the country, and the troubling factors identified exist in states where most of the child population resides.

Produced by the child advocacy group Safe Passage for Children of Minnesota, and authored by Safe Passage Executive Director Richard Gehrman and Maya Karrow, a fellow from a local law school, the project collected information about 88 children who were killed between 2014 and 2022. The Minnesota Department of Human Services (DHS) told project staff that it was aware of 161 child maltreatment deaths during a period that mostly coincides with the period studied.1 But DHS refused to provide information on any of these deaths (in violation of state and federal law), so the staff had to rely on news reports, online court records, and information provided by counties for the 88 cases it had identified.

Like child maltreatment fatality victims nationwide, the dead children were young, with 42 percent under a year old and 36 percent between one and three years old. Children under four were 78.4 percent of the Minnesota deaths very similar to the 76.3 percent for child maltreatment fatality victims nationwide. Black children accounted for 26.1 percent of all the fatalities reviewed. In contrast, Black children were 17.8 percent of children involved with child welfare and 10.6 percent of the state’s child population in 2021.2 Based on the statistics and case file reviews, the report’s authors expressed concern that chld welfare agencies in Minnesota “may have tended to leave Black children in more high-risk situations for longer periods of time than children of other races and ethnicities.” The report’s authors are not the first to have asked whether fears of being accused of racism may be leading agencies to leave Black children in harm’s way even more than children of other races.

The most common causes of death among the cases reviewed were blunt force trauma to the head (33 percent) and body (19.3 percent). The other major causes of death were asphyxiation (17.0 percent) and gunshot wounds (8.0 percent). Other causes included drowing, sepsis, poisoning from drugs, stabbing, hypothermia/hyperthermia, fire, and undetermined causes.

The most common perpetrators of child fatalities were mothers (27.3 percent), mothers’ significant others (23.9 percent), and fathers (22.7 percent). In 65.9 percent of the cases, one or more of the perpetrators had a history of substance abuse. Shockingly, there were seven deaths in foster care, of which six were in kinship foster care. In another appalling finding, there were seven cases in which a child was killed along with the mother or while attempting to intervene in an assault on the mother.

A concerning pattern was the evidence of child torture in a surprisingly large number of cases. The project’s reviewers identified 14 cases (or 15.9 percent) that displayed signs of torture, according to criteria outlined by experts. The authors used the case of Autumn Hallow, who was killed at the age of eight, as an illustration. Investigators found that Autumn’s father and stepmother frequently bound her in a sleeping bag as punishment, sometimes with her hands tied behind her back or overnight, and starved her for six months so that she weighed only 45 pounds when she died. A particularly appalling feature of her case was the “chilling indifference by all the authorities involved to the screams of a child [reported repeatedly by neighbors] and the pleas of an increasingly distraught mother.” Autumn’s cause of death was declared to be asphyxia and blunt force trauma. Her father and stepmother were convicted of second-degree unintentional murder in her death.

The project uncovered numerous systemic flaws that contributed to the 88 deaths reviewed. These included inappropriate assignment of reports to a “family assessment” rather than a factfinding investigation; the failure to respond adequately to repeated reports suggesting chronic maltreatment; seemingly endless chances given to parents to address chronic problems; the return of children from foster care to homes where safety had not improved; the placement of children with kin without appropriate vetting; leaving children with mothers who repeatedly failed to protect them from violent partners; and the lack of integration between child welfare and child custody cases.

The repeated inappropriate assignment of cases to the “Family Assessment” (FA) track, which is intended for low-risk cases, was a major recurring theme in the case reviews. Minnesota is one of 34 states that initially adopted a two-track model, often known as differential response, for responding to reports of suspected maltreatment. (Some states have since terminated the practice). The idea was that a less-adversarial response than an investigation would be a better way to engage families with lower-risk cases. But with its practices like informing parents of visits beforehand, interviewing children in front of their parents, and making no finding as to whether maltreatment occurred, the report explains that FA is not appropriate when the risk to children is high. Yet, by 2020, 62 percent of CPS reports in Minnesota were assigned to Family Assessment. The researchers found that 31 of the 59 families with Minnesota child protection history had at least one and as many as six Family Assessment cases prior to the fatality. As the authors point out, “it is self evident that the repeated use of FA in chronically referred families is inconsistent with the policy that FA be used only in low-risk cases.”

Among the examples cited by the authors for the inappropriate use of FA was one that occurred following a report that a mother and her boyfriend were hitting their children with objects and dragging them by their hair. This family was the subject of six previous reports that included allegations of “physical abuse, sexual abuse, and unhygienic and unsafe conditions, including rotten food, garbage, drugs, alcohol, and sharp objects accessible to children throughout the home.” Twenty days after that last FA, two-year-old Lyla Koob was dead. Her mother’s boyfriend admitted to shaking her in frustration after she vomited. Her autopsy revealed bleeding on the brain and injuries behind both eyes. 

Based on analysis of court records, the researchers found that 71.6 percent of the dead children’s families had previous involvement with child protection. The 61 families included 59 with prior history in Minnesota and two with prior history in another state. In view of these percentages, it is not surprising that the project staff found that Minnesota child welfare had a pattern of failure to respond adequately to chronic maltreatment.

In some cases, the researchers noted a pattern of inaction by child welfare agencies in the face of chronic multitype maltreatment, or maltreatment that includes neglect as well as abuse. The case of Tayvion Davis, who died in 2018 at the age of eight, was used to illustrate this type of negligence. Before he was born, Tayvion’s mother was convicted of malicious punishment of a child after she and two adult relatives held down and beat one of her children. From that time until Tayvion’s death, the family was the subject of at least ten reports of physical abuse, sexual abuse, or neglect. According to court records, the children were hit with a hammer and a metal rod, whipped with a belt, burned with boiling water or chemicals, deprived of food and sleep as punishment, and threatened with death if they talked about the abuse. There were multiple reports of sexual abuse of Tayvion or a sibling by the oldest sibling, juvenile and adult relatives, and an unrelated adult.

Tayvion Davis froze to death in 2018 after his mother locked him in the garage overnight in subzero temperatures. The autopsy found numerous scars that suggested years of abuse that may have escalated into torture. Unbelievably, Tavion’s siblings were returned to their mother after being removed in the wake of Tavion’s death. They remained with her for another five months, during which she was the subject of several additional reports. It was not until they were removed again that they told their foster parents that Tavion was deliberately locked in the garage, resulting in murder charges against the mother.

The researchers also found that counties gave parents multiple chances to address chronic problems, while failing to execute effective safety plans for children remaining at home. One example of this tendency was the case of Aaliya Goodwin, who died at the age of five months. There had been eight reports for two older siblings regarding the parents’ substance abuse. Between 2015 and 2021, four safety plans were mentioned in court records, the oldest sibling was placed in foster care and returned home twice, the mother was charged with nine drug-related offenses and convicted of five, and the father was charged seven times with two convictions. The county opened a new FA in January 2022 due to a report of domestic violence and the mother agreed to a substance abuse assessment. Three days later she was found passed out on the couch after using drugs and alcohol. Aaliyah, squashed between her mother and the couch, was dead of positional asphyxia.

Another pattern cited in the report was counties’ tendency to return children from foster care to a home that was still unsafe. The project revealed that 26 percent of the children who died had been previously removed from their parents and then returned. The case of Khamari Golston was provided as an illustration of this pattern. Multiple abuse injuries to four-month-old Khamari resulted in his and his twin sister’s removal and placement in foster care. Their mother was charged with felony malicious punishment and assault. But only two months after adjudicating these children to be in need of protection, the judge sent them home for a “trial visit.” The mother was said to be cooperating with her case plan but there was no documentation of this in the court record. Eight weeks later, Khamari was dead of suffocation or smothering. He also had multiple injuries consistent with physical abuse. Khamari’s ten-year-old sister reported that their mother frequently choked him and covered him up when he cried.

Some children were returned from foster care to parents with serious mental illness. The report cites six-year-old Eli Hart, whose mother killed him with multiple shotgun blasts to the head and torso nine days after he was returned home. Eli was returned home without evidence that his mother’s mental illness was under control. Instead, her mental health remained a concern throughout the year that he was in foster care and during a trial home visit. She received eight traffic-related convictions (including for speeding and reckless driving) and was also charged with theft of pharmaceutical drugs during the time he was in foster care.

The occurrence of seven deaths of children in foster care, of which six were in kinship care, was a startling revelation of this study. There have been concerns raised around the country that the growing focus on kinship placements may be leading to the placement of children with family members who have not been adequately screened and are not appropriate caregivers. And indeed, the project staff found a “lack of due diligence in deciding whether a kinship placement would ensure the safety and well-being of the child.” To illustrate this pattern, the report offers the history of Leila Jackson, a 17-month-old who was killed by her foster father in 2018. Her autopsy showed “extensive subdural hemorrhages and severe brain injury, as well as extensive bruising on her buttocks.” Layla and her brother were placed in the kinship home after their mother’s parental rights were terminated. The foster parents denied having criminal records or substance abuse histories, but a background check (which was never conducted) would have revealed convictions for DWI, theft, possession of drug paraphernalia, and disorderly conduct.

The pressure to keep children with mothers who were victims of domestic violence, even when these mothers showed they were unable to protect their children, was another systemic problem noted by the project team. The authors found that 28.4 percent of the cases involved domestic violence–not surprising in view of the co-occurrence of child maltreatment with domestic violence. But that seven children were killed along with their mothers, or in an attempt to protect them, was shocking indeed. This is a difficult issue, and removals of children from domestic violence victims by CWS have been harshly criticized. But as the report put it, “at a certain point a line is crossed and it becomes imperative to move children to a safe place.”

In Minnesota, public child welfare cases are heard in juvenile court and custody cases in family court, which means that the same family can have two different court cases with different judges. The findings of the report suggest that the failure to consolidate these cases can place children at risk. In the case of Eli Hart, who was killed by his mentally ill mother, the custody case filed by his father was put on hold pending a resolution of the juvenile court case surrounding his mother. This is despite the fact that the mother’s mental health remained a concern and that all reports indicated that the father was a good and safe parent for Eli.

In sum, the report concludes that “the professional norms currently guiding child protection and foster care are out of alignment with those of the broader community.” As a first step, the report recommends that DHS release more information about child maltreatment fatalities, including making public the fatality and near-fatality reports that counties are required to submit to the state; such reports include information about previous reports and investigations on these families. This recommendation is particularly important because if the public knew about the types of egregious failures described in this report, there might be more public support for changes.

The report contains many specific recommendations to correct the systemic flaws found in the case studies. This year, Safe Passages will be distributing the report to legislators and briefing them on its findings and recommendations. Rick Gehrman, Executive Director Rick Gehrman reports that he will be working with legislators to translate some of these recommendations into legislation to be introduced in the next session, addressing at a minimum some of the Family Assessment practices that endanger children. The ultimate goal, Gehrman says, is to “raise public and legislative awareness of the child welfare practices that endanger children and to bring about a change in the overall philosophy of child welfare services in Minnesota.”

In effect, Safe Passages for Children has unofficially implemented the first recommendation of the Committee to Eliminate Child Abuse and Neglect Fatalities in its 2016 final report, Within Our Reach. That report recommended that each state, with federal funding and assistance, identify and analyze all of their child abuse and neglect fatalities from the previous five years in order to identify factors associated with maltreatment fatalities and agency policies and practices that need improvement to prevent fatalities. Based on this report, every state would develop a fatality prevention plan. Unfortunately, legislation supporting this proposal stalled in Congress and no state has elected to do this on their own. Maryland’s Council on Child Abuse and Neglect and its Child Fatality Review Board, inspired by this recommendation, formed a joint subcommittee that produced an excellent review of child maltreatment fatalities in Baltimore between 2012 and 2015 which identified systemic flaws and made recommendations to correct them.3 Other than that report, I am not aware of any other similar project by a state or local government agency. Let us hope that this report encourages other child advocacy groups and community boards to act where governments have not.

The final words of the report deserve to be repeated. “The erosion in professional norms that has gradually caused human services entities to tolerate the current level of neglect and physical abuse of children has developed over the course of decades. A concerted effort by a community of professionals will be required to restore standards that were once taken for granted, and to place appropriate limits on the ability of adults in a child’s life to harm them.”

Notes

  1. The actual number was likely two to three times as high because the manners of so many maltreatment deaths are misclassified.
  2. See Child Maltreatment 2021. Table C-2, Child Population 2017 to 2021 shows the state’s child population rose from 1,300,061 in 2017 to 1,317,567 in 2021. Table C-3, Child Population Demographics, shows that there were 140,129 Black children in Minnesota in 2021. That figure, divided by 1,317,567 gives the Black percentage of all children in Minnesota as 10.6 percent in 2021.
  3. City of Baltimore Health Department, Eliminating Child Abuse and Neglect Fatalities in Baltimore City. January 2017. This report appears to be no longer available online. Please email marie@childwelfaremonitor.org for a copy.

The new Child Maltreatment 2021 Report: Did child maltreatment really decrease?

The federal government’s annual maltreatment report for 2021 was released on February 9, 2023, and the child welfare establishment is celebrating. New Child Maltreatment Report Finds Child Abuse and Neglect Decreased to a Five-Year Low, crowed the Administration on Children and Families (ACF). “Number of Abuse and Neglect Victims Declines Again,” trumpeted The Imprint, a journal that typically reflects the prevailing voices in child welfare today. Left for the body of the ACF press release (and totally omitted by The Imprint) was the fact that in 2021 the nation was still in a pandemic that kept many schools closed for much of the year, and that child maltreatment “victimization” reflects jurisdictions’ policy and practice much more than it reflects actual maltreatment. Thus, there is no reason to celebrate a decrease in child maltreatment based on this report.

Child Maltreatment 2021 , the latest edition in the annual series from the ACF, combines data from the 50 states, the District of Columbia and Puerto Rico about the number of reports or children involved in each stage of the child welfare system in Federal Fiscal Year (FFY) 2021, which ran from October 1, 2020 to September 30, 2021. The data are obtained from the National Child Abuse and Neglect Data System (NCANDS), a national data collection program run by the Children’s Bureau under ACF. Arizona did not submit data in time to have its data included in this report, so only 49 states are included in this year’s report, along with the District of Columbia and Puerto Rico. Commentaries from most of the states regarding policies and conditions that may affect their data are attached in an appendix. The report’s findings are summarized in Exhibit S-2. All of the figures in this post are taken from the report.

A family’s journey through the child welfare system starts with an initial report, known as a “referral.” Figure 2-D below shows that the total number of referrals (the purple line) rose between 2017 and 2019, dropped sharply in the wake of the Covid pandemic in 2020, as schools closed and many families isolated at home, and increased only slightly in FFY 2021. It is important to remember that in FFY 2021, which began in October 2020, many schools were still closed. Most schools opened over the course of FFY 2021, but some remained closed the entire year. Thus, reporting from school personnel was suppressed for the federal fiscal year.

The rate of referrals as a portion of the child population varied greatly by state. Table 2-1 of the report shows that the total referral rate per 1,000 children in 2021 ranged from a low of 17.8 in Hawaii to a high of 137.0 in Vermont in 2021. Such differences exist every year and reflect factors such as public opinion and knowledge of child maltreatment reporting, as well as state practices. Some states do not even report most referrals to NCANDS, as described in the state commentaries. Pennsylvania has a unique system in which most reports that are not for abuse are classified as “General Protective Services” and not reported to NCANDS. Similarly, Connecticut does not report referrals receiving an alternative (non investigation) to NCANDS. In 2021, state-to-state differences may also reflect how soon in-person schooling resumed in the state after the pandemic. Vermont reported in its commentary that it has been receiving more referrals for concerns that do not reflect maltreatment. Vermont also included several reasons for its high referral rate, including the fact that reports on multiple children in the same family are counted separately. Kansas reported a decrease in reports due to “engaging communities to focus on prevention.”

Once a referral is received, it can be screened in or out by agency hotline or intake units. In general, agencies screen out referrals that do not meet agency criteria, which vary by jurisdiction. Reasons for screening out a referral may include that it does not meet the definition of child abuse or neglect, that not enough information is provided, that another agency should more appropriately respond, or that the children being referred are over 18. Despite receiving slightly more referrals than the previous year, child welfare agencies screened out a larger proportion of them in FY 2021, resulting in a slight decrease in screened in referrals (known as “reports“), from 2020 to 2021 – the blue line in Exhibit 2-D. In the 46 states that provided both data points, 51.5 percent of referrals were screened in and 48.5 percent were screened out.

There is great diversity in the proportion of referrals accepted by states. The percentage of referrals that was screened-in ranged from 15.3 in South Dakota to 98.5 percent in Alabama.1 There are many reasons for these variations, mostly associated with differing policies and practices between jurisdictions. For example, Georgia mentioned in its commentary that after hotline calls increased in 2021, it adjusted screening criteria to screen out more of them. Indiana tried to reduce its screen-in rate by changing criteria related to sexual behavior among teens and preteens, marijuana use by children, and educational neglect. Kansas reported a decrease in reports due to a change in the screening process for educational neglect. Missouri, on the other hand, changed screening criteria to screen in more referrals out of concern for children isolated because of the pandemic.

In FFY 2019, teachers were the most common source of referrals, submitting 21 percent of all referrals. They lost that position in FFY 2020 with the pandemic school closures, while legal and law enforcement personnel increased their share of reports. Perhaps it is not surprising that teachers did not recoup their leading role in 2021, since many students were still attending school virtually for some part of the year. Teachers actually submitted a smaller proportion of referrals in 2021 (15.4 percent) than in 2020 (17.2 percent). It is possible that teachers were making more calls but that more of these calls were being screened out than in the year before. But since ACF does not show the distribution of all referrals by reporting source, one cannot use this data to test that hypothesis.

Investigations

In Chapter 3 of Child Maltreatment 2021 the focus shifts from the referral or report to the child. ACF estimates that 3.016 million children or 40.7 children per 1,000 in the population received an investigation or alternative response2 in 2021. This was a slight decrease over 2020, when 42.0 per 1,000 children received an investigation or alternative response. These rates varied greatly by state, from a low of 12.8 per 1,000 in Pennsylvania to a high of 129.8 in West Virginia. The low in Pennsylvania is not surprising due to its unique system in which most neglect referrals are not reported to NCANDS. But Maryland and Hawaii also investigated small proportions of children– 15.7 and 15.9 per 1,000. These investigation rates reflect the number of referrals and how many were screened in, as well as the number of children per referral.

ACF found that of the children who received an investigation or alternative response, 16.7 percent were found to be victims of child abuse or neglect, as shown in Exhibit 3-B.3 The remaining children were not determined to be victims or received an alternative response. Estimating for missing data from Arizona, ACF calculated a national “victimization rate” of 8.1 per 1,000 children. As Exhibit 3-C shows, this rate has been decreasing since 2018 but the greatest decrease was in 2020 with the arrival of the pandemic.

ACF’s use of the term “victimization” can be misleading. An investigator’s decision about the truth of an allegation is based on limited information and is constrained by available time and staff, and evidence indicates that many referrals are unsubstantiated when maltreatment actually exists. Moreover, these rates are dependent on state policies and practices. Because of the misleading nature of the term “victimization,” the term “substantiation” is used for the rest of this commentary. State substantiation rates per 1,000 children ranged from 1.6 in New Jersey (even lower than Pennsylvania’s 1.8) to 17.0 in West Virginia, suggesting that these rates reflect much more than the prevalence of child abuse and neglect.

Among the many factors that can influence state substantiation rates are:

  • Differences in referral rates and screening practices, as decribed above;
  • Different policies about what is considered child maltreatment and different levels of evidence required to substantiate an abuse allegation;
  • Whether and how much a state uses an alternative (non-investigation response);
  • Natural and social disasters that may vary in their impact between states. Some states went back to in-person schooling for the entirety of 2021, others opened midyear, and others were virtual almost all year. West Virginia, with the highest substantiation rate, has been particularly hard-hit by the opioid epidemic. The state has the highest overdose mortality rate in the nation;
  • Differences in the messages coming from an agency’s leadership about the relative importance of child safety versus family preservation;
  • Variations in the use of kinship diversion, the practice of placing children with a relative without court involvement or case opening. If this happens before the investigation is completed, it may result in an “unsubstantiated finding.

All of these factors can change over time, affecting substantiation rate trends from year to year. It is clear that nationwide, the COVID-19 pandemic continued to suppress reports to CPS hotlines, and therefore investigations and maltreatment findings, in 2021. But the effect of the pandemic differed greatly between states: it appears that some states had more in-person days of school in 2021 than in 2020, and others had less. Additionally, several states described changes in their screening practices in 2021, usually to screen in fewer referrals. Delaware and Washington mentioned an increase in reports diverted to differential response as a reason for declining substantiation numbers in FFY 2021. The emphasis on prevention as an alternative to intervention has been increasing in most states, perhaps affecting the likelihood of substantiation. It is possible also that increases in kinship diversion may have reduced substantiation rates: there is no data to prove or disprove this, but concern over this practice is certainly growing.

To state that maltreatment decreased between 2020 and 2021 is to ignore that “maltreatment victimization” is not a measure of actual abuse and neglect. It is the result of a winnowing process that starts even before a referral arrives. At each stage, the numbers remaining may depend on a wide variety of factors, including policy, practice, natural and man-made disasters and more. The vast differences between state data on referrals, reports, investigations and substantiations shows how unlikely it is that the total number of children found to be victims of maltreatment reflects the actual number of maltreated children, and how irresponsible it is to suggest this might be the case.

A note on Child Fatalities

Last year, ACF used a decline in fatalities due to child maltreatment to headline its press release, Child Fatalities Due to Abuse and Neglect Decreased in FY 2020, Report Finds. This year, the number of child abuse and neglect fatalities reported by states increased slightly, a rise that was not the subject of a headline by ACF. Whether there is a small increase like this year or a decrease like last year means very little, for several reasons. As ACF explains, these child fatality counts reflect the federal fiscal years in which the children were determined to have died of maltreatment, which may be different from the year the child actually died. Such determinations may come much later due to the time it takes to complete a death investigation. For example Alabama reported that for the fatalities reported in FFY 2021, the actual dates of death were between FFY’s 2016 and 2021. Michigan even reported that its child fatality data included the child abuse death of twins in 2003 which was revealed by a cold case investigation.

A second problem with the fatality estimates is that they are widely believed to be too low. One reason is that many states report only on fatalities that came to the attention of child protective services agencies. As the report’s authors point out, many child maltreatment fatalities do not become known to agencies when there are no siblings or the family was not involved with the child welfare agency. Moreover, some fatalities resulting from abuse or neglect are labeled as due to accident, “sudden infant death syndrome,” or undetermined or unknown causes because insufficient evidence was found. I recently reviewed the child fatality review report produced by the District of Columbia’s Child and Family Services agency (CFSA). CFSA relied on the decisions of the medical examiner, which chose not to classify as maltreatment deaths an infant who died after a mother who was high on PCP rolled on top of him when sleeping with him in the same bed (counted as “unknown); a baby left on his stomach with a bottle in his mouth when his mother left the apartment (counted as “undertermined); a child who was shot to death by gunmen trying to kill her father, involved in the violent drug trade, outside a liquor store at 11:00 PM (“non-abuse homicide”), and a child who died of an untreated bacterial infection and had beating injuries diagnosed by doctors as due to abuse (“undetermined”). The total number of maltreatment fatalities was estimated at only three for the District in CY 2021, not including those four deaths. Some researchers suggest that the actual number of abuse and neglect fatalities may be as much as twice or three times that given in the Child Maltreatment reports,4 and the District of Columbia data suggest this may well be the case.

Notes

  1. This leaves out three states that are listed as screening in 100 percent of referrals: Illinois, New Jersey and North Dakota. Both Illinois and New Jersey explained in their state commentaries that reports must meet certain criteria to be accepted for investigation, so it is not clear why they responded that they screen in 100 percent of referrals. North Dakota actually screens in all referrals, but that is more semantic than real. Reports that do not meet agency criteria for a report of suspected chlid abuse or neglect are categorized as receiving an “administrative assessment,” and are not investigated. North Dakota does not report the number of referrals receiving an “adminnistrative assessment;” hence the reports that 100 percent of cases are screened in. It is unclear why New Jersey and Ilinois provided this figure of 100 percent but the reason may be similar.
  2. Alternative response is, as defined in NCANDS, the “provision of a response other than an investigation that determines if a child or family needs services. A determination of maltreatment is not made and a perpetrator is not determined.”
  3. NCANDS defines a “victim” as “a child for whom the state determined at least one maltreatment was substantiated or indicated, and a disposition of substantiated or indicated was assigned for a child in a report.” “Indicated” is defined as a disposition that concludes that maltreatment could not be substantiated under state law or policy, but there is a reason to suspect that at least one child may have been maltreated or is at risk of maltreatment.”
  4. Herman-Giddens, M. E., et al. (1999). Underascertainment of child abuse mortality in the United States. JAMA , 282(5), 463-467. Available from http://jama.jamanetwork.com/article.aspx?articleid=190980. Also, Cotton, E. E. (2006). Administrative case review project, Clark County, Nevada: Report of data analysis, findings and recommendations. Crume, T. L., DiGuiseppi, C., Byers, T., Sirotnak, A. P., & Garrett, C. J. (2002). Underascertainment of child maltreatment fatalities by death certificates, 1990-1998. Pediatrics, 110(2). Abstract available from https://pubmed.ncbi.nlm.nih.gov/12165617/. Herman-Giddens et al. estimate actual child abuse and neglect deaths to be as high as three times the national reported amount; Cotton et al. and Crume et al. found the actual number of deaths to be twice that reported.