Parents, Social Services Implicated in Child Neglect

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LYNN NEARY, host:

I'm Lynn Neary and this is Tell Me More from NPR News. Michel Martin is away. Coming up, we'll talk with a senior swimmer who competes on a Washington team for athletes who have to be at least 50.

But first, it's time for Behind Closed Doors, a conversation about subjects that are hard to discuss. And today, we focus on at-risk kids.

In Philadelphia, criminal charges have been brought against nine people in connection with the death of 14-year-old Danieal Kelly in 2006. Danieal, who suffered from cerebral palsy, starved to death. When she was found, her body was covered with maggot-infested bedsores. She was lying in a pool of her own feces and weighed just 42 pounds. Among those charged were Danieal's parents and two social workers for the Philadelphia Department of Human Services.

The charges came as the result of a lengthy grand jury investigation which calls the failures, in this case, a deeply-rooted problem within the city's child services agency. For an update on this story, we turn first to Elizabeth Fiedler of member station WHYY. Hi, Elizabeth. Thanks for being with us.

ELIZABETH FIEDLER: You're welcome. Hi.

NEARY: Elizabeth, first, fill us in on Danieal Kelly, who was just 14, and tells us what led to this terrible death?

FIEDLER: She was just 14 on July 31st. The district attorney, Lynne Abraham, here in Philadelphia, released the findings from a grand jury report which detailed the life of Danieal Kelly who was just 14 when she died in 2006, weighing just 42 pounds, as you mentioned, covered in bedsores, really laying in her bed full of her own feces. Very terrible conditions.

And the district attorney stressed that she wanted this report, though very disturbing, to prompt people within DHS, the Department of Human Services here, those folks who were charged with making sure her parents gave her the proper care and sent her to school and to the doctor, district attorney said that she wanted this disturbing report to really push - force these folks to reform the system.

Danieal Kelly was only 14 years old, weighed 42 pounds, had not been to school in years. Did attend school for a while when she was in Arizona but was living with her mother here in Philadelphia. And despite frequent calls from neighbors, requests from some family members that the Department of Human Services workers check in on her, these things did not happen, very basic things. In fact, the two Department of Human Services workers who are mentioned, who are charged in this grand jury report, it's really quite shocking the lack of action that they took. Not making regular visits to her despite requests from all these folks who said that little girl was living in really terrible conditions.

NEARY: Now, nine people were implicated in the girl's death by the grand jury. Who's facing the most serious charges?

FIEDLER: The most serious charges are reserved for her mother, Andrea Kelly, who faces murder, involuntary manslaughter and endangering the welfare of the child. Her father is also facing endangering the welfare of the child, that charge, but Danieal Kelly was living with her mother at the time and had been living with her mother for quite a while, and the medical examiner determined that Danieal Kelly's cause of death was starvation, and as the district attorney mentioned when she released the grand jury report, basically, Danieal Kelly's mother did not feed her enough for her to live.

NEARY: Now this is not just the case of a child falling between the cracks because of the lack of resources in terms of what happened in the Department of Human Services. Questions have really been raised about what was going on in that home for a long time. As you mentioned, they were ignored. How did that happen?

FIEDLER: How did that happen? That is really the question that needs to be answered and that everyone here is trying to, sort of, struggling to find a way to make sure this doesn't happen again. It's really shocking. The failure to act occurred on so many levels.

The case worker - there was one case worker named Dana Poindexter, who's charged in this grand jury report, who had a large box in his office and just threw all of his mail from years and years into a case file, didn't - despite calls, just said that - determined that complaints about her condition and that of other children were unfounded, despite never actually having gone out to the home to check on them. Really shocking things.

And his supervisor, also - you know, it was case workers and then it was also supervisors, and it was the subcontractor, who, you know, was just - layers and layers of problems that have existed here at DHS, and this case just sort of illustrates it, unfortunately. A very, very tragic case.

NEARY: All right. And are steps already being taken now to address some of the problems that have been revealed by this case?

FIEDLER: They are already being taken, and actually, since Danieal Kelly died in 2006, there have been some changes and our mayor here, Mayor Michael Nutter, had a press conference shortly after - shortly after the grand jury report was released, and he stressed that the DHS of 2008 is not the DHS of 2006, which is true, certainly to some extent. He has appointed a new commissioner of DHS, Anne Marie Ambrose, who is very focused on children, who certainly has a very good reputation. She's worked for the state.

Whether she's going to be able to change the entire culture of DHS, as the district attorney said, is a huge question. There are so many employees. The system, while there are very good DHS workers, there are - the district attorney mentioned, you know, just a couple who don't do their job can really mess up the entire system and, you know, lead to very tragic cases like this. This has been happening for a long time.

They are reforms, safety assessments, sort of changes in the way that supervisors check on caseworkers to make sure things are actually happening. But it's going to take quite a while to fix this system.

NEARY: Well, one of the shocking things that came out is that these two social workers that we've been talking about were both still working right up until just when they were indicted, is that right?

FIEDLER: They were, and the new DHS commissioner, Anne Marie Ambrose, had a press conference, I believe it was the day after the grand jury report was released or perhaps that same afternoon. And one of the reporters said, why are these people still working at DHS? Why did you not do something? I mean, you know, this girl obviously died in 2006, and though the grand jury report had not been released, everyone knew or heard who her caseworkers were and sort of all of this, and she - she sort of - her eyes welled up with tears when she talked about Danieal Kelly, and she wasn't able to give any sort of answer as to why something had happened - you know, hadn't happened with these workers, why they hadn't been removed or something like that.

Now the cases that the subcontractors charged in this case, the cases that were handled - the DHS cases that they handled - have been reviewed and the cases that were handled by all these DHS workers have been reviewed. So it's important to point out that, you know, that they're taking steps to make sure this sort of negligence didn't happen in other cases.

NEARY: Elizabeth Fiedler is a reporter with member station WHYY in Philadelphia and she joined us from there. Thanks so much for being with us, Elizabeth.

FIEDLER: You're welcome. Thank you.

NEARY: And now we're going to take a moment to try and see just how a case like Danieal Kelly's can happen. Joining us are two social workers, Tammy Linseisen, a clinical associate professor at the University of Texas in Austin, and Debra Schilling Wolfe, the executive director of the Fields Center for Children's Policy Practice and Research, and she's at the University of Pennsylvania. Welcome to both of you.

Dr. TAMMY LINSEISEN (Clinical Social Work, University of Texas at Austin): Thank you, nice to be here.

Ms. DEBRA SCHILLING WOLFE (Executive Director, Field Center for Children's Policy, Practice and Research, University of Pennsylvania): Thank you for having me.

NEARY: Let's start with you, Ms. Wolfe. We've been talking about this case of Danieal Kelly, and every now and then, one of these cases seems to just sort of hunch(ph) through the media and we're all shocked when we see these terrible stories. But they do happen from time to time. They do keep happening in some way. Why? Is there any answer to that question?

Ms. WOLFE: Well, cases like this show us where there are failures in child welfare systems. It doesn't happen just in Philadelphia, it happens across the country. And although hundreds of thousands of kids are well protected and well cared for, one child's death due to systemic failure certainly is going to bring the public's attention to an issue like this.

NEARY: You have written about this. You're in Philadelphia, and you have written about this story. It seems there needs to be a sort of fundamental change going on in the Department of Human Services. What specifically needs to change?

Ms. WOLFE: Well, at the Field Center we really look at this as a systemic breakdown. These cases are classic example of what is wrong in the Department of Human Services. There certainly are efforts and a desire to improve that, and it has to be improved at multiple levels.

For example, in this particular case, kids were not seen. Supervisors were unaware. It didn't adequately monitor the children weren't seen. That's something that's completely unacceptable. There need to be policies and procedures in place that are followed. You can have the best policies and procedures in the world, but if they are not implemented and monitored, they're not as good as the paper that they're printed on.

NEARY: And let's turn to you, now, Tammy Linseisen. First of all, have you ever seen a case like this? Have you ever been involved in one? Do you have any insight that you might add, to begin with?

Dr. LINSEISEN: Well, I really agree with Dr. Schilling Wolfe that the system clearly broke down. And you know, the cases that make the media are these, the ones where there is a huge systemic breakdown, and unfortunately, that's when much of the change tends to happen in agencies, unfortunately, after something serious like this has happened.

NEARY: You know what was really, I guess, really very shocking when you read these stories, was - well, certainly what seemed to be indifference on the part of the social worker in this case. We just heard the reporter say that apparently he had files that he just was ignoring for years, and that's his failure but then there's a failure of oversight, as well. Is there not - I mean, why is this at all part of the system? It just seems like it shouldn't be there at all.

Dr. LINSEISEN: Well, I want to make a pretty significant distinction that I can find no evidence in any of the records that I have reviewed that these people are actually social workers. Social workers are educated and trained professionals who come through accredited social work schools. It is not uncommon to interchange the wording of caseworker and social worker, but there's a very distinct difference. If, in fact, a social worker had committed these injustices, they would be in direct violation of our code of ethics.

NEARY: All right. You'll going to have to explain that a little bit more. What do you mean, there's a difference between - I think people do associate or assume that caseworkers and the people who supervise them are also social workers. So what is the difference exactly?

Dr. LINSEISEN: Well, in the state of Texas, I can tell you that the last numbers I read indicated that about 24 percent of the child welfare workforce was actually social work trained. That means that they have completed a Bachelors in social work program and been licensed by the State of Texas, or completed a Masters in social work program and been licensed by the State of Texas. In the State of Texas, our code of conduct does not allow us to even call ourselves social workers if we are not licensed.

NEARY: So are you saying that in this case and maybe in some of the others that if there was a greater degree of professionalism, this might not have happened?

Dr. LINSEISEN: Well, I can't speak specifically to these individuals, but I can certainly say that there was a lack of professionalism in this case.

NEARY: Right. What is your take on that, Debra Wolfe?

Ms. WOLFE: I do agree with my colleague that there is a distinction between a professionally trained social worker and one who is not, and very often, in this case in particular, we've been reading over and over again that the caseworkers have been called social workers. And to be a social worker, you do need to have a professional degree.

The important thing, I think, is for folks coming into this kind of work to have the appropriate background and training to go into it, but as they are in it also to receive ongoing training and appropriate supervision from people who are professionally trained to do so.

NEARY: Well, even apart from the caseworker - I'm happy to call them caseworkers - but you also have supervisors, people who did not really supervise these people correctly to make sure they were doing what they need to do. And one of the people involved was working for a contractor to the city, so that raises questions about what contractors do. So again, Ms. Wolfe, it returns to the whole idea of this system needing some shaking up, it sounds like.

Ms. WOLFE: Absolutely. Services frequently are privatized and contracted out, and that's not an inappropriate thing to do. The child welfare agency's role should be focused exclusively on child protection, on investigating and monitoring safety of children. And if they do that and focus on doing that well, then that will help to keep children safe.

Contracted agencies provide necessary treatment services to help remedy whatever issues arose to place those children at risk, but it's critically important for the actions of those agencies and the services they provided to be appropriately monitored, and in this case, that clearly did not happen.

NEARY: Here's what I wonder sometimes when I read these terrible stories, and both of you can respond to this. I wonder if some of these people are seeing so many terrible things that they just - they can't - there's some kind of, I guess - I hate to use that phrase, but that compassion fatigue sets in? They simply don't respond to a terrible situation like this because they're seeing a lot of it, and how do you deal with that terrible human frailty, if you want to call it that, that terrible reaction that somebody would be so impervious to such suffering? How does that happen and how do you affect that through training? Can you?

Dr. LINSEISEN: Well, I think we do see this kind of issue come up of compassion fatigue, particularly if workers are not supported in the environment within which they work. It seems that these people - many of these in this particular case - where operating on islands. It's a mystery to me how supervisors were not involved in checking on what was going on with these cases.

In the State of Texas, we certainly have a system that has problems, as well as many of them do. But there are tickler(ph) systems and databases that won't allow for cases to not be assigned for two years - at least, that's in one report that I read. So the lack of supervision, I believe, really promotes compassion fatigue. There needs to be a level of mental health that the workers have and are able to promote, and there needs to be a limit on the number of cases and the amount of acuity that they're dealing with on a daily basis.

NEARY: Debra Wolfe, did you want to add to that?

Ms. WOLFE: Yeah. I certainly agree with everything my colleague stated. And in this particular case, caseload sizes were not extraordinary, so that's certainly...

Dr. LINSEISEN: I saw that.

Ms. WOLFE: Yes. So that certainly is one of the reasons nationally why workers become overwhelmed and stressed, so you really need to look at other issues. And in this case, the supervisory system was not meeting the needs of workers, and in terms of compassion fatigue or secondary trauma, we frequently see that in these cases but that is very well dealt within a system that provides good close supervision, where cases are closely monitored. Workers are provided supervision in terms of both the casework they're doing and their coping with cases because this is extremely stressful work and if they're not provided adequate supervision, they're not going to be able to protect children.

NEARY: All right. Debra Schilling Wolfe is the executive director of the Field Center for Children's Policy Practice and Research. She joined us from the University of Pennsylvania where she is a professor. And Tammy Linseisen is a clinical associate professor at the University of Texas School of Social Work, and she joined us from member station KUT in Austin, Texas. Thanks for being with us.

Ms. WOLFE: Thank you.

Dr. LINSEISEN: Thank you.

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