In parts 1 and 2, I have talked about the shameful roles of Psychiatry and Boston Children’s Hospital in the case of Justina Pelletier, with one piece left to go. Again, I know that any sane person, when first hearing about this case, asks ‘why?’ Why would they do this without a good reason? That is why I am doing this series, to answer that question.
Today, as we all wait with Justina and her family to hear Judge Johnston’s decision on Justina’s fate (it should be given by Friday), I am going to address the final piece of the puzzle: the Massachusetts Department of Children and Families. While this case specifically involves Mass. DCF, the same overreach and incompetence is seen across the country.
I acknowledge that there are good people who truly care about children working for these organizations. However, DCF, by whatever label it goes by in your neck of the woods, is so utterly corrupt that it needs to be entirely scrapped and replaced with an agency that actually looks out for abused and neglected children.
As with the other culprits in Justina’s case, I ask you to simply follow the money. Why would DCF take children whose parents simply disagreed with doctors at Boston Children’s Hospital and sought a second opinion? Why would they track these kids towards group homes, foster care and adoption? Because that is where the money is.
Follow the Money
Simply put, for every child in DCF custody, they get money. For every child placed in foster care, they get money. For every child adopted from foster care, they get money. For every child institutionalized, they get more money.They are heavily incentivized to bring kids into their system, whether those children need to be in it or not. This is why they blithely take the word of Boston Children’s when they say a child is being medically abused. (Although, I should point out, it is not just kids like Justina who are at risk: accusations of abuse and neglect can harass any family in any state, at a hospital or not.) Couple the financial incentives with a nanny state mentality and you have a recipe for disaster. It’s not about the kids, it is about the money.
In 1997, the Adoption and Safe Families Act was passed – ostensibly to encourage the adoption of special needs kids and to correct the practice of reuniting families even when it was not safe for the child.
As is typical of most any type of well-meant government intervention, the unforeseen result has been practices that tend toward NOT reuniting families, even when it IS safe for the child. When you are financially rewarded for removing and keeping children from their families, you are going to be inclined to remove and keep children from their families. There is little, if any, motivation to reunite families. We, the American public, mistakenly believe that the mandate of DCF is the reunification of families, when it no longer is and hasn’t been for years.
Certainly, in the Pelletier case, there is no movement towards reuniting this family. Massachusetts DCF has taken a hard line for such a controversial case involving Connecticut residents. This is inexplicable, until you realize they have no reason to reunite Justina with her family because they are profiting from keeping her away.
After AFSA was passed, child removals drastically increased, predictably. Children in foster care are now mandated to be moved towards adoption, with parental rights being terminated when children have been in foster care for a specified amount of time – 15 months. This explains the Levi Strout case – taken from his mother at Boston Children’s, placed in foster care and tracked towards adoption. His mother is still fighting for custody; their court date is April 7th.
If their mandate was reunification, Levi’s mother would have been given resources to ensure her ability to parent an ill child. But, their mandate is not reunification – it is adoption. AFSA literally gives a bonus for every child adopted out of foster care. That they also receive federal funding for kids in foster care and institutions (like where Justina has resided for the last few months and probably most of the last year.) explains much about most of the cases similar to Justina’s – Elizabeth Wray and others.
We want to think these cases are anomalies. Sadly, the evidence shows that children indeed are being ripped from their parents arms wrongly and it is far more common than we might think. A 1998 report from the National Center for Child Abuse and Neglect, just a year after AFSA was being implemented, reveals some disturbing facts. For example:
- The state of Ohio reported to NCCAN that 22% of the children placed in state care were involved in reports that were ruled unfounded by child protective investigators. Ohio records indicated an additional 20% of the incarcerated children were “in need of services”, but not victims of substantiated abuse or neglect. An additional 4% were placed in foster care for “other reasons.” Ohio’s child protective agency said it did not know the reasons why 2% were taken into state care.
- In Washington, according to NCCAN, 26% placed in state care were cases “closed without a finding” and another 16% were placed for “other” reasons. These “other” reasons are not specifically named, but they were not based on founded charges of child abuse or neglect. In fact, only 48% of the children taken into state custody in 1998 were victims of child abuse or neglect.
- In Kansas, 41% of the children placed in foster care came from families where CPS investigators found complaints of child abuse or neglect to be unfounded.
Protecting children from abuse has gone from simply having an official path to remove children from an abusive situation to a thriving industry benefiting those involved: social workers, government agencies, physicians, attorneys, foster homes and group homes. There is no unbiased voice speaking for the family or the best interest of the children, because everyone is profiting. Everyone, that is, except the child and their family.
Leslie Doty Hollingsworth, a professor of social work at the University of Michigan,warned of the ethical problems social workers face with the passage of ASFA in a commentary published in “Social Work” (March, 2000). “Because there are strong financial incentives to increase adoptions, practitioners may be compromised ethically if required to work for reunification and adoptive placement simultaneously. Social workers should also advocate for policies that separate adoption incentives from child protection decisions and that are receptive to the well-being of children . . .” Hollingsworth also pointed out that “Poor and single-parent families may be disadvantaged, whereas people desiring to adopt may be advantaged.”
As to the increasing power of child protective services, even Richard Gelles, a child safety advocate who helped draft ASFA and someone who certainly doesn’t argue with the necessity of the ‘net being cast wider’ on behalf of children, said in a PBS Frontline interview:
“There were 6,000 reports of child abuse [and] neglect in 1965. There were 3 million last year. … Child protective agencies [used to be] 9-to-5 operations. They went out of business Saturday, Sunday, Memorial Day weekend, Labor Day weekend. Now they’re 24-hour operations; they have cell phones, they have computers, they’ve got pagers, they have 800-numbers. The carrying capacity of the system expanded as the number of cases came in. Again, you could go to the legislature and say, “We got 100 percent increase in reports last year, so we need 100 percent more workers.” Well the legislature would say, “We’re not going to give you 100 more workers, but we’ll give you 35.” Well, that increased their carrying capacity, so they were able to take in more reports and more reports and more reports. …”
There has to be some oversight and some limit to the power of these agencies. There has to be a way to ensure that kids who really are being abused can be protected while also ensuring parental rights and the rights of the kids who are not being abused. I would argue that the best way to do this is to place this responsibility squarely at the state and local levels – with no federal funding to be had, as our founders intended. If you have local people dealing with local problems without outside interference, you would automatically eliminate many of the problems. That is the conservative/libertarian in me speaking, though. Yes, I recognize that this would be an imperfect system but I would also point out the current one is far from perfect itself.
Again, I will point out that all of us want children to be protected from abuse. And there certainly people who abuse children and who need to be evaluated for their ability to parent, perhaps even losing their right to parent. Sometimes families are just broken and there are people who are willing to take kids from those families in as their own, thank God. I know foster parents. I know they have beautiful hearts. I know kids who have been adopted out of foster care. I never really questioned that system until now.
But, the truth is, the other side of that reality is a parent who has lost their child. And the numbers should give us pause to stop and consider if these are all with good reason. Are some removed for a good cause? Absolutely. All? Sadly, probably not. And that is a tragedy. Permanently removing a child from their biological family should be a careful and deliberate choice, one not influenced by money. Surely, we can figure out a way to protect the kids who need protecting while preserving the family unit.
In Justina’s case, it is excruciatingly difficult to claim abuse and justify removing her from her family for such a long period of time. I guarantee, if there was no financial incentive for DCF to take her, Justina would be at home with her family right now.
The abuses that come from the federal financial incentives aside, the horrific incompetence of DCF alone should make it clear that profound reform is needed. This agency that has simply accepted Boston Children’s Hospital’s decree that Justina’s parents are abusing her simply because they disagreed with the doctors at BCH, is the same agency that has lost 134 children – some reports have a higher number, the sad truth is, DCF may not even know exactly how many kids have vanished on their watch.
Let me repeat that: some 134 children who were taken out of their parents’ custody, entrusted to DCF for safe keeping, are now unaccounted for. This past fall a 5 year old boy went missing. They have no idea where he is and he is presumed dead. There are some 36,000 children in Mass DCF custody. There is no way to assure the supervision of each and every one of those children. If you, as a government entity, cannot assure the safety of children in your care, you should not have children in your care.
Perhaps -and here is a wild idea – it would be better for Massachusetts Department of Children and Families, and child protective services around the country, to focus their resources on children who really need them – like poor Jeremiah – rather than expending so much time and money on a child like Justina. Justina isn’t even a resident of Massachusetts. Undoubtedly, there are children in Massachusetts who desperately need intervention, but DCF is instead focused on helping Boston Children’s kidnap children for profit.
Sadly, it is a well known fact that children are not safer in DCF custody. From a CPS Watch article discussing the 1998 NCCAN report:
‘Children are eleven times more likely to be sexually abused in state care than they are in their own homes, according to NCCAN. While 59 out of 100,000 children in the general population are alleged to be physically abused, 160 — more than twice as much — were physically abused in the foster care population. Neglect? The 32 states submitting data in this category reported that 490 per hundred thousand children were neglected in their homes and 760 per hundred thousand were neglected in state care. Tragically, 6.4 children per 100,000 were killed in foster care in 1998 compared to a rate of 1.5 per hundred thousand in the general population.‘
Again, children are more at risk in DCF custody than they are at home, statistically speaking. True, if they are being abused or neglected or killed, foster care would obviously be a better option but if they are not, the actions of well meaning bureaucrats put them in grave risk. I have no recent stats but I would speculate that risk would rise as the case loads increase.
Conflicts of Interest
The conflicts of interest in this situation are appalling. Although the role of the Department of Children and Families is to be a neutral mediator in situations such as Justina’s – a case where one set of doctors disagree with another and with the parents – they are woefully ill-prepared to play such a role. According to the Boston Globe, there is one half-time pediatrician, one half-time psychiatrist and a few nurses on the staff of Mass. DCF across the entire state. The Legislature approved funding for a medical director five years ago and the agency has never filled the position.
In the absence of their own impartial experts, DCF consults with the physicians at Boston Children’s for free. When the agency is called in to look into abuse allegations brought by the hospital, who do they have to turn to for medical advice? The physicians at Boston Children’s. There is no impartial third party looking out for the best interest of the child or the family in these cases. Would an agency who is beholden to the people bringing an abuse charge be able to do due diligence in an investigation? This is more than just an appearance of a conflict of interest, is a big ugly one that results in the destruction of lives.
Once DCF takes over, the courts enter in to the situation. The courts typically look to the hospital physicians and DCF to provide the facts of the case. With BCH and DCF presenting a united front, the judge typically rules in their favor because of their gravitas and credibility. Because there is no objective party looking after the best interest of the child, the state can do whatever it wants with impunity. (Think judges are above the fray? Consider the Cash for Kids scandal in Pennsylvania.) DCF wields its enormous power with a vengeance and, once they have inserted themselves into your life, they will never willingly let go.
Playing Against the House
Like a person sitting down to play in a casino in Las Vegas should be aware that the house almost always wins, so it is true of parents pulled into this nearly unwinnable game BCH and DCF plays. The deck is utterly stacked against the parents and even if you are one of the few, lucky winners, it is at a high price. Legal bills and societal stigma aside, what is done to these poor children and to their brave families is unconscionable and the scars are life-long. While the Pelletiers will undoubtedly sue the pants off everyone involved in this debacle once Justina is safe at home, no amount of money can undo the wrong done to her. Even if she gets the medical care she needs and is surrounded by her loving supportive family, the crimes against her can never be erased or forgotten. The physical toll may be forever but the emotional toll certainly will be.
The best we can hope for is that Justina’s suffering is used for good: that the media backlash and spotlight shines clearly on the misdeeds of ALL involved and the people responsible are held accountable. That the policies that allow this to happen and even encourage it are changed. That a law is passed bearing Justina’s name which will protect children and families from these atrocities. That awareness is raised about the many rare diseases that people suffer from and that doctors will think twice before saying ‘it’s all in your head’. That no child or parent EVER has to live through a nightmare like the Pelletiers again…
Some good resources: