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Justina Goes Home!

2014 June 18
Posted by ethoma

COMMONWEALTH OF MASSACHUSETTS

JUVENILE COURT DEPARTMENT

SUFFOLK, SS.

BOSTON DIVISION

DOCKET NO.: 13CP0034BO

IN RE: CARE AND PROTECTION OF

JUSTINA PELLETIER

ORDER ON PETITIONS FOR REVIEW AND REDETERMINATION

In consideration of the evidence presented in the assented-to petitions for review and redetermination, this court finds:

1. Following the disposition order of March 25, 2014, Justina was placed on May 12, 2014, by the Massachusetts Department of Children and Services (“MA DCF”) at the Justice Resource Institute Susan Wayne Center for Excellence (“JRI”) in Thompson, Connecticut.

2. JRI has proved to be an excellent placement in which Justina and her family have received necessary and appropriate support and services working towards the goal of Justina’s return home. Services have included individual therapy for Justina several times per week, family therapy, medical care, recreational activity, occupational therapy, and physical therapy. Justina returned to school full-time and is engaged and excited to be in the classroom.

3. Since placement at JRI, Justina’s parents, Linda and Lou Pelletier, have been cooperative and engaged in services. A structured visitation plan was initiated immediately. Family members have visited Justina daily. Visits progressed well and were increased to extended, unmonitored visits off the JRI campus.

4. The West Hartford Schools Department convened a meeting on June 6, 2014, and created a comprehensive special education plan for Justina. The individual education plan includes small group and individual classroom instruction, occupational therapy, speech/language therapy, physical therapy, and individual counseling. These services will be put in place immediately upon Justina’s return home.

5. JRI collaborated with Justina’s family, MA DCF, and other collaterals in developing an appropriate plan identifying the necessary support and services for Justina’s return home. The plan addresses medical care and case management, daily access to special education services, individual therapy, and family therapy. Most of these services are ready to begin immediately and others very shortly. I credit the opinion of the director of JRI that with the many qualified, trained professionals assisting in Justina’s care, should an urgent situation arise, there will be immediate assessment, intervention, and support for Justina. It is a solid plan for Justina and her family that addresses Justina’s complex needs.

6. I find that the parties have shown by credible evidence that circumstances have changed since the adjudication on December 20, 2013, that Justina is a child in need of care and protection pursuant to G.L. c. 119, §§ 24-26. Effective Wednesday, June 18, 2014, this care and protection petition is dismissed and custody of Justina is returned to her parents, Linda and Lou Pelletier.

Joseph F. Johnston, Justice

Juvenile Court Department

The Harvard Web of Empire: Part II

2014 June 10
Posted by ethoma
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It seems that the game of political hot potato that’s been played with a young girl’s life hanging in the balance may finally be coming to an end. The Boston Globe reported yesterday that the state “has filed a motion in court that would allow Justina Pelletier, the Connecticut teenager in a long-running custody dispute, to go home, according to a lawyer for the girl’s parents.”

The Globe cited Alec Loftus, a spokesman for the Executive Office of Health and Human Services, as having issued a statement, saying, “We are pleased that the family has engaged around the reunification plan and we have filed papers in court to support our shared goal of bringing Justina home.”

Boston’s WCBV News Center 5 started off its program last night with a teaser for the overage it provided on its news broadcast.

The broadcast features a video posted by the Pelletier family on Youtube on Sunday night, one in which the world for the first time hears the young girl speak for herself. “Pelletier begged Gov. Deval Patrick and the judge deciding her fate to let her go home to her family,” the broadcast explains.

“All I really want to be with is my family and friends,” Pelletier said. “Right now — you can do it. You are the one that’s judging this. Please let me go home Judge Johnson and Gov. Patrick please right now, please let me go home right now. I need to be home with my family. I know you can do it. Please right now, I need to be home right now.”

The coverage has become international in scope, and now includes reporting by many credible mainstream papers such as The Wall Street Journal.

This is the most promising result yet obtained. The only apparent obstacle in the way at the moment would be Judge Johnston, who may decide to create an additional delay, or, heaven help us, to deny the motion. He hasn’t exactly offered to roll out the red carpet by expediting the hearing, which is set to be heard on the 20th.

The Case that Shouldn’t Have Been

This much is certain. Justina Pelletier should never have entered the system to begin with. The Supreme Judicial Court of Massachusetts ruled that: “The courts are not to determine which side of a medical dispute is sound where each side is supported by reason and logic.” Sevigny’s Case, 337 Mass. 747 (1958). That legal precept is as sound today as the day that it was written. And, whether Judge Johnston likes it or not, that law is binding on the decisions that he makes.1

More to the point, the Massachusetts high courts have ruled time and again that:

The law has firmly established that parents enjoy a fundamental liberty interest in the care, custody, and management of their children, an interest that does not simply end when they become something less than ideal caretakers. To find a child in need of care and protection, there must be an affirmative showing of parental unfitness. Parental unfitness, in this context, means more than ineptitude, handicap, character flaw, conviction of a crime, unusual life style, or inability to do as good a job as the child’s parent. Rather, the idea of parental unfitness means grievous shortcomings or handicaps that put the child’s welfare much at hazard.2

High courts in Massachusetts have held also that the issue for determining parental unfitness is not “whether the parent is a good one, let alone an ideal one; rather, the inquiry is whether the parent is so bad as to place the child at serious risk of peril from abuse, neglect, or other activity harmful to the child.” Care & Protection of Bruce, 44 Mass.App.Ct. 758, 761 (1998).

These decisions apply not just to terminations, but to transfers of custody as well. Is there anyone in their right mind that honesty believes that any among the Pelletier family fits the above descriptions?

To be sure, there does exist a small minority of vocal critics who grasp at every straw to discredit the family – sinking so low as to try to discredit Justina’s reports of maltreatment in state care. One of the techniques that these individuals use is to treat the case as if it exists in isolation, which it clearly does not.

Mass Legal Services – which describes its organization as providing an “Online Resource for Massachusetts Poverty Law Advocates,” describes the Connor B. v. Patrick class action lawsuit as alleging that the Massachusetts Department of Children and Families “violates the constitutional rights of children by routinely placing them in dangerous and unstable situations once removed from their parents’ care and fails to take necessary actions to meet the legal and moral obligation of the state-run child welfare system to ensure the safety and well-being of children in its custody.”

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According to the highly-detailed civil complaint, crafted by Children’s Rights, Inc., the Massachusetts foster care system “is causing physical and psychological harm to the abused and neglected children it is mandated to protect. The myriad systemic defects afflicting the Massachusetts foster care system have long been known to Defendants, who are responsible by law for the approximately 8,500 vulnerable children and youth currently in state foster care. Defendants are failing to take the necessary action to discharge their obligations to ensure the safety and well-being of the children taken into their custody.”

There are those among the vocal minority of critics that point to the violation of Judge Johnston’s gag order as evidence of wrongdoing. Nothing could be further from the truth. The Supreme Judicial Court of Massachusetts arrived at the occasion of reviewing the constitutionality of a gag order imposed on a father by a juvenile court judge, arriving at the conclusion that the

order was and is an unlawful prior restraint on the right of the children’s father to comment on the judicial proceedings and on the conduct of the department. The department has not identified a compelling State interest that needs protection. A general rule that bars any parent from directly or indirectly revealing the names of children subject to a care and protection proceeding will not do. There must be evidence and findings as to what effect the disclosure of the names of the particular children will or might have on them.2

According to trial transcripts, Johnston gave his order verbally, saying, “I am issuing a gag order. No one is to talk about this case at all to any media, whether it is local here or local to the family in Connecticut.” The inescapable conclusion is that Judge Johnston, when imposing his order, either did not know the law, or that he freely chose to disregard it.

To the last one, all among the upper echelon have failed to honestly investigate and to intervene. I’d almost move to Massachusetts just to cast a vote against Martha Coakley, who I hasten to add recently donated money to four “charities,” including the Justice Resource Institute – which has been under fire for the high rate of sexual abuse of inmates in one of its juvenile correctional facilities in Pennsylvania; Youth Villages – Germaine Lawrence Campus; and the Home for Little Wanderers, which is currently under fire for an incident involving the alleged rape of a child in its care. All of this came about as Coakley came under scrutiny for alleged fiscal improprieties concerning her Senate campaign.

I’ll admit that my distaste for Coakley goes back to the Amirault case. But, where does she stand on that issue today? According an article on the Blue MASS Group, she remains a true believer, not that donating money to Massachusetts’ private foster care providers should leave any room for doubt. I think it can fairly be said that she appears to be pumping money right back into part of her own backstage political machinery rather than donating money to any truly charitable organizations.

That’s how that web of empire works. If your hand is caught in the cookie jar, you fork some of the cookies over to so-called non-profits that help “abused and neglected children” who weren’t actually abused and neglected until the state took them away from their homes. Is the interconnectedness of it all becoming any clearer now?

Moving Forward

The primary focus – other than that of the most obvious need to set right the terrible wrong that has been done to the Pelletier’s by returning Justina to her home forthwith – should be on one particular point of entry into the system; that of a 51A referral from a hospital’s child protection team. As Neil Swidey and Patricia Wen noted in their Globe article on December 15, 2013, Boston Children’s Hospital files about 400 51A referrals a year, most of which are for neglect, itself an extraordinarily broad term, while an estimated 2 to 4 percent – or 8 to 16 cases a year – involve allegations of medical child abuse.

More to the point is the question of why so many children enter the ER at Boston Children’s Hospital with physical symptoms and, in some cases, a working diagnosis of a rare disease, only to wind up in the psychiatric unit known as Bader 5. While correlation does not necessarily equate to causation, is it entirely unreasonable to speculate as to whether Elizabeth Wray’s departure from Boston Children’s Hospital the day before Justina’s arrival was merely coincidental? Was there a slot ready to be filled in the 26-bed facility?

It isn’t an easy puzzle to solve. An interview with Beth Maloney here, a comment by Jim Ianiri there, an interview with Nurse Katie Higgins there. Questions remain about at least two other children that were said to have been admitted to Boston Children’s Hospital last year. “I know personally of two other families who also are under a gag order by Boston Children’s Hospital,” said Cristy Balcells during an interview last November.4

When Beth Maloney was asked what she thought was going on, she candidly replied that she didn’t know for certain, speculating that it may be a question of Harvard egos at work. She added, however, that in both of the two cases she’d handled, Boston Children’s Hospital did the same thing that it did to the Pelletier family. Specifically, what she said was: “Is not just Mitochondrial childen that they go after. I’ve had two children with an autoimmune disorder that effects the brain, and they did the same exact thing; diagnosed the children with somotaform disorder. There is a psychologist at Boston Children’s Hospital who is very invested in that – Somatoform disorder – she’s written papers about Somatoform disorder.”

The Mounting Evidence

Are young psychiatric residents actually allowed such broad and sweeping powers? The answer is that it would certainly appear to be the case. And, the evidence continues to acccumulate in support of that thesis. According to a document on Boston Children’s Hospital’s web site, Child & Adolescent Psychiatry Residency Training Program, which appears to be provided to all new residents in psychiatric training, and which is signed by David R. DeMaso, the unique training goals of rotation in the Psychiatry Inpatient Service program

are to teach residents to evaluate and manage children, adolescents, and their families, who present with severe psychiatric illnesses, or co-morbid medical-psychiatric illnesses, requiring care in a more restrictive inpatient setting. In this setting our residents function as the primary clinician for two patients. This involves all aspects of patient care, from family, to individual, to pharmacotherapy. They also provide medication management for two additional patients. During this four-month rotation residents receive supervision from their team attendings and staff social workers, as well as from the medical director.

The ‘Evil Spirits’ of Children’s Hospital

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The Massachusetts Board of Registry in Medicine rolled out a ruling against a doctor employed by Boston Children’s Hospital last year. A close reading of the ruling and its associated paperwork would strongly indicate that psychiatric interns at BCH have precious little oversight.

The case involved one Assistant Professor of Psychiatry by the name of Enrico Mezzacappa, M.D., who was “the senior attending psychiatric assigned to supervise” various individuals as they handled the care of patients.

Dr. Mezzacappa, according to the ruling, did not “see patients in the clinic in his role as the Resident Director.” Apparently, his oversight consisted of conferring with his underlings, and signing off on their reports.

The problem in this particular case arose when a second-year Fellow came to believe a young girl – Patient A – “was being hurt by evil spiritual entitites.” The Attending physician apparently also came to believe this. Mezzacappa’s participation in these events extended to that of going so far as to “coordinate a spiritual consultation on Patient A’s behalf and on behalf of the outpatient treatment team from a Christian chaplain at Children’s Hospital.”

Read the consent order and decide for yourself just how great a leap of faith it takes to go from signing off on a possible case of “evil spiritual entitites” being the underlying cause of a psychiatric disorder, to signing off on the possibility that up tp 50 percent of pediatric admissions to your hospital’s emergency room may involve somatoform disorder, rather than an actual physical ailment.

The Fellow, Dr. Raymond W. Kam, was dismissed from the hospital, according to his ruling, which further details the abysmal lack of oversight in the BCH facility that allowed the affair to flourish.

I know it’s hard to believe. Don’t take my word for it, read the documents for yourself to better understand their implications.

Additional Clues

Do be certain to read the civil complaint in the lawsuit most recently filed by Barry Pollack against DCF and Martha Coakley. It provides a handful of critical pieces to the puzzle, including the role of Gary Gosselin in coercing a mother and father into signing their child into Bader 5 under the threat of involving DCF and the possible loss of custody.

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A close reading of the Massachusetts Executive Office of Health and Human Services, Department of Public Health’s publication of April 15, 2013, entitled Conduct of Human Subject Research, clearly indicates that few of the protections that are required by law to be extended to the subjects of such research were applied in Justina’s case.

The 55-page document clearly details the policies and procedures that must be followed according to both state and federal law. The policy document states, in part,

Children who are wards of the State or any other agency, institution, or entity can be included in research approved under 45 CFR 46.406 and 45 CFR 46.407 only if such research is: 1) related to their status as wards; or 2) conducted in school, camps, hospitals, institutions, or similar settings in which the majority of children involved as participants are not wards. If the research meets the criteria above, the IRB requires the appointment of a participant advocate for each child who is a ward, in addition to any other individual acting on behalf of the child as guardian or legally authorized representative. One individual may serve as an advocate for more than one child. The advocate must have necessary expertise and experience, and agree to act in the best interest of the child. Only those advocates without any conflicts of interest can be appointed as advocates.

If you’re wondering what the applicability of a document concerning human experimentation may be, ask yourself whether diverting a young girl from her appointment with a designated physician and into the psychiatric ward on the theory that there is up to a 50/50 chance that she is suffering from an imagined ailment constitutes an experimental procedure. Bear in mind as you ponder that one, that Tuft’s mitochondrial specialist Dr. Korson wrote that it seemed to him that Justina’s treatment team was “out to prove the diagnosis at all costs.”

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There is much more of interest in the Human Rights Handbook, as last Revised November 9, 2007.

The Human Rights Handbook begins with an appropriate admonition, “Senior staff and managers have a responsibility to provide the leadership and model the values necessary to proactively implement this policy, and to ensure that DMH maintains a service environment that promotes respectful and responsive interactions with Clients.”

1. When a child in DSS custody is admitted to a Facility, the Facility should remind the child’s DSS social worker of the application of the Five Fundamental Rights, and should provide him or her with a copy of these guidelines. In addition, these guidelines should be available in DSS offices.

2. In the absence of specific information concerning a risk of harm to an individual child, it should bepresumed that each child shall be permitted to exercise the rights provided in the statute without restriction. Facility staff should ask the child’s DSS social worker whether DSS has determined that anyone would create such a risk.

3. Facilities may not limit the child’s right of access to an attorney, legal advocate, physician, psychologist, clergy member or social worker.

4. Facilities may restrict any rights in order to conform to judicial orders relating to a child. Such orders might include “no contact” orders as conditions of probation, DSS or DYS custody, 209A protective orders, or other orders relative to custody and visitation.

5. Telephone access should be provided in such a way as to permit children to make and receive confidential telephone calls. Unless a child’s right to use the telephone is restricted in accordance with the statute and these guidelines, he or she should be able to carry on telephone conversations without being overheard by staff or other children.

6. For good cause, and with specific documentation in the child’s records, a child’s mail may be opened and inspected in front of the child, without it being read by staff, for the sole purpose of preventing the transmission of contraband.

7. Facilities may limit the exercise of other specific rights, namely, access to telephone and visitors of a child’s choosing, only if the exercise of the right creates a substantial risk of serious harm to the child or others, and if less restrictive alternatives to a restriction have failed or would be futile to attempt. For children, the term harm has physical as well as development components, and may include a substantial risk that the exercise of the rights will have a severe, negative effect on the child’s development or mental health. Ongoing assessment of this risk should include consideration of the child’s age, and present condition, as well as other developmental factors which might influence the child’s exercise of judgment, together with information supplied by parents, and other legally authorized representatives, including DSS. Where DSS has determined that telephone contact or visits with a particular individual or individuals creates a substantial risk of serious harm, DSS should communicate its concerns to the Facility, together with the reasons for its concerns. This communication can be made verbally, or in writing, but should be sufficiently detailed to enable the Facility Director to make a decision regarding such contact.

8. In the event the Facility disagrees with DSS’s assessment of the risk of harm, or believes that there are less restrictive alternatives to the restrictions suggested by DSS, the Facility should inform DSS so that DSS can take whatever further action it deems appropriate, including consideration of seeking a court order relative to the particular issue. If DSS informs the Facility that it intends to seek a court order, then the Facility should impose the restriction for a reasonable time in order for DSS to bring the matter to court. DSS should provide the Facility with an opportunity to present its position to the court, if the Facility so desires.

9. Any such restrictions should be subject to ongoing review by the Facility and DSS to ascertain whether the restrictions need to remain in place and whether less restrictive alternatives are available and feasible.

10. The Facility should document in the child’s record the facts that support imposition of therestriction, as well as its ongoing assessment of the continuing need for the restriction, any available less restrictive alternatives, and, if less restrictive alternatives are not available or feasible, the reasons for such.

11. Nothing in these guidelines precludes a child from filing a human rights complaint, or seeking other remedies if he or she believes his/her human rights have been unduly restricted.

Unanswered Questions Remain

It was not too long ago that some of Massachusetts’ legislators tried to file a resolution with bi-partisan support calling for Justina’s release. That move, however, was blocked by a politician claiming that it would violate the separation of powers between the judiciary and the legislature.

What remains to be squarely addressed is what is to be done with judges who disregard the applicable law as a matter of routine? Advocates have seen Judge Johnston hand down a constitutionally impermissible decree banning the Pelletier family – as well as their attorney – from discussing their case with the media. Others have experienced the very same thing. I am aware of some cases in which the equivalent of a gag order was imposed by the terms of a reunification plan, the only court order backing that up being a blanket order to “comply with CPS” on peril of a contempt filing. It is the judges who act as the gatekeepers to the system, sanctifying the actions of administrative agencies.

Scant attention has been provided to Harvard’s Judge Baker Children’s Center, the crucial distinction between that facility and Bader 5 being the point of entry. Perhaps some journalist will run with that story. Perhaps another may reveal the origins of the Justice Resource Institute, and, much more importantly, the specific direction that it is taking today. Part of the answer is suggested by a New York Times blog entry of recent vintage.


1. Shepardizing a case to see whether it is still good law is always good practice, but this has become something of a lost art with the advent of web-based citations. In any event, Sevigny’s Case has been cited over 50 times in other cases and law journals, and it was most recently cited in Commonwealth v. Sepheus, 82 Mass. App. Ct. 765 (2012), holding that “an opinion given by an expert will be disregarded where it amounts to no more than mere speculation or a guess from subordinate facts that do not give adequate support to the conclusion reached,” which is how Judge Johnston, it seems to me, should have applied the law to effectively trash the somatoform disorder diagnosis right out of the box. Assuming that the conflicting testimony passed that test, when confronted with the conflicting medical testimony of Tuft’s diagnosis on the one hand, and the seemingly reasoned and logical testimony of Children’s Hospital on the other, he ought not have refereed the decision at all. See also for more recent reference Aleo v. SLB Toys USA, INC., 466 Mass. 398 (2013) (same use of citation).

2. For sake of clarity, internal citations and quotation marks have been omitted. This sentiment appears time and again in the case law, variously punctuated. See for example In Re Adoption Of Hamal, No. 13-P-318 (Mass. App. Ct. Oct. 2, 2013); In Re Adoption of Margaret, No. 13-P-215 (Mass. App. Ct. Sept. 24, 2013); In Re Care And Protection Of Yetta, No. 12-P-1540 (Mass. App. Ct. Apr. 10, 2013).

3. Care and Protection of Edith, 421 Mass. 703 (1996).

4. One Massachusetts-based family advocate and I have entered into a confidential but entirely productive mutual exchange of documents and other information. Neither one of us has been disappointed by the exchange, and we share the frustration of knowing that some people are in effect walking around with their own little collection of puzzle pieces tucked away in their pockets. Difficult jigsaw puzzles, to use the closest analogy, are always more readily solved when people sit together on a back porch and work together to fill in all the gaps.


Massachusetts Lawsuit Against DCF Provides Inside Look At Bader 5

2014 June 4
Posted by ethoma
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By way of introduction, Barry S. Pollack is a former federal prosecutor, and the longest-serving board member of the Massachusetts Society for the Prevention of Cruelty to Children. As an attorney, he has represented a number of families in cases involving Boston Children’s Hospital. On May 29, 2014, the law firm of Pollack Solomon Duffy LLP filed a lawsuit in Federal court against the Massachusetts Department of Children and Families stemming from its practice of limiting parental choices and access to second medical opinions.

The Civil Complaint alleges that the Massachusetts Department of Children and Families has violated, and continues to violate the fundamental rights of parents to choose which healthcare providers will examine and treat their children, in violation of the Due Process Clause of the Fourteenth Amendment. The Complaint charges that:

DCF has unconstitutionally expanded the concept of “medical child abuse,” without sufficient and justifiable standards, to intrude on sincere, vigilant and loving efforts by parents who face competing diagnoses and different views on the medical condition of their children.

According to the Complaint, the Mother and Father received multiple diagnoses for their now 13-year-old daughter.1

They received an assessment of Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infection – also known as PANDAS – from qualified providers. What would you suppose happened to the child presenting at Boston Children’s Hospital with a working diagnosis of a rare disease? The Complaint explains that at the inpatient psychiatric unit at Children’s Hospital Boston known as “Bader 5,”

providers initially maintained a diagnosis of an undifferentiated somatoform disorder. DCF has interfered with and improperly chilled the efforts of the Mother and Father to obtain laity and the most appropriate cure for their daughter.

Despite prior diagnoses of physical causes for her condition, after the Daughter went to Children’s Hospital Boston, certain healthcare providers associated with Bader 5 almost immediately concluded that the Daughter suffered from an undifferentiated somatic disorder rather than a physical cause that other healthcare professionals believed still called for medial treatment. In or about June 2012, these Bader 5 healthcare providers threatened the Mother and Father with the loss of parental rights if they did not abandon their treatment in favor of inpatient psychiatric treatment. The hasty diagnosis and threats by the Bader 5 healthcare providers prevented the Mother, Father and Daughter from seeking an additional medical opinion at the time.

The Complaint continues on to say that by labeling parents as engaging in medical child abuse, or doctor shopping, the Bader 5 healthcare providers “have enlisted DCF to prevent further medical opinions that can challenge the viewpoints of Bader 5′s providers.”

The Daughter’s condition deteriorated significantly, the Complaint asserts. At times, the young girl was “forcefully restrained by staff at Bader 5, blocked from the outside world, and deprived of time outside for a substantial time period.”

While Justina Pelletier is not the Plaintiff in this lawsuit, her case is described in the Complaint as being illustrative of the nature of the problem:

DCF’s actions against the Mother and Father are part of its pattern of unconstitutional activity against parents. For example, in a recent high-profile case, also at the behest of Bader 5 providers, DCF stripped Connecticut parents of custody over their young daughter, placing the girl into Bader 5 inpatient treatment inconsistent with the medical opinions of the girl’s regular treating physician at Tuft’s Medial Center. In that case, Bader 5 providers made an almost immediate diagnosis of somatoform disorder contrary to a long-term diagnosis of mitochondrial disorder. Essentially DCF blindly followed Bader 5′s recommendations when initiating proceedings against the Connecticut parents. In other cases, Bader 5 and DCF have taken actions that collectively resulted in inpatient commitment at Bader 5 when healthcare providers elsewhere had reached opinions that the children at issue suffered conditions potentially of likely stemming from physical causes.

Any hospital can make a mistake. While it is not the subject of this lawsuit, prior to the girl’s admission into Children’s Hospital, Massachusetts General Hospital made rather a big one by administering 100 times the proper dosage of a particular medication, while also dosing the young girl up with Ativan, to which she had a delayed allergic reaction. Incredibly, while at MGH, some providers suggested shock therapy as a potential cure for her subsequent deterioration after the overdose and allergic reaction, however they failed to reach a consensus around that modality of treatment after the parents expressed reservations about it.

At least the parents had some measure of influence over their child’s treatment while at MGH. At Boston Children’s Hospital, they had none whatsoever.

In June 2012, the parents attended a meeting with the expectation of discussing a discharge plan for their Daughter. At this meeting, according to the Complaint, “one of the hospital providers informed the Mother and Father that the hospital had obtained a court order to place their Daughter in Bader 5 for purely inpatient psychiatric treatment. The hospital providers threatened to use DCF to remove custody longer term from the Mother and Father if they did not consent to the inpatient treatment at Bader 5.”

The Complaint notes that the meeting was conducted in a manner that was intimidating to the parents. Significantly, there were “three guards stationed in the hallway outside the meeting.”

This is not the first mention of guards being stationed in the hallways of the hospital while children were placed in Bader 5. Indeed, attorney Beth Maloney has spoken of her encounters with guards stationed in the hallways, and of one occasion during which a guard escorted her in an elevator. So, too, did the Pelletier family speak of guards seemingly coming out of nowhere when their Daughter Justina was “intercepted” (for lack of a better term) by Bader 5 staffers.

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On December 21, 2013, Barry Pollack wrote a letter to Cheryl Bartlett, Commissioner of the Massachusetts Department of Public Health, demanding an investigation into Bader 5. In that letter, Pollack mentioned several key players by name, leaving many to wonder – myself included – what their precise role in these matters may be.

Specifically, his letter explained: “As reported in the growing number of cases in which allegations are becoming public, Bader 5 healthcare providers, including Gary Gosselin and Colleen Ryan, along with an in-house counsel named Ellen Rothstein, appear to favor hasty accusations of medical child abuse or the like against parents who challenge them.”

Gosselin’s hands-on role in the case on hand, according to the Complaint, was that against the backdrop of the Mother and Father potentially losing custody of their Daughter,

in a discussion with the Father, Dr. Gary Gosselin of Bader 5 stated in substance and in part that Bader 5 providers as a group had decided that the Daughter needed to be in Bader 5 and, if the Mother or Father did not sign a form admitting the Daughter into the unit, the group would continue with further steps.

The Father correctly understood at the time that Dr. Gosselin was threatening the Mother’s and Father’s custody rights over their daughter.

The Complaint details how the young girl deteriorated over the course of her stay, without the benefit of occupational, speech or physical therapy. She was allegedly locked away in a padded room for extended periods of time, and at one point a relative observed “an excessively large group of hospital staff forcibly restrain the Daughter with undue force, leaving substantial bruises on her face.”

The Complaint continues on to assert that: “In numerous cases involving diagnoses of PANDAS, mitochondrial disorder, Lyme disease and other matters, Bader 5 providers have used DCF to impose the Bader 5 providers’ treatment plan on the patient instead of allowing parents to weigh opinions and choose among various qualified healthcare providers.”

This is not a chapter adapted from Solzhenitsyn’s The Gulag Archipelago, although it may bear some similarities. Rather, this is another brief look behind the scenes at an ivy-league-affiliated medical institution with a sterling reputation based right here in the United States.

The lawsuit does not seek a financial reward. Rather the parents seek declaratory relief in the form of the Court declaring that the policies and procedures of DCF and Boston Children’s Hospital’s Bader 5 staffers are unconstitutional, and are otherwise illegal. The Plaintiff seeks only reasonable attorney fees under 42 USC Section 1988, and any other remedy that the Court would deem just and proper.

 


1. This should come as no surprise, as the Shire Rare Disease Impact Report found that it takes, on average, more than seven years for a patient with a rare disease in the United States to receive a proper diagnosis. Along the way, a patient typically visits up to eight physicians, and in some cases more than that. See Shire plc, “Rare Disease Impact Report: Insights from Patients and the Medical Community,” April 9, 2013. See also Lauren Limb, Stephan Nutt, and Alan Sen, “Experiences of Rare Diseases: An Insight from Patients and Families,” (Rare Disease UK, December 2010).


Thousands Rally for Pelletier Family at Massachusetts Statehouse

2014 May 29
Posted by ethoma
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Copyright © Bharani Padmanabhan MD PhD.
Used with permission

 

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Conservative radio talk show host Jeff Kuhner put out a challenge to his audience. He challenged them to show up last weekend in support of the Pelletier family, and to provide their daughter Justina with a sweet 16 party that she’ll never forget.

By some accounts, only 2,000 people showed up at the rally at the Massachusetts state house. According to Kuhner, whose producer polled state police patrolling the peaceful rally, the actual head count may have been between 4,000 – 5,000.

Whatever the actual number may have been, it was a crowd sufficient to line the sidewalks on both sides of the street, and to spill over into neighboring blocks.

iComrade John providing the opening speech.

Jeff Kuhner played the role of master of ceremonies, and Comrade John, a regular caller of Kuhner’s popular radio show, was first among the lineup of speakers.

John began with an important admonishment to the crowd, saying: “This is not about party affiliation, religion, or race. This is about being an American. And, what is being done to Justina and her family is as un-American as it can get.”

He continued on to say that there are 136 other children known to be missing in DCF’s care, adding that “our thoughts and prayers go out with them and their families as well.”1

He spoke of how different things were when he was growing up. It was a time when parents were entrusted with the care of, and responsibility for, their own children.

“Well, today it’s the state that tells you how you can and can’t discipline your children. And now it’s gonna tell you – and your doctor – what’s best for you and your child, and if you don’t agree they’ll take your child from you.”

If they feel they can get away with this then what’s next? They’ll kick down your door and snatch your child from the dead of night? It’s not that far-fetched and I don’t feel it’s any different than what’s happened to Justina and her family already,” he said

He apparently touched a nerve with that comment, as at this point, the crowd spontaneously broke into a round of applause.

“Some people say we don’t need the government, but from what I remember, we’re the government – they’re the politicians. We don’t work for them, they’re supposed to work for us, not against us.”

iRev Patrick Mahoney describing Justina’s condition.

Rev. Patrick Mahoney thereafter addressed the crowd, describing how Justina had deteriorated while in the state’s care. She’d gone from figure skating while in her parents’ care, to being bound in a wheel chair while in the care of the state. He added that Justina had not only been deprived of her right to attend religious services – which she had always attended while in the care of her family – but had also been deprived of her right to an education as well.

He continued on to explain that because of the level of popular support behind the family, promising things were starting to happen. On May 30th, there is a critical meeting set to be held between the Pelletiers, DCF, and the medical team, at which time a motion may be filed. If things go well, Mahoney said, there is the possibility Justina may be back in the arms of her loving family some time in early June.

“We must keep the pressure on, we cannot give up,” he emphasized. He encouraged the audience to continue to contact the Governor, DCF, and other officials on the family’s behalf.

On Wednesday, May 28, at 12 noon, another rally is planned at DCF headquarters at 600 Washington Street, to demand that Justina is returned to her family immediately, he said.

Kuhner introduced the next speaker as an “absolute warrior” on behalf of Justina, as well as on behalf of families throughout the state.

iState Rep Jim Lyons presented 16 pink roses to the Pelletier family.

State Rep Jim Lyons addressed the crowd, beginning his address by handing 16 pink roses to the Pelletier family in honor of Justina’s 16th birthday.

Lyons did not mince words, saying that Governor Patrick and some other members of his administration had outright “lied” to the public about the details involving the Pelletier case. He went so far as to say that the Governor was hiding behind the court to justify his actions.

Rep Lyons congratulated Mr. Pelletier for his courage in coming forward with his family’s story. Lou and Linda Pelletier are examples of the kind parents who are unafraid to stand up against the state’s bureaucracy, he said.

Lyons added that if it wasn’t for Mr. Pelletier’s courage in standing up to what he described as a “faceless bureaucracy,” no one would know anything about what has been going on.

“Please keep up the fight, and thank you to Lou and Linda Pelletier for everything you’ve done,” he concluded, throwing a firm embrace around Mr. Pelletier.

iJeff Kuhner introducing Lou Pelletier.

Jeff Kuhner introduced Lou Pelletier saying that he could not imagine himself having to be faced with the situation the Pelletier’s found themselves in.

He said that if it was not for Lou Pelletier defying the gag order “slapped on him by that arrogant judge, nobody would know about Justina Pelletier today; she’d still be rotting at Boston Children’s Hospital.”

At this point the crowd burst into a chorus, repeatedly chanting: “Thank you Lou, thank you Lou . . . ”

iLou Pelletier holding the Massachusetts Constitution.

Mr. Pelletier took to the podium holding a copy of the Constitution of the State of Massachusetts in his hand. He said that the Governor and other state officials should take some time to read it. According to Mr. Pelletier, the State’s Constitution grants the Governor the executive authority to release Justina immediately.

Mr. Pelletier – speaking with his daughter Jessica by his side – continued on to describe Boston Children’s Hospital’s role in the affair, emphasizing that the hospital was not the only one that is doing this.

“It’s happening across the country. Justina has become the lightning rod,” he said.

When Justina first entered the hospital expecting to see her designated specialist, he explained, she instead was greeted by a young neurologist on a Sunday morning at 4 AM. That young neurologist – Jurriaan Peters – told his wife Linda that “there’s no such thing as mitochondrial disease.”

A young psychologist – Simona Bujoreanu – barely 12 hours later had diagnosed Justina with somatoform, saying in effect that she was making it all up; that it was all in her head.

Mr. Pelletier demanded that she explain to the public at large that she’d written four papers on the subject of somatoform, one of them raising the claim that as many as 50 percent of the presenting child population entering emergency rooms may be suffering from somatoform disorder rather than genuine physical ailments.

Mr. Pelletier also questioned where director of psychiatry Dr. David DeMaso was, in light of his role of having developed the working definitions of somatoform in the medical literature.2

“If you want to find a disease, you’ll find it whether it exists or not. Unfortunately, he picked the wrong family,” Pelletier told the audience.

He spoke of how quite-nearly impossible his family’s battle had been, adding that: “If you’ve got heart, and you’ve got a legion behind you, nothing is impossible!”

The crowd once again broke into cheers.

Mr. Pelletier explained that he’d spent three days during the previous week in DC speaking with legislators, including John Larson, his Democratic representative. As it turned out, Larson himself had gone through much the same situation with his own son. If he wasn’t a Congressman, his son would have been taken away from him, Pelletier said.

He added that it seemed to him that the tide may be turning even in DC, with some Democrats coming to better understand the true nature of the problem given all of the publicity surrounding his family’s case.

“Unfortunately, Justina – as we’ve all found out – is the tip of the iceberg. It’s happening every day, in every state in this country. And, it could be your child, your child, or your child,” has said pointing his finger at various people in the audience to drive home his point.

“They can take your children, and there’s not a damn thing that you can do about it,” he said.

Mr. Pelletier went on to say that two things have to happen: Number one; “we’ve got to free Justina.” The audience at this point cheered in support, repeatedly chanting “Free Justina”

Number two, he said, should be that for every time a child presents with a medical illness, and someone comes along and says, “Oh, no-no-no-no, it’s not a medical illness, it’s in your head,” that person should lose their license. and do jail time.

“Too many kids have died from this nonsense,” he added with visible and righteous indignation.

In an appeal to growing populist sentiment, he closed out his speech by encouraging everyone to participate in taking the nation back from the hands of the politicians who have in effect taken it away from the people.

iIt took Les Gosule over 4,700 days to have one law passed.

The next speaker was Les Gosule, who worked for years to have Melissa’s law passed by the Massachusetts legislature. He lost his daughter to a murder that many say should never have occurred.

The legislation – unceremoniously signed into law by Governor Patrick in late 2012 – provides a “three strikes” provision for certain violent offenders.

Mr. Gosule said that while it took the legislature only two days to pass an “upskirting” bill, with which he certainly agrees, it took him over 4,700 days to get his bill passed.

He explained that the lack of responsiveness on the part of the Massachusetts legislature to the needs of its constituency has long been an issue, and that the Pelletier family’s plight involving the Department of Children and Families was a reflection of that problem.

Mr. Gosule encouraged the audience to continue to stand behind the Pelletier family, and to demand transparency from the government.

“We the people,” he said, “deserve better.”

Conspicuous by their absence were the Governor, and other gubernatorial candidates, with the acceptation of Mark Fisher. Kuhner introduced him to the audience as someone that he has differences of opinion with, but called him an honorable man for stopping in to lend his voice to those of other supporters. Fisher promised the audience that this was not a campaign stop, and he kept his call for “common sense” among legislators short, and directly on point.

Several thousand people rallied in support of a young girl named Justina on her 16th birthday, and in support of her out-of-state family. That it happened at all is a remarkable thing. That it happened as well as it did, is even more remarkable. It is quite nearly miraculous.

That is, after all is said and done, all that the Pelletier family has been asking for.

A miracle for Justina.


1. The numbers may vary, but there is agreement that a significant number of children in state care cannot be accounted for. See Todd Wallack, “Hundreds may be missing in child welfare system,”Boston Globe, (February 27, 2014). This is not a new issue. It has always been this way. See for example The Lost Children, as written in 1998 before this became a known issue. To be sure, as a general rule, the states continue to bill the federal government for the care of their missing children.

2. David DeMaso’s long list of published articles include: “Promoting scholarship during child and adolescent psychiatry residency,” “Parent and Young Adult Satisfaction with Psychiatry Consultation Services in a Children’s Hospital,” “Depression subtypes in pediatric inflammatory bowel disease,” “Predictors of depression in youth with crohn disease,” and “Longitudinal results of cognitive behavioral treatment for youths with inflammatory bowel disease and depressive symptoms.” DeMaso has also co-authored at least five articles with Simona Bujoreanu.

3. The law removes the possibility of parole for certain repeat criminal offenders should they amass three convictions from a list of 46 violent crimes, while expanding parole eligibility for nonviolent drug offenders. See generally Brian R. Ballou, “‘Melissa’s bill’ signed in nearly private ceremony,” Boston Globe, (August 3, 2012).


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Entire rally – HD – by Bluesmovers – 1 hr 15 min.


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Video of opening with Comrade John, Patrick Mahoney, and Jim Lyons. CRNewsTeam.


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Video of Lou Pelletier. CRNewsTeam.


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Les Gosule, Mark Fisher, closing remarks. CRNewsTeam.


Quebec Human Rights Commission Looks At Lev Tahor Intervention

2014 May 19
Posted by ethoma

First they came for the Socialists, and I did not speak out-
Because I was not a Socialist.

Then they came for the Trade Unionists, and I did not speak out-
Because I was not a Trade Unionist.

Then they came for the Jews, and I did not speak out-
Because I was not a Jew.

Then they came for me – and there was no one left to speak for me.

- Martin Niemöller

 


 

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I love a well-constructed thesis, and this is particularly so when it comes to issues that are of genuine concern to me. I mention this because a brilliant thesis, The Biopolitics Of Indigenous Reproduction: Colonial Discourse And The Overrepresentation Of Indigenous Children In The Canadian Child Welfare System, by Laura Christine Luise Landertinger of Queen’s University, Ontario, provides the needed antidote to the news coverage of the Lev Tahor families.

Her thesis is on the topic of indigenous child removal in Canada, however her analysis is a crucial one, inasmuch as it perfectly addresses the issue of how the news media disseminates “controlling images of indigenous peoples and their children.” In broader terms, her analysis may be applied to journalistic coverage of people of all races, colors, and creeds. With regard specifically to indigenous children in Canada, she writes:

While it is widely accepted that the forceful removal of indigenous children during the residential school era and the “Sixties Scoop” was a colonial strategy, contemporary child welfare practices seem to escape the same scrutiny. This seems to be the case even though indigenous children continue to be removed en masse and are vastly overrepresented in the Canadian child welfare system. Indeed, there are more indigenous children in ‘care’ today than ever before in Canadian history, including the residential school era and following the “Sixties Scoop”. Given these trends the colonial effect of contemporary child welfare practices seems evident.

It’s much the same in Canada as it is in the United States, the Indian Child Welfare Act having been largely ignored by the states. A recent article in a publication no more radical than TIME explains that while social services in Australia deny targeting Aboriginal families, “the statistics of children in out-of-home care paint a disturbing picture.”

Returning once again to the thesis, Laura Christine Luise Landertinger writes:

This project thus seeks to problematize child welfare practices in relation to indigenous peoples. In particular, it is the aim of this thesis to shed light on some of the narratives that underlie these practices. Through a critical discourse analysis this thesis illuminates how news media in Alberta and Manitoba disseminate controlling images of indigenous peoples and their children. I argue that the discourses in both provinces normalize the removal of indigenous children while naturalizing colonial control.

The story on hand does not concern indigenous peoples. Rather, it concerns a reclusive Orthodox Jewish community that has been under siege ever since Ontario Children’s Aid authorities launched a legal battle last year to seize custody of 14 children of the Lev Tahor community and send them into foster care in Quebec. As of December 2013, the situation was unresolved, and it had already begun to grow into an international incident.

In November 2013, 40 families from the Lev Tahor group “fled Quebec and re-located to Chatham amid a social services investigation,” CTV News reported. A Quebec court had ordered 14 children from the group into foster care.

The Religion News Service explains that about 150 members of the group Lev Tahor “decamped from a village north of Montreal to Chatham, Ontario, about 200 miles southwest of Toronto. Comprising about 40 families, the sect fled just before a Quebec court ordered 14 children into foster care. The children, from three families, range in age from 2 months to 16 years.”

The article continues on to explain that: “Quebec authorities said they had evidence of neglect, psychological abuse, poor health care and an education curriculum that fell below the province’s standards.”

As the story progressed, some among the mainstream press were quick to brand the group as “radical” due to its orthodox beliefs, the Toronto Star among them. Nevertheless, the Star itself conceded that: “Officials have said they were unable to find any evidence of direct child physical abuse.”

The Toronto Star, in the same article, went on to describe a statement posted by the group on its web site as “rambling and often difficult-to-understand,” even as it conceded parenthetically that “most members speak only Yiddish or Hebrew.”

When read in the light of the understanding that it was written by someone to whom English is a second language, it doesn’t seem to be “rambling and often difficult-to-understand” at all.

The Times of Israel pulled no punches in its coverage of the story, branding the group as a “Taliban-style Hasidic sect,” while going so far as to castigate their religious leader as holding out an “extremist ultra-Orthodox” philosophy.

“The Quebec social services found very minor things, like a single dirty mattress. They did not find any evidence of abuse, none. They found a few minor issues and we are cooperating fully to fix them. The only reason we left was because of education,” the group’s leader, Shlomo Helbrans said to reporters from The Times of Israel.

That seems to be the crucial point that is lost on many who have provided coverage of the story. Indeed, film crews and photographs reveal children who appear to happy and healthy, at work, at prayer, and at play.

Other reports would bear this out. In early December of last year, a justice of the peace in Chatham denied permission to the Children’s Aid Society to remove the children from the Lev Tahor homes. The Children’s Aid Society appealed, and a hearing was set for December 23. However, CBC News Windsor reported on December 16 that two children had been removed by Children’s Aid, the order of the justice of the peace notwithstanding.

Apparently another court did not share the concerns of the Children’s Aid Society when it came to the drastic step of removing children from the community. On December 17, CTV News reported that:

Children belonging to the Jewish sect Lev Tahor will be returned to their parents with conditions, after being taken into protective custody by Chatham-Kent Children’s Services last week.

CTV’s Rich Garton was at a Chatham-Kent courthouse where a decision was made Tuesday, to return the children to their families. Two children were removed by child services on Thursday.

On December 23, CTV News reported that a judge ruled the media could have access to the story, as well as court documents related to the case, as the matter was one of public interest. This came with the stipulation that names of witnesses and the children would go unreported. That court was also apparently unsympathetic to the urgency of the concerns raised by the Children’s Aid Society, as the case was adjourned until January 10 of 2014.

I’m sure it must be a wonderful thing to have your secluded community packed with film crews and photographers. To the extent that the Lev Tahor community members have any say in the matter, one may reasonably suppose that they want the world to see that their children are anything but endangered, so they allow the intrusions. When my 19-year-old daughter watched a clip of the children at play last December, she said: “They look like normal, happy kids playing – except they’re all wearing black clothes.”

I don’t pretend that it’s possible to be completely color-blind, or unaware of how people wear their hair, or of how they dress. But it is possible not to be a racist. And it is possible to respect, or at least to tolerate, sometimes-extreme differences of opinion regarding politics and religion.

To cast any group as being so unusual that they are worthy of being branded as “Taliban-style” is the worst kind of journalism. And, when it is done in such a manner as to suggest that a religious sect is so different that they may on some level or another deserve to have their children removed, it becomes a bottom-of-the-barrel kind of yellow journalism.

In any event, on April 2nd of this year, the Montreal Gazette reported that: “The Canadian Border Services Agency has made a series of arrests at the Jewish, ultraorthodox Lev Tahor community compound near Chatham.”

A spokesperson for the Border Services said that the Enforcement and Intelligence office of the agency for the southern Ontario region “executed a number of warrants” for suspected violations under the Immigration and Refugee Protection Act. I wonder why it took them so long to do that?

The Montreal Gazette reported on May 14 of this year:

The Quebec Human Rights Commission will study what went wrong in the case of an extremist Jewish sect that fled Ste-Agathe-des-Monts to avoid a hearing in Youth Court.

Last November, a group of about 250 members of the ultra-Orthodox Jewish sect Lev Tahor left the Laurentians town after 12 years to relocate in Chatham-Kent, Ont. They had been due in court to respond to allegations of child abuse and neglect made by Quebec’s Department of Youth Protection.

After several court hearings, the Ontario courts have ruled it would not be in the best interests of the children to execute an order made by Quebec’s youth court to return 14 children to the province and place them in foster care. Chatham-Kent’s Children’s Services has also refused to execute a warrant to remove all 127 children from the community, also issued by the Quebec court in November. That warrant is still outstanding.

“We’re not going to make a judgment about the Lev Tahor intervention, but rather to examine whether we’re well-equipped for these situations in Quebec,” said Camil Picard, the commission’s vice-president who deals with youth protection matters, according to an article in the Windsor Star.

“The commission has to assure that all young people in Quebec in all communities see their rights respected. We want to know that the actors have what they need to intervene in assuring children’s rights are protected.”

On May 16th, the Globe and Mail reported that some members of the Lev Tahor were looking at Guatemala as a possible place to find refuge.

An entire community of reclusive people – yes, Orthodox and Jewish – stands terrorized at the prospect of losing first their children, then their remaining freedoms. They look to Guatemala from Canada as a prospect for finding peace. Meanwhile, some members of the news media – and by no means do I mean all of them – continue to report the story with a particular angle that somehow or other seems to make the situation more palatable for the larger body of their respective readerships.

I continue to hold out hope that the Quebec Human Rights Commission will, at minimum, provide a full accounting of all that has transpired.

 


 

Related:

Manitoba: Mennonite Community Still Awaiting Return of Seized Children

Full Episode: Lev Tahor
Published on Feb 22, 2014
In this episode of 16×9: Chief Correspondent, Carolyn Jarvis travels to Lev Tahor — an Ultra Orthodox Jewish Sect in Chatham-Kent, Ontario — where 16×9 was granted unprecedented access. For a week we documented their culture and traditions, and bring you a candid look at what Lev Tahor is all about.

 

New Reports on Foster Care, Child Welfare, CPS

2014 May 18
Posted by ethoma
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LOS ANGELES COUNTY

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The Los Angeles County Department of Children and Family Services failed to disburse some $1.8 million in child support and other payments owed to foster children when they reached adulthood and left the system, according to a new audit issued by the County Auditor-Controller.

The department has also been sitting on $7.2 million in funds that were designated for foster kids, but the funds were instead held in reserve. The agency, now that this has been exposed, must now come up with a plan to spend the money appropriately.

In the report issued to the County Board of Supervisors, Acting Auditor-Controller John Naimo said that DCFS was notified about the discrepancy back in 2002, and that it simply failed to correct it.

“DCFS needs to ensure Child Support Trust Fund monies are returned to former foster care children,” Auditor Naimo wrote.

Blue Ribbon Foster Care Report

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It’s been while since someone issued an actual “blue ribbon” foster care report. This one comes from Los Angeles County. That’s right – the same LA County that was lambasted by the Auditor-Controller. The report is entitled The Road to Safety for Our Children.

The Blue Ribbon Commission on Child Protection was established after the death of Gabriel Fernandez. The commission conducted 15 public hearings, interviewed hundreds of child welfare leaders, workers and advocates, and examined 28 recent child fatalities.

 


 

CALIFORNIA STATE AUDITOR

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Report 2013-110 was released in April. Among the findings is that while the number of accusations called in to the hotlines is at a high level, the substantiation rate is very low. “Receiving nearly 482,000 allegations of maltreatment of children in 2013, California child welfare services (CWS) agencies substantiated more than 16 percent and removed more than 31,000 children from their homes as a result of their investigations.”

Still, removing 31,000 children from their homes in one year is troubling, and particularly so in view of the Auditor’s finding: “The three county child welfare services (CWS) agencies that we visited are not adequately ensuring that their decisions to remove or not remove children from homes are appropriate.” The audit covers Butte County, Orange County, and San Francisco’s Human Services Agency.

 


 

OREGON

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Secretary of State Audit Report, Keeping the State of Oregon Accountable, Fiscal Year 2013. $24,118,064 in questioned costs in the Department of Human Services. Siilar findings are repeated “year after year.” The Department of Human Services, Oregon Health Authority, and Housing and Community Services Department did not establish adequate internal controls and were not materially compliant with federal requirements for five programs: Temporary Assistance for Needy Families, Foster Care, Adoption Assistance, Medicaid, and Low-Income Home Energy Assistance. We issued qualified opinions on these five programs in fiscal year 2013.

 


 

LOUISIANA

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Louisiana Legislative Auditor Daryl Purpera released an audit on April 9th. What’s new here? Oh, the usual stuff. “High turnover, thinner staffing and heavier caseloads are among the most pressing challenges DCFS faces,” according to the audit, which found that department officials have not always assessed household risk factors consistently, and that they had improperly referred over 2,600 cases to a lower level of care “when an abuse investigation should have been opened.”

“Overall, we found that DCFS did not always conduct its child welfare activities in accordance with its policies and other requirements,” says the report.

 


 

ILLINOIS

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DCFS Inspector General Denice Kane always finds something interesting to write about. In her annual report, 2014, there are a lot of good reads.

Shortly after a CEO left Illinois, after giving himself a fat raise and being ousted from his office, he started up a new company out of state. Thereafter,

the agency, an out of state based agency attempted to become licensed in Illinois. A licensing examination by the Illinois Child Welfare Agency revealed that the former CEO had become the Executive Vice-President of the out of state organization and was now in communication with Department administrators to become a licensed Child Welfare Agency in Illinois. The Inspector General reviewed communications between the former CEO and Department administrators assisting him through the licensing process in Illinois.

The Inspector General discovered that one of the Department administrators who was involved in contract negotiations submitted a personal recommendation to the former CEO when he asked for suggestions in hiring personnel for the new agency.

In addition, the Inspector General learned that another Department administrator, in charge of the Department’s Monitoring Division, had received the complaint from the Board alleging gross misappropriation of agency funds, but had taken no action and had only filed the complaint. He did not advise the new Director of its contents. Once the Department’s new Director was alerted to the allegations against the former CEO, negotiations with the out of state Agency were suspended. This Administrator is no longer with the Department.

The Inspector General also found that the Former CEO owned a for-profit film company, to which he may have diverted some of the Agency funds. The Inspector General’s Office worked cooperatively with the Attorney General’s Office throughout this investigation.

There is much more to be found in her report.

 


 

WASHINGTON STATE

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From Washington State, released this February, Performance Audit, The Experiences and Perspectives of Washington Families who Adopted Children from Foster Care.

“Needs and access varied by the service. For example, the program helps families access the most-needed service – individual counseling for children. But the second most-needed service – family counseling – had the greatest unmet need compared to the other services.

“The families most likely to need help had the most difficulty getting all the services they needed. Sixteen percent of the families we surveyed are raising children with diagnosed disabilities that severely aff ect their lives. Of these families, 57 percent reported unmet service needs. These families were more likely to need, but less likely to get, the services we asked about in the survey.”

Also, Washington State Auditor’s Office, Whistleblower Investigation Report, Department of Social and Health Services, Report No. 1011790. May 12, 2014.

“In 19 of these 33 cases we found unsupported expenditures for items such as clothing, a computer and computer repair and mileage reimbursements for foster parents, some of which may have been unallowable. We also identified overpayments that were not sent to the Department’s Office of Financial Recovery to be collected. “

 


 

CITY OF RICHMOND

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Richmond City Auditor / Inspector General Umesh Dalal never fails to amaze me with what he’ll find next, in this particular department. This time, the City’s taxpayers are footing the tab for the agency’s botched handling of computers intended for use in the Independent Living Program, according to a short audit. Just amazing. Previous audits of this agency may be found here.

The Richmond Times-Dispatch reported a few weeks ago that, “The city’s Social Services department has been on the receiving end of a series of unflattering reports and investigations in recent months, many of them focused on problems in the Child Protective Services unit that may have compromised the safety of children.”

 


 

FLORIDA

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Florida’s Auditor General recently released Information Technology Operational Audit, which looked at DCF’s “Safe Families Network” to see who had access to personal information contained in the computer system. The findings:

In addition to the 18 user accounts with inappropriate access privileges, 3 user accounts belonged to former employees who retained access privileges after their dates of termination. The access privileges for 1 of the 3 former employees had been deactivated as of the date of our review, but had remained active for a period of 10 days after the termination date. The access privileges of the 2 remaining former employees remained active as of the date of our review, or 241 and 309 days after their termination dates. The FSFN access privileges of the 3 former employees were not used after their dates of termination.

Access to incompatible and inappropriate functions increase the risk that misappropriation of assets and erroneous manipulation of data may occur.

Also of interest, an April audit report on the Domestic Violence Program, Telework Program, and Selected Administrative Activities. It seems that DCF is not monitoring the “Coalition” that is supposed to be handling this kind of work:

The Department’s contracts with the Coalition were for $29.2 million for the 2011-12 fiscal year and $30.3 million for the 2012-13 fiscal year. The Department’s monitoring of the Coalition contracts consisted of a desk review for the 2011-12 fiscal year and an on-site review for the 2012-13 fiscal year. Our evaluation of the Department’s monitoring efforts disclosed that the Department did not maintain sufficient documentation supporting the conclusions made regarding Coalition compliance with the contract terms and applicable State and Federal requirements. Specifically:

The Department could not provide documentation supporting the conclusions of the desk review performed for the 2011-12 fiscal year. Our audit tests disclosed that the desk review was evidenced by a single form indicating there were no concerns with the performance or compliance of the Coalition; however, no documentation identifying the documents reviewed or the specific evaluation criteria utilized to assess the Coalition’s performance was available. We also noted that Department policies and procedures did not require monitors to maintain documentation supporting desk review conclusions.

The Department did not always document the performance of planned on-site monitoring procedures or that monitoring efforts were complete and included all elements required by State law.

 


 

CANADA – NORTHWEST TERRITORY

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Report of the Auditor General of Canada to the Northwest Territories Legislative Assembly – 2014, Child and Family Services – Department of Health and Social Services and Health and Social Services Authorities.

“The Department has not established an adequate accountability framework for the delivery of child and family services, which the Minister of Health and Social Services has authorized the Health and Social Services authorities to assist in delivering. It also has not adequately monitored whether those services are delivered in compliance with the Child and Family Services Act. In addition, the Department has not assessed the financial and human resources required by regional authorities to carry out their responsibilities to children, youth, and families, or developed adequate guidance and tools to support delivery of these services. These are serious shortcomings in the delivery structure for child and family services.”

 


 

IN THE WORKS

The Arizona Capitol Times ran a short blurb on April 25 concerning a pending audit of that state’s “maligned department of Child Protective Services” which will cost taxpayers an estimated $250,000 to perform.

Oh, never mind. The Arizona governor just vetoed the bill.

Another audit is currently underway, and it sounds promising. As the Chicago Tribune puts it in an April 20, 2014, article:

A Chicago nonprofit that has received millions of public dollars to provide foster care and other social services is being investigated by state officials for using taxpayer funds to pay for its founder’s condo, car and other personal expenses, the Tribune has learned.

State funds also were used to subsidize the former nonprofit leader’s expenses related to riverboat casino ATM withdrawals, parking tickets, prescription medication and spa services, according to state officials and records.

The Illinois Department of Children and Family Services has awarded repeated contracts to ABJ since 1998, the article explains, adding that: “The nonprofit has received more than $10 million from DCFS and four other agencies just since 2010, according to state comptroller officials, with most of the money coming from DCFS.”

 


 

New Study: Adverse Family Experiences Among Children in Nonparental Care

2014 May 17
Posted by ethoma
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On May 7, 2014, the results of a new study were relased by The U.S. Department Of Health And Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. The report explains that children who are raised by both biological Mom and Dad are more likely to have a safe, happy childhood.

According to the study, the worst outcomes for experiencing traumatic events comes from children in foster care, with no biological parental involvement. Following that category, those raised by one biological parent, and those raised by relatives other than parents come in ranking only behind children who are raised by both parents.

Seventy percent of children raised by their biological parents had no adverse family experiences, compared to only 21.7 percent of those raised by one biological parent, and 18.7 percent of those raised by neither of their biological parents. The study found that as the involvement of biological parents decreased, the likelihood of a child experiencing multiple traumatic events increased.

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While it is easy to become mired in the numbers when reviewing such reports, some crystal clear trends emerge from this one:

When examining the prevalence of children with no adverse experiences versus any adverse experiences, the difference between children in nonparental care and children living with one biological parent was quite small. However, as the number of cumulative experiences compared increased, the differences between children in nonparental care and children living with one biological parent grew. Children in nonparental care were about twice as likely as children living with one biological parent to have experienced four or more adverse events.

FOSTER CHILDREN

The study’s results are of particular concern given the high emphasis placed on child removal and foster care placement as the intervention of choice for many families. The report explains:

Children in foster care were particularly likely to have had multiple types of adverse experiences; almost one-half of them had had four or more. More than one-half of children in foster care had ever experienced caregiver violence or caregiver incarceration and almost two-thirds had lived with someone who had an alcohol or drug problem.

A few words of caution are in order. The study explains: “It is likely that some children in nonparental care find themselves in that situation because they had experienced certain adverse family circumstances that necessitated the removal of the child from the birth family – that is, the adverse experience preceded and perhaps even contributed to the nonparental care status rather than being merely associated with it. For example, more than one-half of children entering foster care in 2007 had experienced severe parental neglect and nearly 30% had experienced parental alcohol or drug abuse as contributing reasons for entering foster care.”

CHILD ‘NEGLECT’

A few words about “parental neglect” are in order before proceeding. Neglect is a broad-sweeping accusation that may encompass anything from taking your eyes off of a child for a few moments, to accumulating excessive absences from school, to shouting at your child from your driveway, to providing an insufficient home environment.

Douglas J. Besharov and Jacob W. Dembosky describe “definitional creep,” the phenomenon of ever-expanding definitions of abuse, neglect, and children “in danger of being harmed according to the views of community professionals or child-protective service agencies.”

The Florida Supreme Court grappled with this issue as long ago as 1977. When the state’s neglect statute was challenged, the Court ruled that “without some statutory standards or guidelines, the Legislature has effectively set a net large enough to catch all possible offenders and has left to the courts the power to say who should be detained and who should be set at large. Such a statute is dangerous and does not provide due process of law.” As the ruling in State v. Winters, 346 So.2d 991 (Fla.1977) explained:

A palacial mansion that is clean and spacious could fail to qualify as “necessary shelter,” if it had no heat. A small, overcrowded log cabin may, on the other hand, meet the test. Depending upon the standard adopted, any given shelter, whether in the suburbs or the ghetto, could be found to fall short of “necessary shelter.” Similarly, each person must ask just how much and what quality of food, clothing, shelter and medical treatment he must provide to avoid jeopardy. Nothing in the statute gives us the answer. There are no guidelines.

The state’s legislators rewrote the offending statute, in an effort to effect a constitutional cure. However, in State v. Ayers, 665 So.2d 296 (Fla. 2d DCA 1995) the statutes were still found wanting for lack of clarity. Florida’s child savers went back to work, this time adding “willfully or by culpable negligence” language to the child neglect statute. Hovever, Arnold v. State, 755 So.2d 796 (2000) still found it hard to digest the broad, sweeping mandates that constituted the legislative definition of “child neglect.”

The terms “alcohol or drug abuse” are almost-always added to the mix to justify child removals. The reality is that we are not finding junkies having babies in back alleys while shooting up with dirty needles – but that is precisely the impression that the child protection industry wants to convey.

iAlexandria Hill was rescued from parents who smoked marijuana as she slept.

Far more typical is the tragic story of Alexandra Hill, who was removed from her home by the Texas Department of Family Protective Services in November 2012 on a claim of “neglectful supervision.”

Alexandria’s dad, Joshua, readily admits they were smoking pot when their daughter was asleep.

“We never hurt our daughter. She was never sick, she was never in the hospital, and she never had any issues until she went into state care,” he said to reporters at KVUE TV.

Nevertheless, that was apparently neglectful enough of a situation for Alexandria to wind up in foster care. Presumably her removal and subsequent placement were sanctified by a judge, at some point in time.

Her outcome was the worst imaginable. Two-year-old Alexandria was rushed to Scott and White Children’s Emergency Hospital and immediately placed on life support. After an investigation, the foster mother’s charges were upgraded to capital murder. Texas MENTOR, the private agency that oversaw the foster home in which she was placed, had a long history of violations.

Bearing in mind that the majority of child removals involve neglect – and certainly do not involve anything resembling what most people would consider as “abuse” – we return once again to the study on hand. The research found that:

Nearly one-half of children in foster care (48.3%) had had four or more adverse experiences, compared with 25%–30% of children in each of the other three caregiver subgroups. Among those other nonparental care subgroups, differences were smaller and mostly nonsignificant.

This is consistent with some other studies of recent vintage regarding outcomes.

According to a California Senate Office of Research study reported on in December 2011, a state survey found that of 2,564 adult prisoners in the state, 14 percent said that they had been in foster care at some point in their lives. The study also found that: “Of the surveyed inmates who had been in foster care, 52 percent of the males and 45 percent of the females said they had resided in group homes. Thirty-one percent of the male inmates and 35 percent of the females lived with a foster family.”

Over one half of the males and nearly half of the females in this population graduated from group home settings.

A British study of children in care or custody released in December 2012 by Her Majesty’s Crown Prosecution Service Inspectorate explains: “the overall outcomes and future life chances for these children and young people are extremely poor. The fact that they were away from their home areas and were moved frequently militated against their chances of rehabilitation. The fact of being looked after could escalate a child into the criminal justice system.”

The British study continues on to explain: “In the overwhelming majority of the cases that we inspected, the outcomes for the children and young people were poor. Children and young people were not always protected. Some had been assaulted or sexually exploited; some had themselves assaulted or exploited other children and young people. They had often been criminalised while in care for offences that would probably not have gone to court if they had been living at home. A significant number had gone missing at some point, some a substantial number of times. Their education had suffered and few were well prepared or supported for transition to adulthood.”

The most recent study by the National Center for Health Statistics mentions parental incarceration as among the difficulties faced by foster children. But this raises the question of which is the proverbial chicken, and which is the proverbial egg? There are many disturbing outcomes resulting from child removal and foster care placement that are as yet incompletely understood.

A 2004 study published by the Vera Institute for Justice examined the chronology of arrest, incarceration, and child placement. Researchers noted that: “Many observers worry that the war on drugs and harsher punishments for minor crimes has resulted in more children entering foster care. The data suggest that the opposite is true.”

Contrary to their expectations, the researchers found that: “The vast majority (90 percent) of maternal incarcerations that overlapped child placement started after child placement, as did 85 percent of the arrests that led to those incarcerations. Child removal appears to accelerate criminal activity among the study group’s mothers.”

From Fiscal Year 1997 (the year of removal) to FY 1999, the study group mothers averaged 2.6 convictions each, “a rate far higher than in the pre-removal years.” The researchers came to a startling conclusion — one that is certainly not mentioned with favor among those in the child protection industry. That is that: “family preservation efforts may function as a crime reduction tool. Successful efforts to avert placement not only keep families together and children out of foster care, but can also prevent the increase in maternal criminal activity that can take place following a child’s removal.”

Marilyn C. Moses, a Social Science Analyst at the National Institute of Justice, reported the results of a follow-up study that arrived at much the same conclusion. Researchers from the University of California and the University of Chicago focused on mothers who were incarcerated in Illinois State prisons and the Cook County area, finding that more than one-fourth (27 percent) of the mothers who had been incarcerated also had a child who had been placed in foster care at some point during the child’s life.

“But surprisingly, researchers found, the mother’s incarceration was not the reason the child was placed in foster care,” Moses explained. While the results appeared to be counter-intuitive, they were nevertheless consistent with those of the earlier Vera Institute study:

In fact, in almost three-quarters of the cases, children were placed in foster care prior to the mother’s first period of incarceration. And in more than 40 percent of those cases, the children entered foster care as many as 3 years before their mothers went to jail.

This finding contradicts a widely held assumption that children are placed in foster care as a direct result of their parents’ incarceration. The early findings indicate that a child’s foster care status is rarely a direct result of a mother’s arrest and imprisonment.

Researchers often appear to be perplexed by such results, perhaps in part because they cling to the perspective that state “intervention” into family life is ipso facto beneficial. Indeed, identifying the “risks” associated with foster care, incarceration, probation, and other interventions frequently becomes an end in and of itself, with researchers paving the way for further inquiry into the devising of appropriate additional interventions to undo the damage done by the original ones.

Simmons Family Seeks Answers A Year After Child Died In Foster Care

2014 May 17
Posted by ethoma


 

The Louisiana Record, Louisiana’s Legal Journal, reports on a lawsuit that charges the Gretna division of DCFS with forcibly removing three children from their home, leading to the death of one child, and to the parents asking questions about the child’s death a year later. The article provides a brief overview of the allegations, but one that only provides an outline of the story:

The plaintiffs allege Eli Simmons was forcibly removed from his parents’ home by Department of Children and Family Services (DCFS) and their caseworkers on Feb. 11, 2013 without just cause. The child, who allegedly had special medical needs, was placed into the care of foster parents who the plaintiffs claim did not have proper training or possess the child’s medical records to handle his medical condition.

On April 8, 2013 the Simmonses assert they were summoned to Children’s Hospital in New Orleans and when they arrived they found their son was dead. They claim they were not offered an explanation of what had caused his death. The plaintiffs allege the death of Eli Simmons was due to negligence on behalf of the defendants.

The defendants are accused of improper placement of a special needs child in a foster home, not ensuring foster parents were properly trained and supervised, placing a foster child with special needs in a home not within reasonable distance from emergency care facilities, failing to timely obtain medical records in order to properly place child in foster care, failing to provide the plaintiffs with a cause of death, failing to ascertain cause of death, failing to allow parents and children to bury their son or sibling, failing to timely provide the coroner with proper medical records, infliction of emotional distress and infliction of pain and suffering.

The Orleans Parish Coroner is specifically accused of mishandling the child’s autopsy, failing to provide the body to the family for mourning and Christian burial, failing to provide the body to the family for a separate autopsy to determine the cause of death, disposal of the body to inhibit the family from exhuming the remains, disregard for the court order to preserve the body, infliction of emotional distress and failing to properly document the autopsy.

iCrystal and Patrick Simmons are still searching for answers a year after their son’s death.

Two months before his death, DCFS removed Eli and his three siblings from his parents’ Gretna home following allegations of abuse, Eyewitness news reporter Natalie Shepherd explains.

“They just came, and when they left, they had the kids with them,” said Patrick Simmons, the children’s father.

5-year-old Eli Simmons’s life ended on April 8, 2013, and it was news that the family received over the telephone.

“You need to get to Tulane University immediately, because Eli is having a medical emergency,” Crystal Simmons said was how she got the news.

The Orleans Parish Coroner’s Office ruled his death an “accident,” and the Simmons say DCFS never gave them an explanation, Eyewitness News reports.

“The last time I seen my child, he was laying on the table at the hospital where he died at,” Patrick Simmons said. The Eyewitness news account continues on to say:

But that wasn’t the end to the heart-breaking news for the Simmons. Patrick Simmons went to the coroner’s office to get his son’s body, only to find a post-it note stuck to the report saying he’d been buried a month earlier.

The Simmons said they were told Eli’s body had been cremated and the remains were put in a potter’s field. They’ve never been able to visit his grave or have a proper funeral. And now there’s no chance the family can have their own autopsy performed to get a second opinion about how their child died.

“Basically, the coroner’s office buried our child without permission,” Crystal Simmons said.

iAttorney Rachel Moss says DCFS is doing everything it can to cover their mistakes.

According to their attorney, Rachel Moss, a Jefferson Parish judge issued a court order to preserve Eli’s body. That order, however, was apparently either disregarded, forgotten, or misplaced.

“The coroner’s office, in their report, didn’t have any reference to the court order that they preserve the body.” Moss said.

“They’re doing everything they can to cover their mistakes and they’re not giving any information.”

The parents to this day don’t even know what the names of their children’s foster parents were.

The family’s troubles aren’t quite over yet. Before it was discovered that Eli’s body had been buried, they were on track to be reunified with their remaining children, according to their attorney. Moss says the state is now pushung for their parental rights to be terminated.

“They’re bullying,” Moss told Eyewitness News. “They’re using the system to bully these parents and to say they don’t want them to have their children.”

iEli Simmons

Patrick Simmons said, “I feel like they didn’t care. I feel like they took me as a name on a sheet of paper. A number. And it’s just their job.”

Patrick wants justice to be done for his son, while Crystal said that what she needs is peace.

“And it would be peace for me to know why my child died,” she said.

The Simmons family may get some answers soon. A hearing in the case is set for May 27.

Presumably now that a suit has been filed, DCFS will provide more than just enough information to fit on a post-it-note.

 

Still Awaiting Answers in Saharah Weatherspoon Foster Care Death

2014 May 17
Posted by ethoma
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Jennifer Jones had it hard enough when she was domestic violence victim. She’d split up with the father of her two children. One day, while picking them up from visitation with him, he fiercely attacked her with a knife, stabbing her in the back several times. As she ran for her life, daddy decided to set the home on fire – with two children still inside of it.

Thanks to rescue workers, both children made it through that ordeal. Then DFACS stepped in, and her nightmare worsened.

“DFACS intervened in the name of protecting the children,” the broadcast explained. The foster home, however, was three counties away from her, and Jones had no car. When she did manage to see her children, she noticed things; things such as bruises, scratches, and a burn on his chest.

Jones told WTVC News that she spent her days trying to contact someone – anyone from the state who could intervene on Saharah’s behalf. Her calls for help went unanswered. She was brushed off by the agency when she tried to report Saharah’s maltreatment.

“Something is going on in that house there,” Jones aid. “Nine different times I know I’ve told the DHS workers. I’ve told everyone in contact with the babies.”

No matter what she did, Jones was ignored until it was too late. Her two-year-old daughter, Saharah Weatherspoon, died on New Year’s Day at a hospital in Chattanooga, according to the May 16, 2014, news broadcast.

The private agency that Georgia had contracted with for the care of foster children was Omni Visions, Inc. Foster mother Clara Edwards worked for Omni Visions as a contracted foster mother, and it was in her tidy suburban home that Saharah sustained the injuries that would ultimately claim her life.

i

Jennifer approached WTVC News because the Department of Family and Children Services was stonewalling her, she had no idea how to proceed. It wasn’t until the News team began investigating and pushing the agency to release the files, that Jennifer discovered just how her child had died.

Jones stood in the cemetery where she’d buried her two-year-old daughter, and with reporters at her side, she read for the first time what the autopsy revealed. The reports made heavy use of black ink, but they were still quite revealing. “An autopsy was completed and there was evidence of bruising found on the back, arms, face, and torso. Had retinal hemorrhages and both new and old brain bleeding,” she said in a near state of shock.

As of May 15, 2014, there were no arrests in the case.

This is not the first fatality that Omni Visions had on its hands. In December 2007, the Knoxville News Sentinel reported:

Omni Visions, the Nashville-based private network of foster care homes that placed 16-year-old Jordan Kaleb Shelton with the man accused of choking him to death last month, is the state’s largest provider of such care.

Contracts with Omni Visions are worth about $40 million annually, Department of Children’s Services spokesman Rob Johnson said.

“They are our largest private provider, and they work all across the state,” he said. “Their overall record has been very good. They are one of our best providers.”

The firm has been a provider to the state since the inception of DCS in 1991.

The Knoxville News Sentinel also reported: “Kaleb’s death is the first inside an Omni Visions home but not the first time a placement has gone awry. Several years ago, a teenager in Omni Visions’ care died on a hiking trip. And the firm is being sued in Knox County Circuit Court over a highly publicized case from 2001, when two girls were placed in the care of a convicted child molester.”

In July 2010, Channel 5 News reported that:

An 11-year-old foster child suffered third degree burns over his entire body. Now his foster parents and the company that placed him in their care are at the center of a three million dollar lawsuit.

The lawsuit claims that a stove fire caused the burns and that the foster parents kept the child suffering in agonizing pain for three hours, before eventually taking him to the hospital.

“In all, the suit asks for three million in damages, not just to help with the boys lifelong disability fund, but also to send a message to companies like Omni Vision, that there are consequences,” Channel 5 News reported.

i

These are not the only problems with this company. In its June/July 2009 Medicaid Fraud Report, the National Association of Medicaid Fraud Control Units reported that Tammie McKuhn, a home health aide, pleaded guilty in criminal court to one count of adult exploitation and one count of theft.

The Fraud report continues on to explain: “It was alleged that McKuhn, an operations manager employed by TennCare subcontractor, OmniVision, Inc., misappropriated funds from the personal bank account of a TennCare recipient. McKuhn allegedly wrote and cashed several checks on the client’s behalf for personal use. Additionally, there were several items purchased for the client which were not found at the client’s residence. McKuhn admitted to misappropriating $820 via fraudulent checks and $488.67 in fraudulent purchases. On January 8 McKuhn was indicted and charged with one count of willful exploitation of an adult and one count of theft of property over $500.000.”


i

Jennifer Jones was not deemed worthy of raising her own children, but DFACS called on her when the decision needed to be made to remove life support.


Final Thoughts on the Justina Pelletier Case

2014 May 16
Posted by ethoma
The courts are not to determine which side of a medical dispute is sound where each side is supported by reason and logic.
Sevigny’s Case, 337 Mass. 747 (1958)

 


 

i

In what appears to be the most promising development of the last 15 months, Justina Pelletier was transferred by ambulance on Monday to the Justice Resource Institute’s Susan Wayne Center for Excellence, in Connecticut.

In stark contrast to her treatment at Wayside in Massachusetts, Justina was allowed extended visitation with all of her family members.

“I went in kind of skeptical as far as what I was expecting from Mr. Andy Pond, the CEO, but I came out of here very, very optimistic,” said Lou Pelletier, according to Beau Berman’s report.

A statement from JRI’s CEO was released late last week. That statement said, in part:

While JRI is not empowered to make placement decisions, our philosophy of family empowerment, our skilled staff, and our track record of family engagement make us a good choice for reunification. Our program respects the privacy of each individual we serve, which is afforded under the federal HIPAA law as well as other federal and state laws, and therefore we will not provide any specific information on any individual’s care or treatment.

Justina’s mother, father, and three sisters visited her inside the facility, and her father said he and his wife, Linda, are now allowed nearly unlimited unsupervised visitation of Justina at the facility in Thompson, according to Berman’s report.

“For now, we’re going along with it. She’s gotten out of that wayside facility where she’s been 4 months now. So now she’s at least in the state of Connecticut and hopefully this is her last stop and hopefully a short one before she’s home in West Hartford,” said Lou Pelletier.

Let’s hope that Mr. Pond lives up to his reputation, and that he facilitates the reunification of the family. He’s certainly a far better diplomat than any we’ve seen up to this point.

An announcement was made on A Mircale for Justina – the family’s Facebook page – asking supporters not to criticize the new facility. No protests are planned at the new location.

Those who love a protest rally take heart. Boston’s popular radio talk show host, Jeffrey T. Kuhner, who describes himself as “Liberalism’s Worst Nightmare,” will be organizing a large rally in support of Justina. The latest information available from the Justice for Justina Facebook page regarding the rally is that it is to be held at the state house in Boston 2-4 pm on Saturday, the 24th.

THE LINGERING QUESTIONS

Serious questions remain about at least two other children that were said to have been admitted to Boston Children’s Hospital last year. “I know personally of two other families who also are under a gag order by Boston Children’s Hospital,” said Cristy Balcells during an interview last November.

Unless and until someone with more information regarding those two cases comes forward, we may never know what their outcomes may be. We don’t know whether the families are adequately represented, or whether their children have since been released. Many troubling questions still remain unanswered about the whole affair at BCH.

In the absence of complete information, it is tempting to speculate, but this much is known. When Beth Maloney was asked what she thought was going on, she candidly replied that she didn’t know for certain, speculating that it may be a question of egos at work.

She added, however, that in both of the two cases she’d handled, Boston Children’s Hospital did the same thing that it did to the Pelletier family. Specifically, what she said was: “It’s not just Mitochondrial childen that they go after. I’ve had two children with an autoimmune disorder that effects the brain, and they did the same exact thing; diagnosed the children with somotaform disorder. There is a psychologist at Boston Children’s Hospital who is very invested in that – Somatoform disorder – she’s written papers about Somatoform disorder.”

Are young residents actually allowed such broad and sweeping powers? The answer is that it would certainly appear to be the case. According to a document on Boston Children’s Hospital’s web site, Child & Adolescent Psychiatry Residency Training Program, which appears to be provided to all new residents in psychiatric training, and which is signed by David R. DeMaso, the unique training goals of rotation in the Psychiatry Inpatient Service program

are to teach residents to evaluate and manage children, adolescents, and their families, who present with severe psychiatric illnesses, or co-morbid medical-psychiatric illnesses, requiring care in a more restrictive inpatient setting. In this setting our residents function as the primary clinician for two patients. This involves all aspects of patient care, from family, to individual, to pharmacotherapy. They also provide medication management for two additional patients. During this four-month rotation residents receive supervision from their team attendings and staff social workers, as well as from the medical director.

In terms of framing the bigger picture, what we do know is that Children’s Medical Center Corporation, the company that runs Boston Children’s Hospital as a subsidiary, is tax exempt as a learning institution, according to the Company Overview provided by Bloomberg BusinessWeek. According to the company’s 990 filings, maintained by the good folks at CitizenAudit.org, as of 2013 the company claimed total assets of $2,052,394,841 and net assets of $531,913,049.

According to Bloomberg BusinessWeek, one of the “key developments” worthy of note regarding the corporation is that on Noverber 6, 2013:

Pollack Solomon Duffy LLP announced a lawsuit filed in Suffolk County Superior Court against Children’s Hospital Boston and several of its healthcare providers, by the Swiss mother of a 14 year-old girl allegedly confined for six weeks in 2012, separated from her mother and inadequately protected from a Haverhill woman allegedly the source of Xanax on which the girl overdosed. When finally discharging the girl, Children’s Hospital returned her to the woman whose Xanax was the source of the overdose. Approximately six months passed before Claudia Felder, the girl’s mother, recovered her daughter through a petition in Federal Court in Massachusetts under the Hague Convention on the Civil Aspects of International Child Abduction.

The Bloomberg BusinessWeek profile continues on to explain: “As alleged, when Felder refused to pay for services while demanding her daughter’s return to Switzerland, Children’s Hospital supported the Haverhill woman’s efforts to separate the girl and her mother. The civil action includes claims for negligence, interference with custody rights, and loss of filial consortium.”

i

We know also what the policy is regarding wards of the state. Document: CIPP 071.001.19, from The Clinical Investigation Policy and Procedure Manual at Boston Children’s Hospital, details the facility’s policy with regard to “Wards of the State.” According to the definition provided in the document: “A ward means any child who has been adjudged dependent by a court and who is under the care or custody of a public official or agency, including foster children, or any child under the control of DSS in the state of Massachusetts. This also applies to children in penal custody or otherwise detained within the criminal justice system.”

There is a specific procedure in place just for such contingencies. Once a child becomes a ward of the state by virtue of a 51A filing and a subsequent rubber stamp by a juvenile court judge, the Department of Children and Families makes all of the decisions. The parents are relegated to the role of being mere nuisances to be kept handily out of the way. The document clearly explains the procedure following a parentectomy:

The Commonwealth of Massachusetts requires that they review and approve all requests for individual Department of Children and Families clients to participate in research. This includes children who are in DSS care or custody. This review is conducted by the Department of Children and Families Research Proposal Review Committee. Investigators are required to complete and submit the appropriate forms in order for this review to occur. No research may begin with a particular ward until approval is obtained.

i

It is easy to dismiss this document out-of-hand by saying that just having a policy in place does not necessarily mean that it is being implemented.

A thoughtful researcher provided a document from the Massachusetts Department of Public Health, entitled Conduct of Human Subject Research, as last revised April 15, 2013.

While the document does provide some meager procedural safeguards, there is no practical way to ensure that they are enforced. And, with DCF making the critical decisions, some may question whether the best interests of children are indeed being served. The document states, in part:

Children who are wards of the State or any other agency, institution, or entity can be included in research approved under 45 CFR 46.406 and 45 CFR 46.407 only if such research is: 1) related to their status as wards; or 2) conducted in school, camps, hospitals, institutions, or similar settings in which the majority of children involved as participants are not wards. If the research meets the criteria above, the IRB requires the appointment of a participant advocate for each child who is a ward, in addition to any other individual acting on behalf of the child as guardian or legally authorized representative. One individual may serve as an advocate for more than one child. The advocate must have necessary expertise and experience, and agree to act in the best interest of the child. Only those advocates without any conflicts of interest can be appointed as advocates.

Naturally, all of this is concealed not only from the public, but from the parents as well. For that purpose, DCF has its near-impenetrable cloak of confidentiality, and the medical facility has the HIPPA regulations to hide behind.

i

To the extent that DeMaso has considerable influence in the community outside of the ivory towers, he and Joseph Gold, M.D. co-authored An Adolescent Mental Health & Wellness Curriculum: A Starter Kit for Schools, which in its essence is a series of mental health screening tools intended to be used on the student population.

School personnel are specifically cautioned to anticipate parental resistance to the prescription of medications intended to “treat” the mental health needs identified by the screening instruments, as the Curriculum itself explains: “Prescribing antidepressants may be resisted by families distrustful of the use of medications and disconnected from the Western medical system.”

Indeed, the Curriculum goes so far as to say “there may be varied responses from parents based upon differing culturally-based viewpoints on mental health, the role of schools, the rights of parents, and family boundaries and privacy.” However, as the Curriculum explains:

Parental resistance is not a reason to abandon the course you have chosen in addressing student mental health, but should be used as an important opportunity for opening a meaningful dialogue with the families of your students. In fact, we suggest that you should expect resistance of some sort – it is reasonable for parents to have questions about how mental health issues will be addressed by a school, or by any professional. Anticipating the questions and concerns parents will have is another part of the internal staff process you can engage in, and responses should be built in to your evolving implementation plan.

i

Finding an affirmative link between David DeMaso and DCF was somewhat problematic, however there is one to be made. The February 2010 issue of Department of Children & Families Monthly Update speaks glowingly of “Building Bridges to Understanding,” a program intended to create a “case based training” approach to psychotropic medications administered to foster children. As the article explains, “The training is unique in that it borrows from a model developed by Dr. DeMaso, and that is geared to teaching practicing physicians.”

The DCF article explains: “With the help of Heather Walters, Chief of Child Psychiatry at Boston Medical Center and David DeMaso, Chief of Psychiatry at Children’s Hospital, a very specific curriculum was developed to address these concerns.

We know also that three Harvard psychiatrists were accused by Senator Chuck Grassley of accepting money from drug companies, and that they were reprimanded for violating conflict of interest polices set forth by Harvard Medical School and Massachusetts General Hospital. According to the Congressional Record of the proceedings, Senator Grassley explained that his staff experienced great difficulty in obtaining answers to his questions, however in March of 2008,

Harvard and Mass General asked these doctors to take a second look at the money they had received from the drug companies. And this is when things got interesting. Dr. Biederman suddenly admitted to over $1.6 million dollars from the drug companies. And Dr. Spencer also admitted to over $1 million. Meanwhile, Dr. Wilens also reported over $1.6 million in payments from the drug companies.

The question you might ask is: Why weren’t Harvard and Mass General watching over these doctors? The answer is simple: They trusted these physicians to honestly report this money.

The key to understanding the significance of all this was explained by New York Times columnist Gardiner Harris, whose article explained:

Dr. Biederman’s work helped to fuel a fortyfold increase from 1994 to 2003 in the diagnosis of pediatric bipolar disorder and a rapid rise in the use of powerful, risky and expensive antipsychotic medicines in children.

Although many of his studies are small and often financed by drug makers, Dr. Biederman has had a vast influence on the field largely because of his position at one of the most prestigious medical institutions.

Joseph Biederman, Thomas J. Spencer, and Timothy E. Wilens, ultimately issued a letter of apology to their colleagues, stating that the two institutions had concluded a review of their practices and found that they had violated conflict of interest policies requiring affiliates to report industry-sponsored activities to the University.

The Johnson & Johnson Center for the study of pediatric psychopathology at Massachusetts Medical Hospital, where Dr. Biederman served as chief, said in its 2002 annual report that its research must satisfy three criteria: improve psychiatric care for children, have high standards and “move forward the commercial goals of J.& J.”

Here is where it gets much more interesting. In order to market a medicine, you have to have a disorder to treat. This was Biederman’s forte, as the annual report explains:

Equally important to effective use of medications is the demonstration of the validity of disorders. Because parents, patients and clinicians are exposed to a media that frequently questions the validity of childhood disorders, genetic and brain imaging studies are needed to show the validity of these disorders as brain disorders that respond to medication.

These and other documents obtained during litigation unambiguously reveal that big pharma is inextricably intertwined with some very influential people residing in the ivory towers at Harvard, and elsewhere.

On November 4, 2013, the U.S. Justice Department announced that Johnson & Johnson was to pay out more than $2.2 Billion to resolve criminal and civil investigations related to its off-label marketing of the prescription drugs Risperdal, Invega and Natrecor.

According to the Justice Department’s press release, “The global resolution is one of the largest health care fraud settlements in U.S. history, including criminal fines and forfeiture totaling $485 million and civil settlements with the federal government and states totaling $1.72 billion.”

On November 12th, 2012, attorney Jim Ianiri posted his accounts of what he described as the “dark side” to Boston Children’s Hospital. His accounts are entirely consistent with those of others who are familiar with the Bader 5 unit of the Hospital.

Just long has this been going on? At least half a decade, according to the testimony of Kimberly Castro before a Connecticut committee. Her daughter, Chelsey Cruz, died as a result of unwarranted state intervention, as she explained to the committee:

We sought help from the Boston Children’s Medical Center. And at first, they agreed and began to wean her off the medications. She began to look and feel better. However, one fatal visit occurred when a chief doctor came on the scene. He demanded that Chelsey be put back on the experimental medications and threatened to call DCF if I resisted. I asked to seek a second opinion and was immediately dismissed. My daughter was forcibly admitted and guards were placed outside her door, keeping me from my child.

Massachusetts Department of Social Services and the Department of Children and Families in Connecticut worked to entrap us, and an order of temporary custody was obtained in Boston. I was told by the Boston Department of Social Services that I was no longer able to make any medical decisions for Chelsey. I went to the local newspapers with my story, sharing my pain and my hope to gain justice.

Most unfortunately, it recently came to my attention that Kimberly Castro passed away without the benefit of knowing that her story had gained wider circulation, and that there was a growing body of people that wanted to reach out to her offering some words of consolation.

FINAL THOUGHTS

In a previous posting, I had analyzed some of judge Johnston’s custody rulings, as they managed to wind their way up to appeals. By all accounts, Dr. Korson was present in the courtroom during a critical stage of the proceedings, and he provided testimony regarding Justina’s diagnosis. The judge disregarded Dr. Korson’s expert testimony, ruling that there was ample evidence before him to conclude that Justina suffered from a severe Somatic Symptom Disorder. The judge should not have rendered this ruling, as it stands in direct contravention to Massachusetts case law.

To the extent that there is any discussion regarding whether or not a judge should act as a referee to resolve conflicting medical debates, there should be no such discussion, as: “The courts are not to determine which side of a medical dispute is sound where each side is supported by reason and logic.” Sevigny’s Case, 337 Mass. 747 (1958).

A Rule was established by the Centers for Medicare and Medicaid Services on February 8, 2013, requiring applicable manufacturers of drugs, devices, biologicals, or medical supplies covered by Medicare, Medicaid or the Children’s Health Insurance Program to report annually on certain payments or transfers of value provided to physicians or teaching hospitals. In addition, applicable manufacturers and applicable group purchasing organizations are required to report annually certain physician ownership or investment interests.

This information is to be posted a public Web site. It is hoped that greater transparency may follow as a result.

They made a movie out of what Bob Woodward and Carl Bernstein of The Washington Post did in 1972 – remember that? A tip of the proverbial hat to Beau Berman for reminding journalists everywhere that breaking stories wide open is still what the public expects them to do. He stands nominated by the National Academy of Television Arts and Sciences, Boston / New England Chapter, for the 2013 Emmy Award Nomination for Best Investigative Reporter.

Hat’s off also to the Boston Globe for their coverage. The Globe’s superb video, “A medical collision with a child in the middle,” is currently on Youtube. Be sure to watch it if you haven’t seen it yet.

They also made a movie in 1973 about a whistle blowing cop by the name of Francesco Vincent Serpico. Al Pacino was nominated for the Oscar for his portrayal of the former New York City cop whose whistle-blowing led to the formation of Mayor Lindsay’s Knapp Commission. An honest cop in a big city, and it’s such big news that it makes the big screen.

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Former Boston Children’s Hospital nurse Katie Higgins, who followed the Pelletier case from the start, wrote a scathing letter on January 8, 2014, addressed to Massachusetts Gov. Deval Patrick, Attorney General Martha Coakley, and Massachusetts Department of Children and Families Commissioner Olga Roche.

Her letter charged that Children’s Hospital is guilty of committing “medical child abuse” by pulling Justina off most of her previous medications for mitochondrial disease. Higgins also asserted that Justina’s health had deteriorated as a result.

Higgins wrote: “As advocate for the family, I informed Department of Mental Health licensing director, Liz Kinkead of the breach of law regarding Justina’s commitment to a locked psychiatric unit and was told that DMH was deferring to the medical expertise of Boston Children’s Hospital.”

Nurse Katie Higgins put her livelihood on the line to do the right thing. It takes tremendous courage to do something like that. It takes a Serpico-kind of courage to do that, particularly when confronting such a well-insulated institution as Harvard.

In 1986, Alison Taylor, a children’s home head in North Wales, approached authorities to complain about violence by staff to children in residential care. She had previously tried to raise the issue with a number of her superiors, but to no avail. A police investigation was carried out, however no criminal proceedings were forthcoming. Taylor quite naturally lost her job, however she continued to press her concerns to anyone who would listen.

In 2000, Alison Taylor was not only morally vindicated; she was also recognized as the recipient of the Pride of Britain Awards in the category of Woman of Courage.

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“For years, children in care in North Wales were abused and beaten by those charged with their welfare. Some social workers turned a blind eye. Others were part of a more sinister conspiracy of silence. Thankfully, one woman was not prepared to look the other way – even though her complaints about the abuses she had witnessed cost her her job,” her biography on the Pride of Britain Awards site explains.

It may take some time, but if this whole affair is given the attention that it demands from the proper authorities, Ms. Higgins may just receive the recognition that she deserves. It doesn’t always work that way, though. Sometimes a measure of fleeting public recognition, and the ability to sleep at night with a clear conscience, is all the reward that you get for doing the right thing.

No admission of wrongdoing – let alone an apology – has been issued by Boston Children’s Hospital or DCF. Hence, there are no assurances that such a thing may never happen again. The same thing may very well be happening to another family at this very moment.

As for the results of the investigation said to be underway for Boston Children’s Hospital, it’s a game of wait and see. Why the FBI or the Justice Department isn’t investigating beats me.

As of today, Friday, A Miracle for Justina had acquired well over 43,000 likes, according to Facebook-provided statistics. That is a remarkable accomplishment, and it speaks volumes to the level of popular support the family gained since going public with their plight. Thank heavens there was someone willing to take their story to the public when they made that decision.

May the winds of good fortune sail the Pelletier family to the happy ending that they so handsomely deserve.