An audit released Aug. 23 by Lehigh County Controller Mark Pinsley and testimony from roughly 30 Lehigh Valley parents (see accompanying article, “Lehigh County calls out child protection problems”) brought to light the costs of the way Child Protective Services (CPS) operates today. A series published in the Bethlehem Press in 2022, “When child protection goes awry,” described some of the ways in which the current system fails families.

Noise in the system

The passage of the Pa. child laws passed in the wake of Jerry Sandusky’s arrest on serial molestation charges dramatically increased the number of reports of child abuse and neglect filed each year. From 2006 through 2014, the annual number of reports ranged from roughly 23,000 to 29,000; in 2015, more than 40,000 reports were filed. The number of reports has stayed in the range of 38,000 to more than 47,000 in the years through 2021.

Data collected in the aftermath of “child abuse panics” in the 1990s and 2000s in Florida, Illinois and New York demonstrate that a lower threshold for calling CPS results in more abuse-related deaths, perhaps because the increased caseload makes adequate investigations impossible for CPS workers.

Epistemological bias

Epistemology is the study of what distinguishes justified belief from opinion. When choosing whom to believe about child abuse allegations, CPS often demonstrates epistemological bias, whether it is the lower bar for hospital-based abuse referrals of black parents found in a 2022 Stanford University study, or the removal of children on “medical child abuse” grounds based on the judgment of a child abuse pediatrician without input from medical specialists.

Our first 2022 article, “Allegations of ‘medical child abuse’ can wreak havoc on innocent families,” started when a member of the Feeney family contacted the newspaper about her family’s situation and the MCA accusations against her mother. Both Willow and Hazel Feeney do have complex medical conditions and have been treated by specialists for years, but were nevertheless taken away from their parents when CPS authorities acted on the opinion of a CAP instead of seeking confirmation or refutation by a specialist in the children’s conditions.

Mistaking poverty

for neglect

Although the 1962 papers underpinning today’s CPS edifice - C. Henry Kempe’s “The Battered-Child Syndrome” and Helen Boardman’s “A Project to Rescue Children from Inflicted Injuries” - focused on sexual and egregious physical abuse, the main reasons for removal in Pennsylvania are related to allegations of neglect. And what looks like neglect, such as an inadequate housing situation, can be a symptom of poverty.

In 2022, Pa. Partnerships for Children reported data - for the first time ever - about reasons for removals in the prior year. The top five reasons Pa. children were taken from their parents were parental drug abuse, neglect, “caretaker’s inability to cope,” inadequate housing, and the child’s behavioral problems. And medical child abuse? The spate of medical child abuse (MCA) allegations in the Lehigh Valley over the past several years is statistically anomalous, given the extremely low incidence of MCA allegations in other areas of the state.

Pulled into a

broken system

The scope of the state’s foster care system is massive, according to data from the federal Adoption and Foster Care Analysis and Reporting System. More than 21,000 children - nearly one percent of the state’s child population - spent time in the foster care system at some point during fiscal year 2021. Of the 13,664 children who were in the system Sept. 30, 2021, 10 percent were living in group homes or institutions. Of the 7,804 children who left the system during FY21, 10 percent “aged out” - a process AFCARS euphemistically terms “emancipation” - and 1 percent ran away. Twelve Pennsylvania children died while in the foster system that year.

Several studies, including three very large studies performed by MIT professor Joseph Doyle, demonstrate poorer outcomes for children raised in foster care, compared with peers from similar biological family situations whose families were preserved. Doyle’s research focused on the “marginal” situations in which the mindset of the assigned investigator - strict or lenient - essentially determined whether parents lost their child to the system. In these situations, kids who stayed home did better over the course of their lives than kids who were removed by the government.

Our second 2022 article, “Unjust family separations harm innocent children,” focused on the trauma suffered by parents and children alike when unjust separations persist for months or even years. Some children have spent most or all of their first year of life in “the system,” with family bonds weakening and milestones like first steps going unrecorded and uncelebrated.

Alternatives

to the status quo

There are alternatives to the way the child protection system currently operates in most states. One example is the Family Representation Project at Legal Services of New Jersey. Through the FRP, caseworkers from the Division of Child Protection and Permanency refer families to LSNJ before filing a petition for child removal - at a time when LSNJ attorneys can help remove family preservation obstacles such as pending evictions, immigration status issues and welfare denials.

In Lehigh County, parents are asking for the mandatory inclusion of testimony from doctors with expertise in specific health conditions - rather than relying solely on the limited expertise of child abuse pediatricians - during child protection investigations. Controller Mark Pinsley recommends that an opinion outside a referring hospital be sought, rather than following the current circular process that allows - for example - physicians at the Child Advocacy Center to review the allegations made by their own Lehigh Valley Hospital Network colleagues.

Our third 2022 article, “How should the system work, and what changes are needed?” examined the legal underpinnings of current CPS practice, and found that much of what currently happens has a shaky foundation. Seton Hall Law School Professor Solangel Maldonado and UNC Law School Professor Maxine Eichner both noted that the state is supposed to respect parents’ right to seek appropriate medical care for their children.

“When there is a disagreement among physicians,” Prof. Maldonado explained, the parents should decide […] The state is supposed to intervene as little as possible.”