To the End of June : The Intimate Life of American Foster Care (9780547999531) (11 page)

Within these generalized descriptions, there are thousands of subtleties and examples of various other kinds of racism threading their way through child welfare. Most of it isn't intentional or centrally located in one “bad” child welfare director, or organization, or design flaw. It's akin to the criminal justice system, which is also disproportionately filled with people of color—and where, again, experts argue about the sources of disparity. Is the root problem there one of poverty, inequitable opportunities, institutionalized racism, or one giant pileup of minor discriminations? Again, the answer is yes, yes, yes, and yes.

Another way to look at race and foster care is to look at money, because this is one area where the numbers match. African Americans accounted for two-fifths of the 558,000 children in foster care in 2000, which is similar to the proportion of all poor children who are African American (40 percent). In other words, African American children are represented in child welfare in comparable proportion to their distribution in low-income families.
And the National Incidence Study (NIS) for Child Abuse and Neglect, which gives the most comprehensive estimate of all cases, has unequivocally determined low income to be a strong risk factor for all forms of maltreatment.

In the eighties and nineties, the NIS studies consistently reported that African American parents do not abuse their children any more than white parents do. In fact, they found no significant differences in the incidences of abuse and neglect across any ethnic or racial lines.
But then, in 2010, the NIS produced its most comprehensive report yet and something shifted: it found a 73 percent higher rate of black maltreatment over white.
Chapin Hall Center for Children, a major progressive policy research center, released an issue brief on both these findings and cosponsored a conference with Harvard University on race and child welfare. Although the brief addressed the potential of racism in foster care, the authors mainly attributed the disproportionality in maltreatment to the disproportionality in poverty among blacks and whites. It's time, they said, to stop trying to reduce the numbers of African Americans in care because we presume there's a bias and instead focus on the
reasons
the numbers are so much higher and direct help toward the families that need it.
If poverty and its attendant burdens—depression, anxiety, drug use, heightened community violence, paucity of support systems, and so on—can sow the seeds for child abuse, then child welfare needs to go back to prevention. But this is a tall order for one sprawling and splintered administration, which has always been reactionary: it treats symptoms, not disease. The solution, as it has always been, is bigger than foster care, bigger than abuse; the real solution will be rooted in society as a whole.

 

This kind of perspective shift, on a smaller scale, has been a rallying cry for drug-using mothers too; rather than just calling in foster care and removing a baby at delivery, we could pan back and treat the addiction. We could see addiction as a health issue, rather than a crime.

This would be an important change, because drug testing largely spotlights the substances that harm adults—not the ones that harm the infants. Alcohol, for instance, is not illegal and it won't turn up in a drug test, but it is one of the most dangerous substances for a fetus.
The so-called crack babies, on the other hand, have grown up—and the dire predictions about them proved false. A review in the
Journal of the American Medical Association
of thirty-six studies that looked at physical growth, cognition, language and motor skills, behavior, attention, affect, and neurophysiology found
no connection
between prenatal exposure to cocaine and a decrease in functioning.

Dr. Barry M. Lester at Brown University is a principal investigator for the largest longitudinal study on cocaine-exposed babies (thousands of these babies are now in their late teens),
and he's working with the National Institute on Drug Abuse on a similar study looking at babies and meth. At a conference in 2009, Dr. Lester said that they'd tracked around 450 babies (half meth-exposed and half drug-free) for the previous three years, and so far no substantial differences had emerged.
In fact, meth-exposed infants exhibit many of the same characteristics as cocaine-exposed babies, Lester said: at birth, these babies can have some difficulty feeding, then they seem to even out symptom-wise for a couple of years. I spoke with Dr. Lester a few years after the conference, when the kids in the meth study had hit five years old. By this time, just like the kids in the cocaine study, the kids started showing poor inhibitory control,
which means that they acted out more and didn't always know how to stop themselves.

“We see this when they go to school, probably because there are more demands put on them there, and because their failure in behavior control becomes more obvious,” Dr. Lester said. And he contextualized the findings further. “Yes, there are drug effects, but they aren't of the magnitude everyone thought they would be; they're much more subtle—on the order of ADHD.”

Lester's studies subtract for factors like poverty and foster care, so that only prenatal drug exposure is considered. This means he can add back in, for instance, a child's experience with child welfare to see how that affects the developing brain. “Out-of-home placement is one of the factors that seems to ride along with drug exposure, in terms of affecting the prefrontal cortex and poor inhibitory control. It's sort of a double whammy,” he said. That's why he doesn't think we should be legislating automatic removals in the delivery room. “We're seeing an escalation in the legislation getting more punitive with meth. We already learned this with all the research on cocaine—that addiction is a mental health disorder. There's plenty of evidence that it's treatable. There's also plenty of evidence that mothers who use can be adequate parents. Of course, some are not adequate parents, but then there are also mothers who don't use who are not adequate parents either.”

One final troubling statistic is that the newborn drug tests are
wrong
on average more than 25 percent of the time. A study by the U.S. Substance Abuse and Mental Health Services Administration and the American Association for Clinical Chemistry found that initial urine screenings can produce false positives. Even tests on a baby's first stool (long considered the gold standard in drug testing) can be wrong up to 70 percent of the time.

I'm not suggesting that doctors shouldn't be looking for signs of use of drugs like meth or cocaine in the hospital. But the American College of Obstetricians and Gynecologists, even as a moderate and mainstream voice in the medical establishment, has come out against newborn drug testing. It endangers critical trust between a mother and her obstetrician, the College claims, and mandated reporting can conflict with the therapeutic obligation. Patients have the right to informed consent and bodily integrity and shouldn't be tested for anything against their will or knowledge. And as for the business of states penalizing women for their behavior during pregnancy: it's a slippery slope, as all sorts of things (drug use, poor nutrition, prescription medication, depression) can affect a baby's health too. Punitive policies discourage prenatal care, the lack of which also harms children—the very thing the drug laws were designed to prevent.
Addiction, they say finally, is a disease and not a moral failing.

Robbyne and Doreen lived in a city, and an era, when using drugs could get your children removed but wouldn't necessarily land you in jail. Now, in twenty-five states, it's a crime to expose children—not just the fetus—to illegal drug activity, such as narcotics possession, sales, or manufacture. For example, it's a felony to possess any controlled substance in Idaho, Louisiana, Alabama, and Ohio in the presence of a child. Also, crystal meth has eclipsed crack cocaine as the most highly legislated drug, and fourteen states have singled out the manufacture or even possession of methamphetamines around children as a particular felony.

The trouble with this is what happens to the children in such cases: the children go into foster care because the parents go to jail, and the parents don't receive treatment for what many still consider to be a health issue, rather than a criminal issue. Drug treatment in prison is notoriously worse than what parents can receive on the outside. And if they're afraid they'll be locked up and have their children taken away, parents aren't likely to ask for help early on.

In states where drug use isn't criminalized as child abuse, many child welfare agencies are connecting with drug rehabilitation programs and referring or court-ordering parents into rehab. Studies have shown that parents who are given treatment earlier, in settings they can easily access, are more likely to be reunited with their children than parents who don't receive treatment.
And women who keep their kids complete treatment at a higher rate.

In one way, this is obvious: better drug treatment yields better parenting. If you're a mom who's using, you probably know you need help—and many mothers want it. Some don't, or won't, or can't, accept treatment for reasons that range as wide and as deep as the range of human frailties: there's mental illness, there's ego, there's community and loyalty and loss in the network of drugs, and there's the protection drugs afford, the scabbing over of one's own early traumas and scars. But if you live in a state where you're going to be charged with child abuse for your addiction, or you know your kids will be taken away if you show up at a treatment site, you're stuck regardless. You have to try to get sober alone (which has disastrously low success rates) or continue raising your kids while using drugs on the side.

For this sole reason, Robbyne is grateful that her children were removed; even after her son was taken at birth, she couldn't get clean on her own. Once the children were gone, though, she continued to use for some months, and then missed them terribly. Unlike Doreen, who had landed a prison sentence, Robbyne could enter rehab and regain her kids.

For six months, Robbyne lived in a residential drug treatment program. She faced down her depression, memories of sexual abuse in childhood, and the trauma of a car accident—all of which she felt contributed to her addiction.

After Robbyne graduated from the treatment program, she fought to get her children back, but with the delays in child welfare and family court systems, it took another two years for her oldest two to come home. Caiseem, the baby, wasn't returned until the following year. Robbyne, sober and determined, visited her kids at the agency regularly while they were in care; once, she saw a foster mom slug Bacardi straight from the bottle as she dropped them off. Robbyne demanded a new placement. Her daughter complained of sexual abuse; Robbyne called an emergency meeting on that case, and her kids filtered through several homes. It was torture to watch her kids leave with strangers she felt were dangerous.

And at that time, Robbyne said, there weren't the kinds of programs and support available to parents that there are now. “I can honestly say that I needed that time to get me together,” Robbyne told me, leaning forward on the cane she still uses to walk. Robbyne is short, a good three inches shy of five feet, and the day we met she wore a pink sweater and big gold hoop earrings with another gold circle on a chain around her neck. Much about Robbyne connotes roundness—her jewelry, her body type, her cheeks that plump upward when she smiles. Her manner is soft and open, and her many Facebook pictures show her grandchildren piling on her lap or snuggling in her neck. She's a young grandmother, her hair still dark and her skin still young, and she looks blissful in the role. “But if I'd had support groups and parenting groups or people to come into my home and help me and not be afraid they were going to take my kids if I said something—” Robbyne choked up and looked down at her hands. “If there was more support, I could have done it with the children at home. But the way things were back then, there was no option but removal.”

Robbyne says there are better programs now, and she works for CWOP, the nonprofit organization that didn't exist when her kids were taken. CWOP provides biological parents who have kids in care with support groups, parent training, and advocacy. CWOP also created the first parents' advisory group to the commissioner of ACS, so that for the first time ever, biological parents had some say in the system. ACS now has a division devoted entirely to preventive services—though the budget has been cut, then reinstated, always on less stable funding grounds than direct foster care
—so when a child's situation is determined to be somewhat risky but not bad enough to warrant removal, ACS caseworkers can suggest, and even fund, certain protocols. They can identify the treatment programs or support groups Robbyne had wished for, and then follow up sometime later, so the kids can stay at home. But many parents are hard-wired to panic at the mere mention of ACS, and much of Robbyne's job is devoted to reeducation.

“There are moms out there who are too afraid to get help because they're too scared of ACS: they think ACS is out to get them,” she said. “A lot of parents are unaware of how much the system has changed. I have to tell them—it really has changed.”

Or this is the idea. Of course, kids are still removed all the time, and determining a child's risk and a parent's commitment to improvement is entirely subjective, dependent on a caseworker's personal experience and perception. In the case of drugs, even Robbyne knows there's a lot of gray area. Some parents, she says, can't or won't get better. “But most parents just need help when drugs overpower them, and I want them to know they don't have to be as afraid as before. People are listening to us now.”

 

Because drugs and alcohol are such potent plot points in the saga of child welfare, people often give them more stage time than they deserve. Even when drugs aren't the obvious problem in a family's life, judges and lawyers assume that they are.