Child Abuse Deaths Prompt Massive Overhauls

Commissioner John B. Mattingly of New York City's Administration for Children's Services (ACS) recently issued a statement following the occasion of his 1-year anniversary at his post. Among the accomplishments trumpeted was the fact that his agency had “continued the historic decline in the number of New York City children living in foster care — passing the 20,000 mark, the 19,000 mark, and the 18,000 mark, to the current census of nearly 17,300.” Following publicity surrounding the recent deaths of several children in their homes after their families came under ACS's scrutiny — some of them reunited with those families after initially having been taken away and others who arguably should have been separated from their families, but weren't — the social value of this trend has come into question.

The children's stories are now familiar: 16-month-old Dahquay Gillians, once placed in the custody of his mother's relatives after his older brother was scalded by his mother's then-boyfriend, was returned to his mother's home where he drowned when left unattended in his bath. Seven-year-old Sierra Roberts, whose case came under investigated by ACS after doctors became suspicious that injuries she had suffered were signs of abuse, died of internal injuries allegedly sustained after her father beat her over a 2-day period; Nixzmary Brown, dead at the age of 7 after her stepfather allegedly beat her for eating a container of yogurt without permission; and 4-year-old Quachaun Browne, whose family ACS workers visited multiple times, was allegedly beaten to death by his mother's boyfriend after the child knocked over a television set.

To be sure, this is not a new problem. Although the deaths of these four children have garnered massive media attention, many children whose families are being monitored or investigated by ACS die of abuse each year in New York City. This recent spate of highly publicized cases, however, has spurred a push for changes within ACS and altered the pace of child/family separation activities.

Reforms Are Announced

After the deaths of Dahquay Gillians and Sierra Roberts, ACS conducted an internal review of its own handling of the two cases. When that report was completed, Commissioner Mattingly defended his agency's actions, saying, “What we have learned from this work is very similar to what we shared with the public when we announced that we would look into the practice in these cases — in the final analysis we cannot fault the original decision in either case to return the children to their parent.” He went on, however, to state, “[W]e now know from the reviews that there are particular areas of practice that we need to strengthen to improve our safety assessments of families and provide workers with the supports they need to protect children.”

As a result of these two investigations, ACS planned to alter its practices in cases involving reunification questions and other child welfare issues. Some of the initiatives announced were better education programs for staffers to enable them to assess and understand the effects of substance abuse on families, and improvements in communication between Family Court and case workers. ACS also announced it would improve reunification decisions by implementing the following changes: 1) Making pediatric medicine and mental health experts available to assess parents' readiness to take care of their children once reunited; 2) Reviewing ACS's policies for helping parents deal with substance abuse; 3) Expanding use of skills-based parenting training; 4) Conducting mental health screenings of parents before recommending reunification; and 5) Having Family Court review all reunification and adoption cases prior to discharge.

Still, less than a month after these reforms were announced, Nixzmary Brown's stepfather allegedly killed her. What came to light following this tragedy shocked the community: Nixzmary had suffered previous injuries that ACS workers were aware of, but their investigations did not lead to substantiation of abuse allegations. She had missed school repeatedly in the current and previous school years, but although ACS employees investigated the school absences in May of 2005 — 46 of them — they failed to find the child educationally neglected. Caseworkers had tried to visit Nixzmary's home in the month before her death and were refused entrance, but they never obtained the court order that would have allowed them access to the apartment. A caseworker was told to visit the child's home the evening of Jan. 10, but did not go until the morning of Jan. 11. When the caseworker finally did go to the home, an ambulance was there, and Nixzmary was already dead.

These lapses prompted a second round of reforms at ACS. Commissioner Mattingly announced that three Children's Services employees – two supervisors and a child protective worker from Brooklyn — would be suspended immediately without pay pending disciplinary hearings. Three additional employees were also disciplined and placed under new supervision. Further, several top-level administrators in the Division of Child Protection were reassigned to strengthen the management of the division.

Commissioner Mattingly also an-nounced a change with a broader impact: the creation of a new ombudsman unit. The office of ombudsman is meant to serve as a clearinghouse for information on child welfare cases, allowing city agencies and others concerned with child safety and welfare to coordinate and track progress in particular cases.

A few days after Commissioner Mattingly announced these reforms, Mayor Michael Bloomberg unveiled even more widespread changes, admitting that following the Nixzmary Brown case “the City must be honest about our failings and take steps to address them.” Among the changes to be made is the creation of a new position, Family Services Coordinator, to assist agencies serving children and families to resolve interagency problems. In addition, there are plans to hire 20 law enforcement personnel to work in field offices, helping with investigations and training child protective workers in effective investigatory techniques. Thirty-five new senior child protective managers will be hired to oversee the work of frontline staff and Children's Services will add 325 child protective workers to its roster. Finally, 32 attorneys will be hired to ensure that Family Court cases are more efficiently handled. The City plans to invest millions of dollars into these and other reforms.

The Mood in the Trenches

In 1995, the death of Elisa Izquierdo, a New York City child beaten to death by her crack-addicted mother, made child welfare reform a cause c'l'bre. Several newspapers took up her story, and Elisa's face was featured on the cover of Time magazine. Although far from the only the only child to die that year in an abusive New York City home, Elisa's tragic death became a lightning rod for change. Family Court proceedings, previously closed affairs, were opened up to the public, ensuring that shoddy child welfare case work, inadequate legal assistance and unsound judicial decisions could more easily come to light. At the same time, the emphasis in child placement decisions moved along the spectrum away from keeping families together at all costs and toward separating children from abusive and neglectful families. As Caroline Kearney, Family Law Coordinator at Legal Services of New York's central office noted, the Elisa Izquierdo case was a seminal event that led to the idea, “When in doubt, take them out.” Although never an official policy at ACS, this phrase summed up the general inclination of child welfare workers at that time.

Eventually, when the furor over the Elisa Izquierdo case began to die down, the pendulum swung back. Foster care, after all, is not always a happy solution and it is often fraught with similar dangers to those faced by children in their own homes. In addition, most children prefer to remain with their families even if those families are imperfect. Hence, Commissioner Mattingly's proud pronouncement that the foster care rolls are shrinking in recent years.

However, since the stories of the deaths of Dahquay Gillians, Sierra Roberts, Nixzmary Brown and Quachaun Browne broke, the number of removal hearings in Family Court has increased dramatically. Family Court Administrative Judge Joseph M. Lauria has said that the Family Court in Queens, which used to get about five new abuse or neglect cases per day, is now seeing 25. Four additional judges were assigned to Family Courts in New York City in February to help handle the new caseload.

Some child welfare advocates are concerned that any increase in the number of foster care placements may be an overcorrection. For example, Members of the Adoption and Safe Families Act (ASFA) Ad Hoc Implementation Committee — a group of parents, ACS workers, court personnel, attorneys, and academics — have seen and heard anecdotal evidence of a significant increase in the number of children being assigned to foster care and have determined to study the issue. The group recently sent requests out to parents' advocates and attorneys asking them to submit information to The Center for Family Representation if they are representing parents in cases that “would probably not have been filed in the past, or in which a removal would probably not have been sought” before the recent publicity. The group plans to use the information it obtains in a discussion with ACS, planned for March 6.

Says Kearney, a member of the (ASFA) Ad Hoc Implementation Committee, “If there really is a backlash issue, we want to discuss it and find out if it is a temporary one.” Her concern, and that of many others in the child advocacy field, is that some children who might have fared better at home will be taken away from their families because caseworkers feel that doing too much is better than doing too little; in other words, a return to, “When in doubt, take them out.” Judges will be overwhelmed with removal hearings and won't be able to concentrate as much time on other important aspects of Family Court practice, like adoptions. And, finally, Kearney fears that removal of children from imperfect homes may be no panacea for the problem of inadequate supervision of at-risk families; “If we overload the foster care system, we're going to see just as many oversight problems developing there.”

Commissioner John B. Mattingly of New York City's Administration for Children's Services (ACS) recently issued a statement following the occasion of his 1-year anniversary at his post. Among the accomplishments trumpeted was the fact that his agency had “continued the historic decline in the number of New York City children living in foster care — passing the 20,000 mark, the 19,000 mark, and the 18,000 mark, to the current census of nearly 17,300.” Following publicity surrounding the recent deaths of several children in their homes after their families came under ACS's scrutiny — some of them reunited with those families after initially having been taken away and others who arguably should have been separated from their families, but weren't — the social value of this trend has come into question.

The children's stories are now familiar: 16-month-old Dahquay Gillians, once placed in the custody of his mother's relatives after his older brother was scalded by his mother's then-boyfriend, was returned to his mother's home where he drowned when left unattended in his bath. Seven-year-old Sierra Roberts, whose case came under investigated by ACS after doctors became suspicious that injuries she had suffered were signs of abuse, died of internal injuries allegedly sustained after her father beat her over a 2-day period; Nixzmary Brown, dead at the age of 7 after her stepfather allegedly beat her for eating a container of yogurt without permission; and 4-year-old Quachaun Browne, whose family ACS workers visited multiple times, was allegedly beaten to death by his mother's boyfriend after the child knocked over a television set.

To be sure, this is not a new problem. Although the deaths of these four children have garnered massive media attention, many children whose families are being monitored or investigated by ACS die of abuse each year in New York City. This recent spate of highly publicized cases, however, has spurred a push for changes within ACS and altered the pace of child/family separation activities.

Reforms Are Announced

After the deaths of Dahquay Gillians and Sierra Roberts, ACS conducted an internal review of its own handling of the two cases. When that report was completed, Commissioner Mattingly defended his agency's actions, saying, “What we have learned from this work is very similar to what we shared with the public when we announced that we would look into the practice in these cases — in the final analysis we cannot fault the original decision in either case to return the children to their parent.” He went on, however, to state, “[W]e now know from the reviews that there are particular areas of practice that we need to strengthen to improve our safety assessments of families and provide workers with the supports they need to protect children.”

As a result of these two investigations, ACS planned to alter its practices in cases involving reunification questions and other child welfare issues. Some of the initiatives announced were better education programs for staffers to enable them to assess and understand the effects of substance abuse on families, and improvements in communication between Family Court and case workers. ACS also announced it would improve reunification decisions by implementing the following changes: 1) Making pediatric medicine and mental health experts available to assess parents' readiness to take care of their children once reunited; 2) Reviewing ACS's policies for helping parents deal with substance abuse; 3) Expanding use of skills-based parenting training; 4) Conducting mental health screenings of parents before recommending reunification; and 5) Having Family Court review all reunification and adoption cases prior to discharge.

Still, less than a month after these reforms were announced, Nixzmary Brown's stepfather allegedly killed her. What came to light following this tragedy shocked the community: Nixzmary had suffered previous injuries that ACS workers were aware of, but their investigations did not lead to substantiation of abuse allegations. She had missed school repeatedly in the current and previous school years, but although ACS employees investigated the school absences in May of 2005 — 46 of them — they failed to find the child educationally neglected. Caseworkers had tried to visit Nixzmary's home in the month before her death and were refused entrance, but they never obtained the court order that would have allowed them access to the apartment. A caseworker was told to visit the child's home the evening of Jan. 10, but did not go until the morning of Jan. 11. When the caseworker finally did go to the home, an ambulance was there, and Nixzmary was already dead.

These lapses prompted a second round of reforms at ACS. Commissioner Mattingly announced that three Children's Services employees – two supervisors and a child protective worker from Brooklyn — would be suspended immediately without pay pending disciplinary hearings. Three additional employees were also disciplined and placed under new supervision. Further, several top-level administrators in the Division of Child Protection were reassigned to strengthen the management of the division.

Commissioner Mattingly also an-nounced a change with a broader impact: the creation of a new ombudsman unit. The office of ombudsman is meant to serve as a clearinghouse for information on child welfare cases, allowing city agencies and others concerned with child safety and welfare to coordinate and track progress in particular cases.

A few days after Commissioner Mattingly announced these reforms, Mayor Michael Bloomberg unveiled even more widespread changes, admitting that following the Nixzmary Brown case “the City must be honest about our failings and take steps to address them.” Among the changes to be made is the creation of a new position, Family Services Coordinator, to assist agencies serving children and families to resolve interagency problems. In addition, there are plans to hire 20 law enforcement personnel to work in field offices, helping with investigations and training child protective workers in effective investigatory techniques. Thirty-five new senior child protective managers will be hired to oversee the work of frontline staff and Children's Services will add 325 child protective workers to its roster. Finally, 32 attorneys will be hired to ensure that Family Court cases are more efficiently handled. The City plans to invest millions of dollars into these and other reforms.

The Mood in the Trenches

In 1995, the death of Elisa Izquierdo, a New York City child beaten to death by her crack-addicted mother, made child welfare reform a cause c'l'bre. Several newspapers took up her story, and Elisa's face was featured on the cover of Time magazine. Although far from the only the only child to die that year in an abusive New York City home, Elisa's tragic death became a lightning rod for change. Family Court proceedings, previously closed affairs, were opened up to the public, ensuring that shoddy child welfare case work, inadequate legal assistance and unsound judicial decisions could more easily come to light. At the same time, the emphasis in child placement decisions moved along the spectrum away from keeping families together at all costs and toward separating children from abusive and neglectful families. As Caroline Kearney, Family Law Coordinator at Legal Services of New York's central office noted, the Elisa Izquierdo case was a seminal event that led to the idea, “When in doubt, take them out.” Although never an official policy at ACS, this phrase summed up the general inclination of child welfare workers at that time.

Eventually, when the furor over the Elisa Izquierdo case began to die down, the pendulum swung back. Foster care, after all, is not always a happy solution and it is often fraught with similar dangers to those faced by children in their own homes. In addition, most children prefer to remain with their families even if those families are imperfect. Hence, Commissioner Mattingly's proud pronouncement that the foster care rolls are shrinking in recent years.

However, since the stories of the deaths of Dahquay Gillians, Sierra Roberts, Nixzmary Brown and Quachaun Browne broke, the number of removal hearings in Family Court has increased dramatically. Family Court Administrative Judge Joseph M. Lauria has said that the Family Court in Queens, which used to get about five new abuse or neglect cases per day, is now seeing 25. Four additional judges were assigned to Family Courts in New York City in February to help handle the new caseload.

Some child welfare advocates are concerned that any increase in the number of foster care placements may be an overcorrection. For example, Members of the Adoption and Safe Families Act (ASFA) Ad Hoc Implementation Committee — a group of parents, ACS workers, court personnel, attorneys, and academics — have seen and heard anecdotal evidence of a significant increase in the number of children being assigned to foster care and have determined to study the issue. The group recently sent requests out to parents' advocates and attorneys asking them to submit information to The Center for Family Representation if they are representing parents in cases that “would probably not have been filed in the past, or in which a removal would probably not have been sought” before the recent publicity. The group plans to use the information it obtains in a discussion with ACS, planned for March 6.

Says Kearney, a member of the (ASFA) Ad Hoc Implementation Committee, “If there really is a backlash issue, we want to discuss it and find out if it is a temporary one.” Her concern, and that of many others in the child advocacy field, is that some children who might have fared better at home will be taken away from their families because caseworkers feel that doing too much is better than doing too little; in other words, a return to, “When in doubt, take them out.” Judges will be overwhelmed with removal hearings and won't be able to concentrate as much time on other important aspects of Family Court practice, like adoptions. And, finally, Kearney fears that removal of children from imperfect homes may be no panacea for the problem of inadequate supervision of at-risk families; “If we overload the foster care system, we're going to see just as many oversight problems developing there.”