Critics find flaws with new DHS abuse rules
By LEE ROOD • REGISTER STAFF WRITER • April 6, 2008In the wake of a baby’s violent death in Waterloo, child advocates are stepping into the public light to tell state leaders: We warned you.
A wide mix of advocates - foster and adoptive parents, attorneys for children, policymakers, social workers - say they told state officials and legislators that serious child abuse is flying under the radar of Iowa’s recently redesigned child-welfare system.
They are criticizing the Iowa Department of Human Services for saying child safety is improving, even as the agency is filing fewer child abuse cases in court. Many say they believe the DHS, which has a statutory obligation to protect children, has become too cozy with abusive parents in a push to meet much tougher federal standards.
The result, according to advocates, is that the system is missing opportunities to help children before it’s too late.
DHS officials dispute that contention.
Michael Sorci, whose nonprofit legal agency represents roughly half of all abused children who pass through Polk County juvenile courts, said the death of 8-month-old Antwuan Williams Jr. in February was “an egregious case” that raised serious questions about decisions made in abuse cases that are driven by the DHS.
However, the child’s death by head trauma “was not the most egregious case I’ve seen since they’ve put in these new practices,” the head of Des Moines’ Youth Law Center said. “I really think it’s important that someone examine what’s going on.”Sorci and other advocates contacted the Des Moines Sunday Register in the past two weeks after court documents published by the newspaper detailed 18 months of child abuse and questions about oversight, including:
- Ziarah Williams, daughter of Antwuan Sr. and Tiara, suffered multiple fractures by the time she was 3 months old, but no criminal charges were filed after the DHS determined in December 2006 that she had been abused.
- A DHS recommendation in May 2007 that the Williamses’ parental rights to Ziarah should be terminated.
- DHS workers, a judge and other child-welfare professionals agreed in January 2008 that Antwuan and Tiara Williams were safe to parent again. This meant Ziarah, age 1, was returned to her parents after spending more than a year in protective care.
- The death of Antwuan Jr. in February, after he was found not breathing at the family’s home.
- Court records later showed that medical workers found Antwuan Jr. and his twin sister, Auqusia, suffered broken bones, bruises and bite marks.
Also last week, one of the physicians who made recommendations to the DHS after Ziarah Williams was abused chastised others involved in the case for ignoring her expert advice and sending the girl home. The chances of new abuse or even death were high in such a severe case, she said.
“Somebody failed to protect this child, and the other two who came along after her,” said Dr. Resmiye Oral, clinical director of the Child Protection Program at University of Iowa Hospitals.
Lawmakers plan probe of case
State lawmakers announced last week that they plan to investigate the case and work with the DHS to identify possible holes in the system. Sorci and Oral have said they would like to be at the table.
Still unanswered, however, is whether anyone - DHS workers, Ziarah’s court-appointed guardian ad litem, prosecutors - should be held accountable.
DHS Director Kevin Concannon has declined to answer more specific questions about the case until the father, Williams Sr., is tried for murder.
Leaders at the state agency and others in the child-welfare system reject the notion that the tragedy is a symptom that the new system is failing.
In fact, the defenders say, numerous signs suggest the system - once overwhelmed and broken down in the wake of another high-profile baby death in 2000 - is working better.
Caseloads for state social workers are smaller, visits to at-risk families have increased, reports of new abuse of children who have been in state care are down, and more families are involved in decisions.
“Of course, it was a terrible tragedy,” said Cory McClure, an assistant Polk County attorney who applauds the agency’s new approach. “It’s also a terrible anomaly.”
When a child dies, pendulum swings
Shelby Duis proved one child’s death can have a profound effect on an entire system. Highly publicized stories of the 2-year-old Spirit Lake girl’s horrific beating death in 2000 - despite numerous cries in her community for state intervention - triggered a statewide call for better child protection.
But Iowa’s already ailing system teetered toward chaos after thousands of additional anxious Iowans flooded the agency with more reports of abuse.
In 2003, state leaders directed the DHS to draw up a new system, but the caseloads of DHS workers and their helpers leapt even as the agency finalized its plan.
Scores of families also had begun to complain loudly that the DHS had adopted a take-the-child-first, ask-questions-later approach.
By 2005, petitions filed in juvenile court reached a high of 6,417, social workers’ 50-family caseloads were some of the highest in the country, and the federal government had given the state poor marks in several areas, but particularly for a failure to work with birth parents and failure to stop further abuse.
McClure, the Polk County prosecutor who often battled the DHS in court cases at the time, said families and lawyers resented the DHS because the state agency was bringing too many families to court.
The new system that emerged last fall attempted to shuffle thousands of less-serious cases of alleged neglect and abuse to private contractors and mediators, and insisted that formal court intervention be reserved for only the most serious abuse. The DHS centralized abuse-report intake and services in eight regions. More parents were invited to take part in meetings where the decisions about a child’s future were being made.
Freed from their heavy caseloads, DHS workers were to turn their attention to the most serious abuse - especially cases involving at-risk children under 6 years old.
Less than six months after some of the final changes to the system were implemented, however, concerns about the changes are reaching a fevered pitch.
Significant decline in court cases
State Sen. Keith Kreiman, Sorci and other advocates allege that the DHS is declining to initiate court action and remove children from homes where there is chronic methamphetamine use, domestic violence or further acts of abuse.
Instead, they say, some parents in those cases are being offered informal interventions that were supposed to be reserved for lower-risk cases. Although child abuse is founded - confirmed beyond a preponderance of doubt - workers are not taking emergency action or filing petitions that would trigger greater legal protection, Kreiman and Sorci say.
Statewide numbers of formal child-in-need-of-assistance cases filed in court for 2007 are not available, according to state court officials.
However, filings in Polk County - home to the state’s busiest juvenile courts - and other counties suggest formal court intervention in abuse cases has dropped off significantly. Last year 409 new child-in-need-of-assistance cases were filed - down 57 percent from the 951 cases opened in the county in 2005.
Woodbury County saw a 26 percent dip, from 485 new cases in 2005 to 358 in 2007.
The number of new cases in Scott County dropped more than 21 percent, from 231 to 182.
And the number of new child-in-need-of-assistance cases in Black Hawk County, where the Williams family lived, dropped more than 15 percent, from 155 in 2005 to 131 last year.
Vern Armstrong, a division administrator at the DHS, said the agency has weeded out many cases that never should have required court action. It also no longer has to initiate a formal court case just to offer services such as counseling or parental skills.
In Polk County, family meetings and mediation meetings are now being widely used to work with abusive or neglectful parents outside the courtroom.
“Now what happens is structured on the outcome of the abuse report, the age of the child, and the score on a risk assessment,” Armstrong said. “That determines whether the family becomes eligible for DHS involvement, community care (private services) or nothing.”
However, he said, the agency’s view of what kinds of abuse should trigger formal action - abuse that by law would require the involvement of a prosecutor, a lawyer for the child and a judge - has not changed. In fact, state statistics show the percentage of children who suffer new abuse after a first report is down - from 12.9 percent in 2004 to 8.2 percent in 2007.
Armstrong said it “might be possible” that some cases involving meth use had somehow avoided formal court intervention for a period of time. “But that would be an extreme rarity,” he said.
Oral and others say abuse cases at the state’s four abuse-detection centers are steady or climbing. But Susan Tesdahl, director of St. Luke’s Child Protection Center in Cedar Rapids, said she is concerned because the DHS slowly stopped ordering drug-detection hair tests in July for children whose parents are suspected drug users.
The center performed 132 of those tests in the first two months of last year. By February of this year, it had performed nine.
“We are really nervous about the lack of drug testing,” Tesdahl said. “About 25 percent of the kids we tested were under the age of 3. That’s the only way we’d ever know if the parents are exposing children to illegal drugs.”
More cases of lost rights
Federal regulators gave the DHS poor marks five years ago for failing to work well with families and failing to find permanent homes for children. Funding cuts were threatened if improvements weren’t made by the state’s next review, in 2009.
Sorci and some lawmakers now complain the agency is sending some children home to unsafe conditions and giving abusers too much sway to improve its marks.
Wendy Rickman, a DHS service manager who helped spearhead the redesign of the child-welfare system, rejects the notion that the agency has become too soft on families.
Terminations of parental rights cases - which typically involve the worst parents - have not declined. In fact, those cases actually increased about 17 percent in 2006, the first year of the redesign. State figures for 2007 were not available.
“We’re engaging families differently,” she said. “I think we needed to. We weren’t doing very well at that for some time.”
Yet Oral, who treats about 150 abused children annually, said she’s personally been involved in other cases in which child-welfare workers and judges have given abusers second chances when they shouldn’t.
“I don’t think we should push the pendulum too far toward family reunification,” she said. “When we have families we know are dysfunctional, we should acknowledge that and give a child an opportunity to be safe and alive.”
Does incentive help or hurt?
Social worker Bruce Buchanan of Des Moines and lawyer Sorci are among those concerned that success in the state’s new system is tied to money.
Firms that subcontract with the DHS, they say, now receive bonuses from $50 to $500 if no new abuse is reported; children are kept at home; or, if they are removed, children are reunified with parents or adopted quickly.
Armstrong said that the incentives are intended to help the DHS find more permanent homes for children, reunify more families, and better ensure the safety of children - areas where the DHS had been criticized before.
Some child advocates contend, but others disagree, that the practice could act as a disincentive, resulting in workers failing to check on children in unsafe conditions.
“They are required under law to report abuse, but now there is a financial incentive not to,” Sorci said.
The DHS also has contracted with a much smaller number of large umbrella organizations, which subcontract with smaller firms to provide services such as in-home monitoring and therapy.
Those big firms are paid about $470 monthly to meet all the needs of at-risk families, including the salaries of workers, transportation costs and other necessities if they are deemed necessary to keep the child safe.
At the same time, funding and services for any children over the age of 6 - no longer a priority in the new system - are hard to come by, many of those service providers say.
“This new system is limping and broken,” said Buchanan, a licensed social worker and therapist who treats older children and teens, and consults with several private agencies. “My fear is that many more children will be getting hurt.”
Legislation stuck in committee
Sorci, the Youth Law Center chief, drafted legislation this year that would have required the DHS to take formal court action in all founded abuses cases in which the agency finds there is a high risk of new abuse.
At least then, he said, judges would have to review the cases and a lawyer would be appointed to act in the best interests of the child.
He said he thought legislators would widely support the measure, but it never got out of committee.
Others say it’s too soon to tell whether sweeping action is needed to fix the state’s safety net.
Jerry Foxhoven, director of the Children’s Rights Clinic at Drake Law School, said the clinic represents children in about 100 cases annually and is seeing mostly positive results.
“I might have had one or two cases where I thought they gave these parents too long to work things out,” Foxhoven said. “But in those cases where they did that, they eventually did file a formal case.”
Rickman said the agency is doing its best to focus on safety, find more permanent solutions for children, and do more hands-on work with families. At its low point a few years ago, she said, 9 percent of families reported to the agency were seen by state workers on a monthly basis. Today, almost 60 percent of families see workers that often.
She says fewer court cases mean judges and prosecutors also have more time to review the most serious cases more often.
Tesdahl and others say more long-term data are needed before judgments can be made. Most of the biggest changes to the redesign were completed last October.
In the meantime, Kreiman, a Democrat from Bloomfield, said he hopes state officials and the Legislature are willing to take necessary action when the inquiry into Williams’ death and the system concludes.
He worries that the state hasn’t had the political will to make the safety of children a priority.
“I hope and pray that’s not the case after this tragic case,” he said.
Reporter Lee Rood can be reached at (515) 284-8549 or lrood@dmreg.com
