NCCPR Child Welfare Blog News and commentary from the National Coalition for Child Protection Reform concerning child abuse, child welfare, foster care, and family preservation. Tuesday, October 5, 2010 Dept of DUH: Big new study finds CPS doesn't work Brace yourselves: this is bound to come as a shock. A big new academic study, published in the Archives of Pediatrics and Adolescent Medicine finds that when you send a child protective services investigator into a home where there's already a lot of stress simply because the family is poor and then pull the children aside and ask traumatic questions, possibly throw in a stripsearch, and inspect every nook and cranny of the home to see if it passes some caseworker's white glove test – it doesn't make things better, and sometimes makes things worse. They had to do a study to figure this out? In fact, as I told Time magazine's Healthland Blog, this study simply confirms what NCCPR has been saying for years: Child Protective Services won't be effective until it becomes Child Poverty Services. But contrary to what one of the study authors suggested this morning on WNYC public radio, that doesn't mean you have to eliminate poverty to eliminate child maltreatment – though whoever does the first will come closer than anyone else to doing the second. You can make enormous strides simply by ameliorating the worst effects of poverty. Some examples are in our publication Thirteen Ways to do Child Welfare Right. (The WNYC interview is worth listening to for the comments of the other guest, Mike Arsham, executive director of New York's Child Welfare Organizing Project.) Of course, the scenario I described above in which the investigator interrogates, stripsearches and then goes away, is far from the worst that CPS can do. In other cases, the parents will be forced to jump through a series of hoops either to keep their children with them or to get them back. It's almost always a cookie-cutter "service plan" almost always requiring lots and lots of "counseling" and "parent education" while the actual problems of poverty are ignored. So the "services" only add more burdens to this family. At worst, of course, the caseworker leaves with the child, throwing that child into foster care, and probably doing at a minimum, serious psychological damage to that child. Then, if the child is returned, the family has to heal from this, while it is still just as poor and just as stressed out as it was in the first place. So why, exactly, is anyone surprised that this doesn't work? It is a testament to the love and resilience in many poor families that only one of the many variables measured in this study got worse. A FEEBLE DEFENSE OF CPS One of the more feeble attempts to defend CPS came from one Janice Warren, DSW at the University of Virginia in Charlottesville, who told MedPage Today: "Many children are taken out of very dangerous living situations permanently based upon investigations conducted by CPS. CPS serves an essential front line of protection for the most vulnerable children in our society," In fact, very few of the 250,000 children taken from their parents every year are taken from "very dangerous living situations." That is clear from the results of many other studies, most notably two that compared more than 15,000 typical cases seen by CPS workers. Those studies found that children left in their own homes typically fared better even than comparably-maltreated children placed in foster care. That was true even when CPS agencies provided families with little or no help. In other words, when CPS traumatizes a family and then goes away, it doesn't do any good. When CPS traumatizes a family and compounds the trauma with needless foster care, CPS goes from doing no good to doing a great deal of harm. That doesn't mean no child ever should be taken from his parents; it doesn't even mean CPS should be abolished. We need an agency to protect the relatively few children in real danger. Rather it means that foster care is an extremely toxic intervention that must be used sparingly and in very small doses. SUGGESTIONS IN AN EDITORIAL The study was accompanied by an editorial which recommended some solutions. The editorial argued that law enforcement should handle allegations of "abuse" on grounds that all abuse is a criminal act, and public health nurses should investigate "neglect." But there are problems with arbitrary distinctions between abuse and neglect. For starters, you're going to ratchet up the largely pointless sideshow debate about corporal punishment if you start sending the cops in every time a parent is accused of spanking a child too hard. Conversely, though they are very rare, there are forms of neglect, like deliberately starving a child, which are criminal – and much more serious than some forms of abuse. And what do we do when there are allegations of both, either against the same child, or even an allegation of abuse against one child and neglect against a sibling? As for turning over some cases to law enforcement, nearly a decade ago, the State of Florida asked County Sheriffs departments to take over the investigative function of CPS workers. A few counties agreed. But nothing changed. The Sheriffs investigators made the same mistakes as the CPS workers, and rates of child removal generally didn't change. But there is a better way to achieve the goals the editorial is getting at: "Differential response" in which when the allegation of maltreatment, whether abuse or neglect, is less serious, the response is an offer of voluntary help. Differential Response is discussed in this previous post to this Blog. Differential response is somewhat different from what the editorial proposes. The editorial proposes using public health nurses, apparently based on the Nurse Family Partnership program. That is a very good program, but it is a primary prevention program, and it is strictly voluntary. In the cases discussed in the editorial, there's already been a report to a child protective hotline, and it is not clear if the editorial contemplates families having a right to say "no" when the public health nurse comes to the door. ERRORS IN THE ARTICLE There also are some disturbing errors in the article itself. ●Right at the outset, the article declares that "A CPS investigation, regardless of outcomes, signals a household at risk." No, it doesn't. It might mean the household is at risk, it might not. Given how easy it is to start an investigation it may just signal a household being harassed by a neighbor or a spouse harassing a spouse. Given the way calls to hotlines spike after a high-profile case is in the news, it might simply be that there was such a case in the news, and some well-meaning neighbor, or someone who saw the family in a store and didn't like what he saw, overreacted. Indeed, this University of Minnesota study (another study showing that comparably-maltreated children fared worse in foster care than when left in their own homes) also suggests that there may be very little if any difference between the impoverished families who come to the attention of CPS via neglect allegations and those who don't. It may be little more than random chance. ● There also is a claim that "Family preservation … services after investigation are not associated with reductions in repeat maltreatment or foster care placement." That claim is flat wrong. Indeed, few interventions have a stronger "evidence base" than real Intensive Family Preservation Services programs. That evidence of success is summarized in our Issue Paper on that topic. Posted by NATIONAL COALITION FOR CHILD PROTECTION REFORM at 12:57 PM Monday, October 4, 2010 Just what child welfare needs: One more conference! If there is one field that is over-conferenced, it's child welfare. Occasionally, someone comes up with a conference in which the information is genuinely new and useful. But I doubt you could throw a dart at a calendar without hitting a date that includes some kind of conference (or worse, a "webinar") somewhere in the country where all the same people gather to say all the same things.
But this would be no ordinary conference. This would be a White House conference, something that used to occur every decade or so. And we all know that White House conferences are to conferences as, say, a Mayoral Interagency Task Force is to a plain old, ordinary Interagency Task Force. Of course, the real difference between a White House conference and a plain old conference is that you get to meet in, I assume, the East Room, and get your picture taken with the President after he makes some opening remarks. After that, it's down to the usual keynote speeches, "breakout sessions" and plenary sessions where participants will learn that: ● Children are not a priority because they don't vote. ● Prevention costs less in the long run. ● We can pay now, or we can pay later. ● It takes a village. And, the real shocker: ● Children are our future. So, all in all, I think CWLA's proposal is – a great idea! In fact, I wish them all the luck in the world in getting their White House conference. Here's the way I figure it: CWLA already has expended a lot of time and effort trying to get this conference. Imagine what happens if they succeed: Just think of all the committees, subcommittees, steering committees and coordinating committees. All that time planning an agenda, lining up speakers, thinking up ideas for panels. Maybe there'll even be focus groups to solicit "input" from "stakeholders." In other words, it will keep the folks at CWLA and like-minded groups very, very busy. And the more time they waste on the conference, the less time they'll have to do actual harm – like undermine efforts at real reform of child welfare financing. So by all means, let's have a White House Conference on children's issues. In fact, let's do it every year! Posted by NATIONAL COALITION FOR CHILD PROTECTION REFORM at 8:54 AM Thursday, September 30, 2010 Foster care in Los Angeles: LA Times discovers civil liberties issues in child welfare – sort of "I was never told I could refuse their search, and the tone and level of authority of my attackers made me feel that it would be dangerous to even try." The quote comes from Darlene McDade-White, who says she was a victim of an illegal search by the Los Angeles County Department of Children and Family Services. Her story was told yesterday in the Los Angeles Times. When I saw the headline on Garrett Therolf's story about the case – "Child welfare official alleges warrantless search" – my first, fleeting, thought was: Wow, someone at DCFS is coming to McDade-White's aid and demanding civil liberties be respected in child abuse investigations - and the L.A. Times is covering the story! I was wrong on both counts. Darlene McDade-White is not a child who was, say, pulled out of her class and interrogated in the principal's office by a caseworker who suspected she'd been abused. She was a not a child who was stripsearched by a caseworker looking for bruises. Nor was she a child forced to undergo a terribly traumatic examination for sexual abuse based on someone's anonymous call to a child abuse hotline. Nor is Darlene McDade-White a parent whose child had to endure any of those things. Nor did she have to endure a warranteless search of her home by DCFS workers checking to see if there was enough food in the cupboards as they prepared to confuse poverty with "neglect." Indeed, it's highly unlikely that any of those things ever will happen to Darlene McDade-White, or anyone in her family. Because Darlene McDade-White actually works for DCFS. In fact, she's their lead internal affairs investigator. She's the "child welfare official" mentioned in the headline. McDade-White was a victim of a different kind of search. She says the allegedly illegal search was conducted by other DCFS workers. They searched her purse, allegedly looking for evidence that McDade-White might be the one who leaked information about child abuse fatalities to the Times. They found no such evidence. And that, of course, is why this search is the one that caught the attention of the Times. If the allegations are true, the harm to McDade-White is not trivial. But she is an adult. And the harm to her does not come close to the harm that unreasonable searches and seizures, based on no more than an anonymous call to a hotline, do, routinely, to children all over the country. That call is all it takes to send caseworkers to any home where they will demand immediate entry and the right not only to search the home, but sometimes the right to stripsearch the child looking for bruises. (Policies vary across the country – in some places the caseworker does it herself, in others the child may be taken to a doctor – but the child still will be stripsearched by a total stranger, they'll just call it a "medical exam.") That doesn't mean DCFS and its counterparts should stop investigating allegations of child abuse. It does mean that, as I've discussed before on this Blog, here and here, "children's rights" should include the Constitution's #4 – the one about being free from unreasonable search and seizure. In other words: At least meet the minimal standards required to get a judge to issue a warrant. Although the 9th U.S. Circuit Court of Appeals, which covers California, repeatedly has ruled, most recently last December, that warrants are required if parents don't give consent, (with the same exceptions as in criminal cases), there is no requirement to give families the equivalent of a Miranda warning. Indeed, what McDade-White said of her own situation, applies so perfectly to families confronted by DCFS workers that it's worth repeating: I was never told I could refuse their search, and the tone and level of authority of my attackers made me feel that it would be dangerous to even try. And unlike the situation with McDade-White and her purse, if a family says no to a warrantless search by a child protective services agency, the caseworker can call law enforcement, claim the case is an emergency and get the child removed on the spot. But those kinds of warrantless searches, which occur over and over in LA County, and everyplace else in America, never have attracted the attention of the Times. Apparently, Garrett Therolf and his colleagues are interested in violations of Amendment #4 only when they might impinge, even indirectly, on the Times' rights under Amendment #1. Posted by NATIONAL COALITION FOR CHILD PROTECTION REFORM at 8:33 AM Monday, September 27, 2010 Foster care in Florida: State's reforms are NCCPR's latest "Way to do Child Welfare Right" UPDATE, SEPTEMBER 28: Check out Sarasota Herald Tribune columnist Tom Lyons' take on Florida's improvement, and the waiver that did so much to make it possible. Today in child welfare, Florida stands for something else: It stands for openness, innovation, and progress. And it stands for the fact that you can't have child protection without family preservation. That's why today NCCPR adds the transformation of child welfare in Florida to our list of "Ways to do Child Welfare Right." Two changes were crucial: First, in the tradition of a "team of rivals," Gov. Charlie Crist, then a Republican, brought in one of the state's most popular Democrats, former Attorney General Bob Butterworth, to lead DCF. The joke at the time was that when Butterworth failed, Crist could blame the Democrats. If that was the plan, the joke was on Crist. For starters, Butterworth and his successor, George Sheldon (another Crist rival) started by dragging the agency out of its bunker, initiating a policy of telling the press and public as much as the law allowed, and interpreting all ambiguity in favor of openness. Butterworth also started listening to current and former foster children – for real, not for show. And that probably was the single most important factor leading him to reverse the agency's course and embrace safe, proven approaches to keep children in their own homes. Sheldon built on that as well. Most recently, he launched an initiative to try to make foster children's lives as normal as possible – that is, an effort to reduce barriers to living a normal family life that most of us don't even think about – like the difficulties in getting a driver's license or the requirement for background checks before a foster child can sleep at a friend's house overnight. THE WAIVER MADE A BIG DIFFERENCE But the Crist administration doesn't deserve all the credit. Former Governor Jeb Bush, who did so much to plunge the agency into chaos, also made one crucial decision that made recovery from his own mistakes easier: He accepted a waiver from federal funding restrictions. Money that, in other states, can be spent only on foster care, Florida can spend on better alternatives as well. (It's been argued that Bush's decision had nothing to do with enlightened public policy and everything to do with him wanting to help his brother, the former President. But who cares? It worked). It's all led to a 35 percent reduction in the number of children torn from their families between 2006 and 2009. Independent evaluations, required by the waiver, have found that child safety improved. If the Senate follows the House and approves legislation to restore the authority of the Department of Health and Human Services to issue such waivers, it will be easier for other states to achieve similar results. But there was one last barrier to adding Florida to our list. No state could be considered a national leader in child welfare as long as it banned fit, loving parents from adopting just because of their sexual orientation. The worst kept secret in Florida is the fact that the Crist Administration's DCF leadership hated that law, but it was not struck down by a Florida appeals court until last week. Florida still has a long way to go. It's a big state and not every region has gotten the message. So even with all the progress, the rate of child removal in Florida still was slightly above the national average in 2009, the most recent year for which data are available for every state. And, as with all good systems, there still are huge mistakes in all directions. Some children still are left in dangerous homes. Other children still are needlessly taken from their families. As we note in the publication we now call Thirteen Ways to do Child Welfare Right: All of the things that go wrong in the worst child welfare systems also go wrong in the best – but they go wrong less often. In addition, there is a powerful group of providers, advocates and others who still don't get it – people who actually view the take-the-child-and-run era as the good old days. And they never miss a chance to exploit the inevitable tragedies in a huge system to advance their agenda. But for now, Florida child welfare is heading in the right direction. And while other reformed systems had to significantly change direction to start doing child welfare right, for Florida it was even harder. In Florida it required a U-turn. Posted by NATIONAL COALITION FOR CHILD PROTECTION REFORM at 12:31 AM Friday, September 24, 2010 A win for kids: House passes child welfare waiver bill, allowing flexible use of foster care funds The House of Representatives passed legislation Thursday to restore the authority of the Department of Health and Human Services to grant funding waivers like the one that has helped Florida dramatically improve its child welfare system. How big a win is this? I'm not sure. Members of Congress want to get out of town to start campaigning as soon as possible, and I'm aware of no action at all on this in the Senate. But this is at least a small step in the right direction. The bill would restore HHS' authority to authorize a wide variety of waivers, but the most important are waivers like the one granted to Florida. That one allows the state to use all of the federal aid other states can use only on foster care for better alternatives as well. In exchange, Florida gave up the right to receive ever more federal money for taking away ever more children. So it's no wonder the child welfare establishment is not thrilled by this. In keeping with their approach of never say no, just "yes, but…" it to death, the Child Welfare League of America, the trade association for public and private agencies, many of which can't exist without a steady supply of foster children, and the Children's Defense Fund, which thinks we're still living in 1968 and can't conceive of anything that doesn't involve federal control and "entitlement" funding as being good, declared that "CDF, CWLA and others have concerns that extending waivers now will have a chilling effect next year on comprehensive child welfare financing reform." But what CWLA and CDF want is neither comprehensive nor reform. They want to keep the open-ended entitlement for foster care, and they want something called "delinking" which would eliminate the one small brake on that entitlement. (For details, see our report on child welfare financing.) Even were this a good idea – and it isn't – this is already in the deep freeze in Congress for one simple reason: At a time when any new spending is poison, this plan is not cost-neutral. The waivers, however, are. What CWLA, CDF and much of the rest of the child welfare establishment really fear is that more states will opt for such waivers and succeed, reducing needless removal of children from their homes – and putting at least a few private agencies out of business in the process. Or worse, from CWLA's point of view, Congress might see how well the waivers are working and simply offer the Florida option to every state without a complex waiver process. I suspect that's the kind of real reform the bill's co-sponsor, Rep. John Linder (R-Georgia) had in mind in his remarks on the bill: This bill comes to the floor in a fashion too many bills have not in this Congress: First, we held a subcommittee hearing; then the legislation was drafted with bipartisan support; and finally we ensured it does not increase the deficit by even a penny. It is an example of what can happen if we pursue in a bipartisan way goals that are widely shared, and that have been demonstrated to achieve real results.
Since 1994, 22 States have joined Florida in using child welfare waivers. This legislation extends the authority for all States to do so for 5 years. This will allow other States to test and replicate policies that are working. And it is my hope this will one day pave the way for successful Federal reforms covering all States. Meanwhile, let's move this bill forward and continue our efforts to improve the lives of all children. Actually, Florida's waiver wasn't the first, as that line about "joined Florida" may imply – but it is the only comprehensive waiver that applies statewide. Michigan initially accepted the same deal and chickened out at the last minute. Oh, and it was nice of CWLA to put that little "yes, but…" statement out yesterday morning, just hours after the website for Youth Today published an NCCPR Blog about how CWLA has impedes real child welfare reform. I'll have more news related to Florida on Monday. Posted by NATIONAL COALITION FOR CHILD PROTECTION REFORM at 8:36 AM Tuesday, September 21, 2010 Connecticut and CR are back in court over foster care. They're both wrong. AS THE TWO SIDES SQUARE OFF, NCCPR RELEASES A REPORT ON CONNECTICUT CHILD WELFARE, AND TEN SPECIFIC RECOMMENDATIONS FOR REAL REFORM
In 1991, three state child welfare systems signed consent decrees with the states that were suing them. Two of those decrees, in Alabama and Illinois, helped transform their states into, relatively speaking, national models. The third decree, in Connecticut, accomplished very little. The reason will come as no surprise to any regular reader of this Blog. The Alabama suit focused on rebuilding that state's system to emphasize family preservation. The Illinois suit ultimately did the same. But the Connecticut suit was brought by the group that so arrogantly calls itself Children's Rights (CR) – and we all know what that means. Connecticut is a state which, year after year, takes away children at a rate well above the national average, (and, at the moment, double the rates in Illinois and Alabama). It is a state so fanatical about taking away children that at least three times judges have blasted the state child welfare agency for deliberately misrepresenting cases in order get the courts to rubber-stamp removals. It is a state which has had at least two devastating foster-care panics since 1995 and may be on the verge of another. Yet CR's consent decree does nothing to force the state Department of Children and Families to stop taking away so many children needlessly. That guarantees a system that always will be overloaded, a system where none of the other serious problems will be fixed. Money isn't the problem. Connecticut spends on child welfare at one of the highest rates in the nation, a rate more than triple the national average. But it throws vast amounts of money away on needless foster care, and on the worst, and most expensive, option of all, group homes and institutions. Connecticut also ships hundreds of children to out-of-state institutions at a rate which, while not as atrocious as Rhode Island, still is horrendous. COURT HEARING TOMORROW Tomorrow, Connecticut DCF and CR are scheduled to be back in U.S. District Court fighting over the consent decree. DCF says they've made such magnificent progress implementing the decree that they should be let out of it. CR says the agency still is so wretched that it should remain under the latest version of a decree that dates back nearly two decades. They're both wrong. DCF does indeed remain a child welfare agency that does so much harm to the children in its care that some kind of court oversight is essential. But DCF won't change as long as the consent decree ignores the elephant in the room. What's urgently needed is a new consent decree – one that is focused on getting DCF to stop taking away so many children needlessly. All this is illustrated by a "friend of the court" brief filed by the Center for Children's Advocacy (CCA) at the University of Connecticut Law School and posted on the Ct. Mirror news website. The brief combines data showing that, when it comes to things like institutionalizing children and shipping them out of state, DCF's performance actually is getting worse, with heart-rending case examples like this one: "Maybe if you put my picture on flyers and post them on telephone poles, someone might see it, and decide they want me and will take me home," says Michael … Kind and generous and engaging and curious-all words to describe this eight-year-old little boy who sits at a SAFE Home - a group home for young children- waiting and waiting and waiting for a family to take him home. Michael first became the victim of abuse at the hands of his parent. After his mom's rights were taken away, Michael was placed in at least two different foster homes, split from his other 6 siblings. When DCF finally found the "home" Michael so desperately wanted, and the agency placed him in this adoptive home, his adopted dad sexually abused him and Michael found himself for a second time removed from his "family" and waiting for someone to provide him with the nurturing home he longs for. After months at the SAFE Home, anxiously waking up every day wanting to know if DCF had found another family, this time a "safe" one, DCF finally came through and placed him in a therapeutic foster home. But when Michael's behaviors became too much for them to take, they gave him back, "returned" him to DCF, like he was a piece of clothing to take back to the store. And so as of the filing of this amicus brief, Michael sits at the SAFE Home once again looking and waiting for that one person in this state who will call Michael his son. But the brief also illustrates why the current consent decree is doomed to fail. Over and over again, the authors offer only one alternative to the current mess in Connecticut: Recruit more foster homes. But no child welfare system in America ever has fixed itself simply by adding more foster homes. In Connecticut, as in most systems, the problem isn't too few foster parents, the problem is too many foster children. (The case of Michael illustrates part of the problem. His adoptive home was abusive and his foster home gave up on him.) But even if CCA believed that the real heart of the problem is that Connecticut takes away too many children, they couldn't say it in their brief. Because it CCA said that DCF needed to stop taking away so many children, DCF would immediately respond that no one has the right even to mention that issue in court - because it's not in the consent decree. So all sides have a vested interest in pretending the elephant in the room isn't there. REINFORCING STEREOTYPES The brief also reinforces the false stereotypes about families that poison the child welfare debate. ●The case examples feature only brutally abused children, even though they represent a small fraction of the cases seen by DCF workers. ● All children in the system are referred to as "abused and neglected" children "already traumatized by abuse, neglect and removal from the parent or guardian…" This is wrong as a matter of fact and law. Some children are in foster care for months before a court ever decides if there was any maltreatment at all. And for some children, they only trauma they suffered was the trauma of removal. ● Perhaps most disturbing, in discussing the problems of children who "age out" of the system at 18, the brief quotes a DCF document stating that the outcomes for these children may be "homelessness, arrests, hospitalization, [emergency room] visits, or return to the families from which they were removed." CCA then refers to all of these outcomes, equally, as "tragedies." Connecticut needs a whole new approach. For starters, the state's elected officials and DCF need to take steps to ensure the state doesn't endure still another foster-care panic, in the wake of a high-profile case in Torrington. Such panics plunged the system into chaos in 1995 and 2003 – the first time with what amounted to an endorsement of the panic from CR's founder and director, Marcia Lowry. Then the state needs to sit down with CR and radically reform the consent decree. What gets measured gets done – and right now efforts to curb entries into care aren't even measured. Illinois is successful because the two sides realized their original consent decree wasn't working and they came up with something better. In 2011, Connecticut will have a new governor and, almost certainly, a new DCF commissioner. That would be a great time to sit down with CR and start over. FOR DETAILS ON ALL OF THIS SEE NCCPR'S REPORT ON CONNECTICUT CHILD WELFARE. Posted by NATIONAL COALITION FOR CHILD PROTECTION REFORM at 6:19 AM Monday, September 20, 2010 Worse than foster care: Scandal at America's most famous orphanage Last April, I noted on this Blog an excellent series of stories in the Atlanta Journal-Constitution about the problems plaguing many of that state's latter-day orphanages. As one story reported: Fights. Sexual assaults. Consensual sex between young teens. Abuse by foster parents and group home employees. Escapes. Suicide attempts. All occur with regularity at many of Georgia's 336 private foster care agencies, the Journal-Constitution's examination found. But it's not just your obscure, run-of-the-mill orphanages that are plagued with problems. Every few years, a newspaper reveals big trouble at one of the model institutions – the very places orphanage advocates point to in support of their calls to warehouse children. ● In 2001, it was SOS Children's Village in Florida. The South Florida Sun-Sentinel revealed that between 1999 and 2001 33 reports were filed with Florida's child abuse hotline alleging abuse of children at the 50-bed facility; 21 were "substantiated" or "indicated." During the same time period 13 "house parents" and 14 "parent assistants" quit or were fired. (So much for that argument you always hear from orphanage proponents about how the places provide "stability.") ● Then came Maryville, one of the places to which media flocked after Newt Gingrich proposed throwing poor people's children into orphanages if their parents couldn't afford to raise them after welfare "reform." In 2002, the main campus at Maryville, near Chicago, was revealed as a place of terror for many of the children confined there, according to documents obtained by the Chicago Sun-Times. The newspaper reported that "the place is often up for grabs, with staff struggling to handle suicide attempts, sex abuse, drug use, fights and vandalism…" In 2001, police were called to Maryville 909 times. In 2004, Illinois pulled all 270 state wards out of Maryville – something it could do because it had done such a good job of reducing needless foster care. In Illinois, substitute care no longer is a "sellers market." ● And now scandal has reached the very pinnacle of American orphanages – the very place Gingrich himself cited as the perfect place to stash poor people's children. The Omaha World-Herald reports that the State of Nebraska has suspended admissions to two programs at Boys Town. The reason: "investigators found staffers improperly restraining and isolating children." According to the World-Herald: "Staffers at a Boys Town National Research Hospital program, for instance, sometimes placed children face down on gurneys and locked them into place with belts. They used the practice, which has been discontinued, to prevent children from harming themselves and others." The story also reports that "A program director at the hospital reported 19 times in the last year that drugs were used to calm patients, although Boys Town says it doesn't use drugs." A Boys Town official said the state must have misquoted the program director. The decision to suspend admissions is all-the-more remarkable since it was made by the state child welfare agency in Nebraska. There may be no child welfare agency in America more in love with taking away children and holding them in foster care. When NCCPR compares states we compare entries into care and the number of children in foster care on any given day. And we use both the fairest method, comparing to impoverished child population, and comparing to total child population. Year after year, only one state is among the three worst states in all four catagories: Nebraska. Will the problems at these particular programs be fixed? Sure. Boys Town will implement a "corrective action plan" and the programs will clean up their acts – just the way SOS and Maryville did. And things will be fine. For awhile. But when you're dealing with a population that is either hated or feared that is out of sight out of mind, sooner or later things will deteriorate again. And no corrective action plan can correct for the fact that institutionalization is inherently harmful and almost always unnecessary. In the meantime, if what that program director reportedly said is true, perhaps Boys Town needs to change its famous slogan. How about: "He's not heavy, he's overmedicated!" 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