Sunday, May 6, 2007
Arizona: State of willful ignorance
Last week, I was contacted by a reporter for the Arizona Daily Star, the
larger of two competing dailies in Tucson. He’d contacted me the week
before, acknowledging he was new to the child welfare beat and knew
little about the subject. This time he was calling because he’d gotten a
tip.
He’d been sent a memo showing that in Arizona, state
employees receive 30 cents an hour of their pay as an incentive bonus.
They lose that 30 cents if their agencies fail to meet certain goals
each year. The state human services agency, which includes child
protective services, needs to meet any two of the following three goals:
● Promote economic self sufficiency
● Safely reduce the number of children in out-of-home care (by less than one-third-of-one percent) [emphasis added].
●
Reduce the number of children and adults placed in institutions by
developing the capacity of extended families and communities.
I
told the reporter I certainly understood why this was newsworthy and why
he was calling, but I told him it also was a bit frustrating. I
explained that child welfare was a system filled with pervasive
incentives, financial and otherwise, and almost all of them encouraged
everyone in the system to do the wrong thing.
These incentives include:
● Bounties paid to the state by the federal government for every finalized adoption over a baseline number.
●Per diem reimbursements for private agencies, encouraging them to hold children, needlessly, in foster care.
●
Avoiding the risk of negative news coverage by taking away huge numbers
of children needlessly, since no caseworker ever has been attacked in
the press for taking away too many children, whereas such attacks are
common if a worker leaves a child in his own home and something goes
wrong.
● Avoiding firing, suspension, demotion or any other penalty
of any kind by doing the same thing. Though caseworkers often claim
they’re “damned if we do and damned if we don’t” that’s simply not true;
when it comes to taking away children, they’re only damned if they
don’t.
But reporters almost never write about these incentives.
In
our previous conversation, I’d told the reporter how Arizona was in a
state of perennial foster-care panic. Between 2002 and 2004, removals of
children had soared 40 percent - -and, as usual, this had left children
less safe. By 2005, deaths of children known-to-the-system had set a
record, as workers, overwhelmed with false allegations, trivial cases
and children who didn’t belong in foster care, actually had less time to
find children in real danger.
And, of course, as a result,
thousands of children needlessly were torn from everyone loving and
familiar; they were forced to endure the emotional devastation of foster
care and they were placed at risk of abuse in foster care; where there
probably is abuse in at least one foster home in three.
In most
states, after a year or two of foster-care panic, people calm down, look
around, say, in effect, “Oh, my God, what have we done to these
children?” and change course. But in Arizona, the foster-care panic has
never stopped. Children still are being taken at the same rate as when
the panic was at its height.
To counter the state of never-ending
foster-care panic, the financial incentives to take away children and
the non-financial incentives to take away children, the State of Arizona
offered one puny counter-incentive: 30 cents an hour, which also could
be retained by meeting other goals.
And to top it off: It didn’t
work. The incentives didn’t, in fact, reduce removals. There is no
evidence that the incentive, which required maintaining safety,
compromised that safety. But there is plenty of evidence that
foster-care panics, including the one in Arizona, leave children less
safe.
But one thing deeply disturbed the reporter: Why, he asked,
should there be any incentives at all in child welfare? Why can’t
workers exist in a state of noble purity, immune from all base
influences and able to make decisions based solely on what was best for
the children?
I told him that was a nice idea - but it could work
only if the public knew about all of the incentives and if policymakers
then were able to eliminate all of them. I pointed out that incentives,
good and bad, are a fact of life in every endeavor, including
journalism.
Reporters self-censor, avoiding stories they know
management hates, and pursue stories that appeal to editors’ interests
in order to curry favor. Or they work harder when they know there’s a
vacancy in a coveted bureau – or rumors of still another round of
layoffs. Or they work a little less hard if it’s the Friday before
vacation and they’re anxious to get out of the office - -just as a
caseworker may not make the extra phone call to find, say, a relative
with whom to place a child if she can just dump that child in a shelter
instead.
It’s human nature in journalism, child welfare, or any other line of work.
So
what could good leadership in a child welfare agency do about this?
They could try to repeal the laws of human nature and eliminate all
incentives. Or they could do everything possible to balance the
incentives, so workers are encouraged to do what’s best for the
children, and discouraged from doing anything else. That’s exactly what
Arizona tried, except the attempt at balance was so feeble, so pathetic,
that it changed nothing.
But readers of the Arizona Daily Star would learn none of this.
On
May 3, they would find, instead, a lead story headlined “CPS staff to
see pay cuts if goal is unmet.” They would finish the story left with
the impression that there existed one, and only one, incentive in child
welfare: The 30-cents-an-hour for goals that include safely keeping
families together. CPS did nothing to correct this misimpression (or if
they did, the reporter omitted it) saying only that the incentive would
not prompt workers to compromise safety. (Going only to CPS - an agency
nobody ever believes, often for good reason - is the standard way
reporters with an axe to grind give the illusion of presenting all
sides, without the substance.)
Readers probably weren’t alone in
being left in the dark by the Star story. Editors read what a reporter
turns in, not what he leaves out. So I don’t know if the reporter’s own
editors know about all the other incentives. At least one editor from
another part of the paper had no idea there were any financial
incentives other than the one in the story (and when I explained this,
didn’t much care).
It does not appear that the reporter explained
this to people he contacted for quotes, either. So it is no wonder the
story was filled with comments like this one from a legislator: “We’re
tipping the scales with performance pay,” he said. In fact, the
incentive did not tip the scales at all; rather it was a puny, pathetic,
failed effort to bring them back into balance.
And soon, even
that will be gone. You can bet that within a week a memo will go out
rescinding the incentive either in fact or by implication. And, of
course, the story itself will give one more kick-start to the
never-ending Arizona Foster Care Panic.
When I e-mailed the
reporter to complain about the omission of all mention of other
incentives, I discovered that in just a few days, his question about
“why are there incentives at all?” had morphed into a decree; a dictat
from which no dissent shall be permitted. He wrote:
You seem to
miss the point. It is not that keeping kids with the family is good or
bad. It is not that putting them in foster care is good or bad. It is,
rather, the issue of linking employee bonuses to outcomes. Those
decisions should be made based strictly on the best interest of the
children involved. Financial motivations, or even the perception someone
could be swayed by financial motivations, are inappropriate.
There are several problems with this.
For
starters, while such a comment is appropriate coming from a columnist
or an editorial writer, such pronouncements have no place coming from a
reporter. Whether financial incentives are or are not appropriate is
something for readers to decide - after being given enough information
to make an informed decision.
Second, the story deals with only
one kind of incentive - and since that incentive deals with only one
kind of outcome, keeping kids with the family, the story does indeed
deal with the issue of whether “keeping kids with the family is good or
bad.” Only a story which dealt with incentives in both directions could
be genuinely neutral on this point.
And third, by pressuring CPS
to abolish an incentive in one direction while leaving all the others
intact, the story does the opposite of the reporter’s own alleged goal.
Arizona’s vulnerable children are a large step farther away from a
system that makes decisions purely on the basis of best interests than
they were five days ago, because the scales are now father out of
balance. And that means, these children are less safe. (Of course, if
the reporter’s real goal was to encourage more foster care, then his
goal was accomplished; and I’ll leave for another day the whole issue of
defining best interests and what happens when the best interests of the
child conflict with the best interests of children.)
As it
happens, on the very day the Star story appeared, the need for balance
in incentives was illustrated, albeit indirectly, in a story in Tucson’s
other daily, the Tucson Citizen.
It reported on the trial of a
foster mother charged in connection with the death of her foster child,
Dwight Hill. Dwight died in November, 2005, within weeks of the death of
another Tucson area foster child, Emily Mays. These cases got far less
attention than the recent deaths of children in the same community at
the hands of birth parents. (Nothing new, there.)
Dwight was born
with cocaine in his system. He was confiscated at birth and parked at
the local parking place shelter. Then he was placed in a foster home
recruited and overseen by a private agency. They also were caring for
three other foster children, including two toddlers, and a birth son
with medical problems. The foster father listed his occupation as
unemployed, the foster mother listed hers as “foster mother” – raising a
question about financial incentives a lot bigger than 30 cents an hour.
Eleven
days later Dwight Hill was dead. According to the Citizen: “A Pima
County coroner's autopsy report indicated the baby died of blunt-force
trauma, bleeding in the brain and a fractured skull.” The prosecutor
said he died "in a way no person should have to endure."
The
foster mother says she has no idea how Dwight died and was not negligent
in getting him medical attention. That, a jury will decide.
But here’s what we do know:
There
was every incentive for the caseworker to confiscate Dwight at birth -
and no incentive for her to, say, fight extra hard to find a drug
treatment program where mother and child could live together, which
research shows is far better for a child’s well-being than even a good
foster home. There was every incentive to just dump Dwight at the
shelter – nothing could be easier, and no one would ever question it -
and no incentive to work extra hard to find a relative, if Dwight really
couldn’t stay with his mother. There was every incentive for the
private agency, paid for every day Dwight was held in foster care, to
push to keep him there as long as possible. There was every incentive
for that private agency to stuff as many foster children into that home
as the law allowed. And there was no incentive for anyone to ask if four
very young foster children and a disabled birth child were too much for
the foster mother.
This all happened before the state tried to
balance the scales with that tiny incentive to think more carefully and
work a little harder to keep children like Dwight and Emily out of
foster care.
So by the logic of the reporter who wrote the Star
story, the decisions to remove Dwight Hill from his own home and place
him first in a shelter and then in the foster home where he died were
perfect in their purity, utterly untainted by filthy lucre, and so, must
have been made solely based on Dwight Hill’s best interests. The same
must have been true with the decisions in the case of Emily Mays.
One thing puzzles me, though.
How was it in the best interests of Dwight Hill and Emily Mays to die?
Posted by
National Coalition for Child Protection Reform
at
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