Md. child protective reforms are urged

Baltimore's top health official proposed yesterday that the state reform its troubled child protective system by stationing abuse caseworkers in hospitals 24 hours a day and acting more quickly to remove minors from dangerous homes.

Dr. Peter L. Beilenson, the city's health commissioner, said the reforms to the state-run Baltimore Department of Social Services could help prevent deaths such as that of 2-month- old David Carr, whose fatal beating was detailed in The Sun on Sunday.

"As illustrated in recent local media reports, far too many children are being abused while on the watch of the Department of Social Services," Beilenson wrote in a report released yesterday. "Too frequently, our city's children suffer in the wake of DSS's poor decision making."

Neither the department's interim director, Floyd Blair, or his boss, state Human Resources Secretary Christopher J. McCabe, returned calls yesterday seeking comment on the report.

Henry Fawell, a spokesman for Gov. Robert L. Ehrlich Jr., said the governor "would welcome the suggestions and they will certainly be reviewed at the departmental level, by the Department of Human Resources."

An investigation by The Sun, which drew on criminal court records and interviews with child abuse experts, revealed that David Carr's death on Feb. 12 in a West Baltimore rowhouse was in part the result of an overburdened Department of Social Services and juvenile courts that often fail to protect abused children in the city.

Norris P. West, a spokesman for the Department of Human Resources, sent the newspaper an e-mail Sunday stating that the article "grossly misrepresented the role and responsibilities of the Baltimore DSS caseworkers in this very disturbing and tragic case. We are very saddened by the loss of innocent life and disappointed that the Sun erroneously caricatured caseworkers who pride themselves on saving vulnerable children."

West refused to elaborate and did not return calls for comment on Beilenson's report.

Chief among Beilenson's recommendations for reform is for the state to assign child abuse caseworkers seven days a week, 24 hours a day, at Johns Hopkins Hospital and the University of Maryland Medical Center so that abused children don't have to wait for hours for them to appear after being called by hospital staffers.

The report also urges the state's juvenile court system to shift its definition of the child's "best interest" away from reuniting families at almost any cost toward protecting minors from abusive parents.

Susan Leviton, director of the Children's Law Center at the University of Maryland School of Law, said she was disturbed that the state refused to answer any questions about David Carr's death or respond to the suggestions for improvements to the agency.

"This drives me crazy with this agency, because any time you find any problem, they say, `We can't talk about it; we have to protect the children's confidentiality,'" Leviton said. "When a child dies, and they won't talk about it, who are they really protecting? The agency."

Beilenson is chairman of the city Child Fatality Review Committee, which scrutinizes the deaths of about 120 children a year by nonmedical causes, such as vehicle crashes, accidents and abuse.

As part of that review, Beilenson said that he was disturbed by a trend of a large number of children who appeared to be dying of abuse after they entered the state's Child Protective Services system.

"In looking at the child abuse deaths, the vast majority of the cases were known to DSS," he said in an interview yesterday. "The children were being taken out of abusive families by the DSS, and then returned to the families, or placed in situations that were clearly dangerous."

In November, Beilenson created a special task force called the Child Welfare Reform Committee, for which he recruited eight experts, including Leviton and Dr. Allen Walker of Johns Hopkins Hospital. The panel's report was released yesterday.

The Sun's recent investigation into the failings of the DSS and juvenile courts to prevent the death of David Carr underscored the urgent need for reform, Beilenson said.

"These deaths you have been writing about are only the tip of the iceberg," said Beilenson, referring also to the deaths of 5-year-old Travon Morris in February and 15-year-old Ciara Jobes in December 2002.

David Carr's mother, Keisha Carr, was on probation for breaking the arms and legs of her older child, James, at age 2 months and was supposedly under the watch of the state's Child Protective Services system, when her second son, David, was killed, his skull, ribs and arm broken.

About three months before David's death, a health counselor called the DSS to warn that Keisha Carr had dropped out of a court-mandated psychiatric treatment program and might harm her children again. But the call did not inspire the agency to put her babies in foster care, according to court documents and interviews.

Among the recommendations in Beilenson's report:

The state should increase staffing and training for the Child Protective Services emergency call center so that people calling to report emergencies don't have to put on hold for more than 30 minutes, as they sometimes are today.

The state should study the mental health history of foster parents and guardians before approving the placement of children in homes.

The state should form committees of caseworkers to analyze their most difficult cases so that employees of Child Protective Services don't have to make life-and-death decisions on their own. These committees could be assisted by a computerized system similar to the CitiStat software that the city uses to study trends in crime, lead poisoning and other areas.

Mayor Martin O'Malley said yesterday that he would have instituted several of these reforms had Ehrlich's administration not usurped his right to jointly select a director for the city Department of Social Services.

Instead, Ehrlich picked Blair, a former Bush administration official whom O'Malley asserts has almost no management experience, for the post in September. The mayor sued Ehrlich in November in an attempt to block Blair's appointment; the lawsuit is pending.

"You can't improve a department unless you have a combination of leadership and resources, and the will to bring about reform," O'Malley said. "I do think there is much greater public understanding of the problem now. ... But leadership is still a missing ingredient."