The baby was born meth-exposed. The mother’s urine test came back positive for meth and opioids. And the father admitted he drinks beer daily and uses marijuana occasionally.

Is this enough evidence for the state to take custody of the child?

Maybe at one point in the history of the Department of Child Safety. But not necessarily now.

The state’s child-welfare agency has revamped its training — officials call it a “renovation” — to emphasize keeping families together while still ensuring kids are safe.

The key changes are a more-detailed definition of “safety,” more time for case investigators to spend with a family, and more eyes on the situation. Decisions about a child’s welfare are now the responsibility of a team, rather than just one staffer.

MORE: Real progress at DCS, but ‘a long way to go,’ report says

For longtime watchers of Arizona’s child-welfare efforts, it’s easy to see this policy as just the latest swing of the pendulum that’s moved over the years between seemingly opposite strategies: Remove kids from potentially abusive or neglectful situations to keep them safe, or keep them at home and work with families to improve their situation and avoid foster care.

Both approaches pose risks to children. In a troubled home, a child could suffer neglect, or worse. In foster care, she could suffer from being separated from her parents. Plus, the system must for care for yet another child on top of the nearly 15,000 already in foster care.

So any tweak to the decision-making process could help families, or could harm them and the state’s efforts at large. 

It’s too early to gauge how the program is faring for kids. But even its most-ardent advocates caution there will be challenges, and the program will be adjusted as it progresses.

“No system is perfect,” said Suzanne Schunk, director of family-support services at Southwest Human Development, a social-service agency that provides many of the programs DCS offers parents. “I hope for the best. I believe in family preservation.”

Present danger

The updated safety protocol sets a seemingly high bar for when a child-welfare worker should remove a child from his or her home.

It’s called “present danger,” meaning “something that is immediate and severe and observable, happening right now in the present,” said Katherine Guffey, DCS’ inspector general and an assistant director.

And even then, officials might find a way to keep the child at home. For example, the adult who’s posing the danger could leave, Guffey said. Or a relative could stay with the children — which was the case with the meth-exposed baby.

The new standard was not an easy sell. Seasoned DCS staffers were skeptical, at least initially. Some were concerned it might be too lenient in an effort to keep kids with their parents.

Indeed, since the new practice started late last summer, there have been child deaths and near-fatalities in which DCS was involved.

It’s unclear, at this point, whether any of those cases involved a decision to leave a child at home, or under the supervision of a “safety monitor.” Investigations are ongoing.

Agency officials anticipated resistance to the new approach, saying it’s akin to a cultural change. 

“We see that is our greatest opportunity and our biggest challenge,” deputy director of support services Mike Faust told lawmakers last summer, just as the program was about to roll out.

It’s far from complete: Training is still rolling out for caseworkers. Behavioral-health providers are also in the queue for training.

The training focuses on one key point: When is a child really in danger?

‘Don’t take my baby’

Breanna Donaldson was ready, sort of, for a visit from DCS.

The day after her baby girl, Mazie, was born substance-exposed, a DCS investigator showed up in her hospital room.

Donaldson, now 23, knew her treatment for her heroin addiction — regular doses of methadone — would put her on DCS’ radar. The methadone clinic had warned her.

She also had heard stories about DCS, about people losing their kids, and she was panicked she would be the next parent to lose her child.

“Don’t take my baby, don’t take my baby,” she kept repeating to herself as she lay in her bed at Scottsdale Memorial Hospital last September.

The investigator didn’t.

Instead, the investigator explained that methadone had turned up in the baby’s system, which the hospital had to report to DCS. She had a long talk with Donaldson about her pregnancy, her heroin use, her decision to use methadone to taper off the drug rather than going cold turkey.

“I gave her a walk-through of what I had been through and how Mazie motivated me,” Donaldson said, marveling at the immediate and strong bond she felt with the infant. “I told her about all the support I have, and how I was living with my family again.”

She calmly answered the investigator’s questions, searching the woman’s face for clues on how she was doing. But internally, she was freaking out. When the investigator stepped into the hall to talk to Donaldson’s mother, she figured it was game over.

It wasn’t.

The investigator said Donaldson was going to keep her daughter. There was no sign the infant was in any kind of imminent danger, meaning Donaldson wouldn’t need a safety monitor to keep tabs on Mazie.

Donaldson burst into joyful tears.

Then came the “but.” She would have to undergo regular drug tests. DCS would provide her with social workers to help her as she entered a new phase of her life: motherhood.

She would be assigned a caseworker to track her progress.

“This is not what I was expecting from DCS,” Donaldson said as she cradled Mazie at her Scottsdale home. “Everyone says it’s so scary.”

A pendulum swing?

Early in his term, Gov. Doug Ducey gave the agency a clear directive to reduce the number of children in foster care. That is happening.

DCS is on a downslope from a high of nearly 19,000 children in foster care as of spring 2016, to fewer than 15,000 today. Agency officials say it can’t be attributed to any one factor, but it’s clear that doing more to keep families together helps drive down the numbers.

MORE: With backlog of cases down, Arizona DCS director wins child-welfare award

Also fueling the shift is research that shows children suffer when they are taken from their parents.

“What we don’t recognize is the trauma a child experiences when removed from the home,” said Monique Mitchell, a research assistant professor at the Center for Child and Family Studies at the College of Social Work at the University of South Carolina. 

She interviewed hundreds of children about their experiences in foster care and found that even in cases where they are removed from dangerous circumstances, they feel the loss of family and a familiar environment.

Added to that is the uncertainty of their situation: The children don’t know where they’re going, they’re often placed with strangers, and even if they’re sent to a relative’s home, there are unknowns, Mitchell said.

“They don’t know how long they’re going to be there. No one can tell them how long until they return home, because no one knows,” Mitchell said.

Somewhere along the line, child-welfare practices lost sight of those impacts, which can be traumatic and long-lasting, said Karen Kline, direct-practice administrator at the Center for Child Well Being at Arizona State University.

“In the 1980s and ‘90s, we focused on safety and sort of forgot about the well-being part,” said Kline, who worked at Arizona’s then-Child Protective Services division more than a decade ago.

She welcomes the renewed focus on keeping families together, noting that’s always been the goal of child welfare. The updated policy sharpens the focus and gives investigators and caseworkers more guidance, she said.

At DCS, Guffey said recent research shows a child’s brain development is positively linked to a stable environment.

“When they’re able to stay at home, they’re able to stay with their friends. They go to the same school. Everything that is familiar to them is still there,” she said. “Which is incredibly important.”

Guffey says the policy, if done well, should stop the swings in what’s emphasized by child-welfare officials.

“The purpose of the safety model is not to swing a pendulum from removal to family preservation, but to stabilize that pendulum at accurate, safety decision-making,” she said.

When is a child safe?

DCS guidance states a child is safe when there is no threat of danger.

It’s not as simple as it sounds: Even if there is a threat — such as drug use in the home, or a parent who isn’t feeding the child — if the situation can be managed by a parent or other adult, there’s not necessarily a need to remove the child from the home.

“For instance, you might have a parent who has a substance-abuse addiction and it would be very dangerous to a baby because they’re very disorganized and not providing adequate nutrition,” Guffey explained. “But a 16-year-old who is going to school and maybe has their own job and has some income and can get food otherwise, it may not be a safety threat.”

DCS outlines five criteria, all of which must be met to determine when a child is in the kind of “present danger” where taking him out of the home might be needed.

The standards include whether a child is dependent on an adult for protection or food; whether a family situation is unmanaged and out of control; and whether there is severe harm that could result in injury, terror or even death.

Even in situations that meet those criteria, removing the child is not automatic.

DCS is directed to come up with a plan for the “least intrusive” way to manage any impending safety threat. For example, maybe the family agrees to find a relative or friend to serve as a safety monitor who will be home at key times, such as meals or bedtime.

That plan is to be in place for two weeks while DCS works with families on longer-range plans to address their problems.

‘Chicken nugget’

At her Scottsdale apartment she shares with her mom and Mazie, Donaldson ushers in a small crew of social workers. They arrived to check in on her progress, two months after Mazie’s birth.

The new mom gets glowing reports.

“Mom’s doing real good,” said Leisha Lucas, a family counselor with the family-preservation team for Southwest Human Development, a DCS service contractor. “She’s very open.”

Donaldson is doing well on her recovery goals, Lucas said. She’s already identified the circumstances that might trigger her to start using again, and has outlined a list of coping skills.

She’s on track with her drug counseling at Terros, which provides drug and alcohol treatment, among other things. She’s consistently had clean drug tests and is sticking with her methadone treatments.

Donaldson also is building her parenting skills, and Mazie is proof. The infant tracks Mom’s voice, follows the direction of a mobile above her crib, and lifts her head during “tummy time,” when she’s set on her stomach.

She also participates in a long-running program called Healthy Families, which, as its name implies, helps families with newborns get off to a healthy start.

At first, Donaldson said she was overwhelmed by the multitude of programs offered her. Getting her schedule straight with so many appointments to keep while caring for Mazie was an adjustment.

Caseworker Jeremy Karelson is there to track it all and, like the others, gives Donaldson high marks.

He calls her a “chicken nugget,” his shorthand for her case being an easy one.

Does it work?

Services are a key part of the renewed focus on family cohesion, said Southwest’s  Schunk.

It’s too early to tell if the program is working, say Schunk and others involved in the process.

ASU’s Kline said the renewed protocol is the right thing to do, since having the government take your kids should be the absolute last option.

But, she said, humans are hard to predict.

“This is taking a chance on the family being honest and doing them (safety plans) the way they say they’ll do things,” Kline said.

Likewise, Linda Scott at Jewish Family Services said the “safe-action” model DCS is adapting has been successful in other states, but there are always risks. Her agency provides many of the social services assigned under the safety model.

“When you make change in a system, people get nervous,” Scott said.

Action for Child Protection, which worked with DCS on the new protocol, did not return phone calls seeking information about how the safety model has performed elsewhere.

DCS Director Greg McKay said the fact the agency rid itself of a 16,000-case backlog has freed up caseworkers to spend more time with families. And under the safety protocol, the agency is encouraging caseworkers to take that time, he said.

Noting the drop in the foster-care numbers — lauded by Casey Family Programs as the steepest in the nation at 10 percent between 2016 and 2017 — McKay credited a changed atmosphere at DCS that focuses more on providing services to families while the children are in the family home.

“I attribute this mainly to a safe culture within the organization, (one) without fear,” he said.

Reach the reproter at [email protected] and follow her on Twitter @maryjpitzl

Circumstances when child might be in danger

DCS policy outlines five circumstances, each of which must be met, to conclude a child might be in impending danger.

• Observable family condition: A family condition that endangers a child and is real, can be described and reported, and is evidenced in explicit and unambiguous ways. This does not include suspicion or gut feelings.
• Vulnerable child: A vulnerable child is dependent on others for sustenance and protection, and/or is exposed to circumstances that she or he is powerless to manage. Vulnerability is judged according to age, physical and emotional development, and ability to communicate needs and seek protection.
• Unmanaged: The family conditions pose a danger to the child and are unmanaged, without limits or monitoring, and not subject to influence, manipulation or internal power within the family’s control (that is, no one in the family can control the situation). There are insufficient caregiver protective capacities to manage the danger threat.
• Severity: Severity is the harshness of the effects of maltreatment that would include harm that has just occurred, is occurring now, or could potentially occur in the near future. Severe harm is something that results in serious pain, serious injury, suffering, terror, extreme fear, impairment or death.
• Imminent: A belief that threats to child safety are likely to become active without delay; a certainty about occurrence within the immediate to near future. This is consistent with a degree of certainty or inevitability that danger and severe harm are possible — even likely — outcomes, without intervention.

About this report

A three-year grant from the Arizona Community Foundation supports in-depth reporting at The Arizona Republic and azcentral.com on child welfare and the state’s children in foster care.

Are you part of the child-welfare system? We want to understand your story. Go to childwelfare.azcentral.com.

READ MORE:

Judge: All children in DCS care are now part of class-action lawsuit

Arizona’s foster care boards don’t look like their communities. Here’s why that matters

A horrifying journey through Arizona foster care, and why we don’t know how many more children may be abused

 

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