“I was given a stack of papers, and I remember on a couple pieces of paper the words were blurry, this is how much copying was going on. They just said, ‘it’s a normal consent form; if something happens to you and the baby, if the baby’s heart stops beating or yours, do you want us to save you?’ Of course I do, so I signed the form, a bunch of forms.”

Get TalkPoverty In Your Inbox

Brewington said she was later told those papers included the consent forms that gave her providers permission to drug test her and her child. She said she never saw such consent plainly stated, even when she checked for it after the fact.

Drug testing pregnant and postnatal people and their infants without the patient’s informed consent is a common practice in the United States — but only among certain demographics. Several studies have found that Black women in particular are subjected to prenatal drug testing at higher rates than women in other racial and ethnic demographics, but do not have higher rates of positives. A study published in the February 2004 issue of Child Abuse & Neglect also found several other factors unrelated to drug use that led to higher testing rates, including single motherhood, tobacco use, a history of preterm labor, and a history of child services involvement, among others.

“I provided care in Black and brown communities, so [drug testing pregnant and postnatal patients] was routine, and it wasn’t until I got out and saw the difference in the way care was provided in communities that…were wealthier that it became clear that this is not routine, this is not what everybody does,” said Jamila Perritt, an OB-GYN in Washington, D.C., and the president and CEO of Physicians for Reproductive Health. Perritt also recounted that when she was pregnant, she was not drug tested despite being one of the more commonly-tested demographics (Perritt is a Black woman), which she attributed to her status as a physician.

Now activists are fighting back, saying the practice is rooted in racism and classism, and that it denies patients crucial agency over their care.

“Is our consent truly informed? It can’t be in those reams of paper that people are signing,” said Perritt. “What does it mean if we as physicians say informed consent is one of our core values? …Who would think you’re signing a form that could result in such severe consequences? The truth is that it is a violation of trust to not take the time to name that [drug testing consent is included] and its consequences.”

As Brewington’s case demonstrates, those consequences can be devastating. After her newborn son tested positive for opiates and cocaine, which Brewington admits to using once during the last term of her pregnancy, New York child services placed him into foster care. Although her two older children were out of the state at the time on a vacation with their father, child services ordered her to bring them back and placed them into foster care as well. They are home with their mother now, but Brewington is still fighting to regain custody of her son, who was awarded to his father.

“The medical profession, health profession, that is still one of the top three referrants [to child services],” said Jeyanthi Rajaraman, a parental defense attorney at Legal Services of New Jersey. Rajaraman added: “I’ve asked [at hospitals] when do you drug test and when do you not, and the information that comes out is that ‘if mom shows up and we’ve never seen her and she didn’t do a hospital tour and says she’s had no prenatal care and she’s by herself.’ What I really think they are also saying is Black and poor or no medical insurance because that is the majority of our clients who face and experience drug testing.”

Because child removal data is self-reported by the agencies, which do not track how many removals occur due to hospital drug tests, it is difficult to gauge how often these tests lead to severe consequences on a national level. One report by Movement for Family Power estimates that in 2017, in the Bronx borough of New York City alone, 60 babies under one month of age were removed because of maternal substance use. The United States child services system acknowledges that Black and Indigenous children are markedly overrepresented when it comes to system involvement; between 2000 and 2011, one in nine Black children and one in seven Native American children had been removed from their parents’ care, versus one in 17 white children.

Infants who do experience side effects due to in utero substance exposure, which can occur from both prescribed and non-prescribed substances, fare better when they are able to have close maternal contact. Removing newborns from parents like Brewington because of substance use — a common result of pre- and postnatal drug testing — can decrease feelings of bonding and the parenting sense of competence, and has been linked to some infant cognitive and memory impairment in animal studies. It also leads to decreased ability to breastfeed, which normally helps reduce symptoms of withdrawal in substance-exposed newborns and provides some protection against illnesses, including COVID-19.

Rajaraman noted that she often encounters medical professionals who recognize this reality but are shockingly unaware of how their call impacts the family. “I’ve had many doctors say to me that by calling [child services] they don’t know the baby would be taken, they say ‘I was calling because I thought it would help get mom into [a] program, I would never recommend separation.’”

In 2021, New York State attempted but failed to pass a law that would ban drug testing of pregnant and postnatal people and their newborns without informed consent or a legitimate medical necessity.  Activists are planning to push the bill again during the 2022 legislative session. Should it pass, it would require that written consent be obtained at the time of testing and delivered to the patient in a manner that is clear and understandable. It must also include a statement that the testing is voluntary. Activists in Washington State also considered pursuing similar legislation, but decided to table the movement for the time being. Should New York succeed in passing the informed consent bill in 2022, it could pave the way for other states to take necessary action to protect pregnant and parenting people and their infants from non-consensual drug testing.

This November, the Supreme Court will hear arguments on Fulton v. City of Philadelphia, which will decide whether foster and adoption placement agencies have the right to use their religious beliefs as an excuse not to comply with nondiscrimination protections.

Get TalkPoverty In Your Inbox

In 2018, the Philadelphia Department of Human Services (DHS), the city’s child services department, stopped referring prospective foster and adoptive parents to Catholic Social Services for certification and oversight after a story in the Philadelphia Inquirer revealed that the agency was actively discriminating against gay and lesbian couples for religious reasons. When Catholic Social Services refused to change their stance on licensing queer foster parents, the city allowed their foster certification contract to lapse; the subsequent lawsuit, which is now pending before the Supreme Court, claims that the city violated their religious freedoms by ending their contract for this reason.

Barrett has expressed a number of beliefs in her public life that suggest bias against the LGBTQ community. She was a signatory on a letter to the Catholic leadership expressing commitment toward “the significance of sexual difference and the complementarity of men and women…and on marriage and family founded on the indissoluble commitment of a man and a woman.” She described the application of Title IX protections to transgender people as a “strain,” and has openly opposed marriage equality. She was also faculty for the Blackstone Legal Fellowship, which is run by a law firm whose executive director recently argued for reestablishing criminal penalties for consensual queer sex.

Fulton is not the only way in which LGBTQ rights within the foster system have been questioned this year. An executive order issued by President Trump in late June, titled “Strengthening the Child Welfare System for America’s Children,” does not directly address the upcoming Supreme Court case, but it does seek to solidify the rights of faith-based organizations to work in the child services field, and to clearly solidify their First Amendment rights to engage in this work — the very argument up for debate with the Supreme Court.

The order states: “This guidance shall also make clear that faith-based organizations are eligible for partnerships under title IV–E of the Act (42 U.S.C. 670 et seq.), on an equal basis, consistent with the First Amendment to the Constitution.” It is this same brand of messaging that has surfaced repeatedly in Barrett’s opinions related to LGBTQ rights, and on the rights of the Catholic Church to exact its views on society at large.

“It’s really critical and important to note…the language used,” said Alexandra Citrin, senior associate at the Center for the Study of Social Policy. “The language in the Executive Order might appear harmless, but what we’ve seen from this Administration is consistent undermining of certain communities including those who are LGBTQ+, Black, immigrant, etc. and prioritizing who they believe should be foster and adoptive parents. We are likely going to see guidance that emphasizes partnerships for faith-based organizations — including those that use federal dollars to discriminate.”

That creates anxiety for LGBTQ families, who have only recently gained the right to foster and adopt. It was not until 1997 that the first state in the country, New Jersey, officially allowed same-sex couples to adopt statewide. Florida was the last state to overturn its anti-gay adoption policies in 2010.

“The concerns that LGBT adults have about whether or not they’re going to be discriminated against have not gone away,” said Stephanie Haynes, executive director of Philadelphia Family Pride, which is a co-appellee in the Catholic Social Services case. “You can imagine families in same-sex couples would decide not to become foster parents at all because of the risk of being turned away, not only because they do not want to subject themselves to that but also for families with kids already, they would involve their kids in discussions about the possibility of having foster kids in the home, and want to protect their kids from that possible discrimination from the foster care process.”

LGBTQ foster and adoptive parents are not the only queer group who face discrimination in the foster system, though they have received the most attention and study in the field. LGBTQ youth, for example, remain overrepresented in the child welfare system, and are at heightened risk for homelessness. And one study of low-income Black mothers found that those who identified as lesbian or bisexual were 4.19 times more likely to lose custody of their children than heterosexual Black women, a population already subject to racial disproportionality within the system.

Nancy Polikoff, a professor of Law Emerita at American University Washington College of Law, said that discrimination “can be obvious, as in not recognizing who the child’s family members are, but it can also be more subtle.” She cited a case in Kansas in which a lesbian mother was told by her case worker, who was employed by the faith-based agency St. Francis Community Services, that she needed to be “fixed” so that she would not spread her queerness to her child. Ultimately, her parental rights were terminated. While her orientation was not cited as the reason that her children were removed from her home, interactions between her and the case worker indicate that it likely played a role.

Similar concerns exist for transgender children. “We have had a number of cases where parents who have, in particular, trans children end up having their child removed because they are supporting their children’s gender identity,” said Cathy Sakimura, family law director at the National Center for Lesbian Rights, which filed an amicus brief in the Supreme Court case. “We recently had a case where a very low income mother lost all of her children; they were all removed because one of her children was gender non-conforming…There really wasn’t anything else other than some vague allegation about the home being dirty, and all of the testimony — everything that was presented — was all about the child and whether the child was given feminine clothing.”

“There are great faith-based organizations that partner with child welfare agencies and do it well; the problem is there are some faith-based organizations that discriminate…against what foster parents they will license, which can limit who can be licensed – for example, if there is only one licensing agency in the community, an aunt might not be able to be licensed to care for their niece if the agency doesn’t agree with her identity. And, it also raises into question how these are supporting the diverse identities of youth in foster care,” said Citrin.

If Barrett’s confirmation is successful, her placement could tip the Supreme Court in the direction of anti-LGBTQ policymaking. The ruling on Fulton v. City of Philadelphia will undoubtedly have dire impacts on children caught up in the foster system, but a broad enough decision could also open the doors for discrimination in any social service setting that contracts with agencies that cite their religion as an excuse to discriminate, including homeless shelters and food banks. It is impossible to predict how Barrett will vote on the case; however, several of her past actions showcase clear bias.

The case is currently pending before the Supreme Court, and arguments are set to begin just after Election Day. In the meantime, Catholic Social Services is still contracted with Philadelphia DHS to conduct case management for system-involved families of origin.

San Francisco enacted a citywide shelter-in-place order on March 17. Prior to the lockdown, Moss was seeing her three children twice a week in supervised settings like the public library or a designated visitation center. Now, she can only see her children through a screen.

Get TalkPoverty In Your Inbox

In response to the pandemic, child welfare agencies around the nation have been limiting or completely cutting off in-person visitation between children and their parents, leaving many families wondering when they will be in the same room again. It’s not just the immediate emotional consequences at stake: the extended time apart is bound to weaken some parents’ reunification cases. Experts are concerned it will lead to permanent dissolution of families unlucky enough to have open cases during the pandemic.

Although people unfamiliar with child protective services might believe the term refers to a unified national agency, “CPS” is actually an informal moniker that references a network of individual agencies run at state and jurisdictional levels under a variety of names, which are held together by a loose set of federal guidelines and a complex web of federal and state funding sources.

In some states, like New York and California, there have been no official statewide orders cutting off all in-person visitation; instead agencies have been directed to make decisions on a case-by-case basis. But those on the ground say this is still leaving many parents without a voice in the decision-making process.

Despite state-level guidance that visits take place whenever possible in New York, for example, “in individual cases we are seeing visits being curtailed…you might have a foster mother who has a vulnerability to COVID so she doesn’t want the children in her care going home for the weekends with their parents and coming back,” said Emma Ketteringham, managing attorney for the family defense practice with the Bronx Defenders.

In other states, like Idaho and Illinois, all in-person supervised visitations have been suspended. A few states, like Louisiana, continue to legally allow in-person supervised visitations, but are closing their buildings to the public and directing employees to work from home, which means supervised visitations, which often take place in these buildings and require staff to be physically present, cannot practically take place. While agencies appear to be allowing remote visitation when possible, for some — like parents with newborns and toddlers or children with developmental delays — remote visits just don’t work. In other cases, the parents, foster families, or agencies themselves might not be equipped with the technology necessary to facilitate remote visits.

Even in cases where these factors don’t apply, video communication is a meager replacement for face-to-face contact between a parent and a child, interrupting crucial bonding and raising the possibility of increased anxiety and depression in both parties, according to Richard Pittman, deputy public defender at the Louisiana Public Defender Board. Pittman expressed particular concern that parents might become so dejected by the loss of substantive contact with their children, as well as the loss of therapeutic services and mandatory classes that has gone hand-in-hand with the curtailed visits in many locations, that they might disengage altogether from the case. “Any progress they’ve made healing from the trauma of the initial removal is going to be reversed through all of this,” said Pittman.

Moss’ youngest child turned one shortly before the lockdown but had been in Texas with his foster mom on his birthday. Moss has still not been able to celebrate with him in person, and she’s terrified that she is now also going to miss his first steps.

“[He] had a long hard time learning to sit up and crawl. Luckily before this [lockdown] happened I got to see him to crawl and sit up. Now he’s on the verge of standing up on his own and I should be there for that. [His foster mom] is experiencing all this stuff that I should experience…I think it’s just going to break me if I don’t see my son walking,” she said. Moss also noted that her son has struggled with a recurring bronchial cough, which is particularly stressful during the pandemic, but she is barred from even texting his caregivers to inquire about his health without the social worker’s permission.

In child welfare cases, the consequences go further than feelings. Under the Adoption and Safe Families Act (ASFA), agencies are required to file for termination of parental rights when a child has been living in a non-relative out-of-home placement for 15 of the past 22 months. Some states have shortened that timeline to be as few as 12 months. Although parent attorneys should have a good case for requesting an extension — ASFA allows for consideration of mitigating circumstances and it’s hard to think of a better one than a pandemic — those extensions are neither guaranteed nor infinite. And once a termination petition is filed, bonding between parent and child is a crucial determining factor.

The factors that are used to determine whether or not it is in a child’s best interest to keep them permanently separated from their parent vary somewhat by state, but typically revolve around the ASFA timeline, the parent’s completion of court-ordered services like drug treatment and parenting classes, and the bond between parent and child, which is often measured by the frequency and quality of their visits.

“An agency can say ‘we understand the reason there weren’t visits is because of the coronavirus, but at this point it’s been x many months in foster care and they haven’t made progress and it would hurt the kids to go home now,’” said Amy Mulzer, a family defense appellate attorney in New York and an Elie Hirschfeld Family Defense Fellow at the NYU School of Law Family Defense Clinic.

Shayna, a Native American mother who lives in Wisconsin and asked that her real name not be printed in this story, has two children out-of-home in two different counties. Her youngest child has been on an adoption track, which means Shayna is fighting an uphill battle to have him returned home rather than having her parental rights terminated and her child forcibly adopted to his current caregivers. For her, the issue of bonding is not an abstract future hypothetical; it’s a very real factor she must now find a way to prove without being able to interact with her three-year-old in person.

“It seems like they are using the coronavirus as a reason to keep my son from me because they know the court date is coming up, which is not good because they don’t have observations on me from now to then,” she said. Her son’s foster placement had been in pre-adoptive status, but she was recently able to get her case placed back on a dual track, which means adoption and reunification are both on the table for the next six months. For her, visits could literally make or break her reunification case — but she says the social worker is refusing to use an approved family member as a supervisor in order to continue visits, even though that is technically allowed. “They are not utilizing any other options, just using this coronavirus to stop and hold the visits. I think they should look at the bigger picture: this little boy needs to be back with his mom.”

Less restrictive alternatives exist. For example, Richard Wexler, executive director of the National Coalition for Child Welfare reform, suggested moving visits to open spaces like parks when possible, and expediting the return of children who can safely be returned home. San Francisco recently issued an order requiring agencies to make efforts to supply families in need with the appropriate technology to engage in remote video visitation. It also directed agencies to analyze and identify cases in which children were nearing reunification, and to fast-track their return home when possible. Advocates in New York City say similar efforts are being made, though it is unclear (in both locations) exactly how many families are on track to actually receive these benefits. These directives also leave a host of other details unanswered, such as the minutiae of moving a child from one location to the next — suddenly far more complicated when having to also consider infection control.

The Children’s Bureau within the federal Department of Health and Human Services issued a letter in response to the pandemic that included suggestions to state agencies about how to handle a variety of topics, including parent-child visitation. The guidelines discourage courts from “issuing blanket court orders reducing or suspending family time,” and asks agencies and courts to “be mindful of the need for continued family time, especially in times of crisis and heightened anxiety.”

While these suggestions come from a credible source and can bolster arguments in favor of continued family visitations, without Congressional action or agency rulemaking, they are not actual orders. This leaves states and agencies the license to develop their own pandemic protocols.

“If a child can’t see their parents for months at a time, they start to believe maybe their parents don’t love them,” said Michelle Chan, a mother with prior child services involvement, and founder of California Rise, a Bay area child welfare activist group. “I really am worried about the deterioration of the parent-child bond. I feel it should be the most important thing.”

The bill seeks to make three major changes: It would define illicit drug use during pregnancy as child abuse regardless of actual harm to the infant; remove the state’s obligation to engage in family reunification efforts when a child was exposed to drugs; and significantly shorten the amount of time it takes to begin terminating parental rights.

Get Talk Poverty In Your Inbox

Although the bill’s stated purpose is the protection of infants, opponents say it does the exact opposite: Separating infants from their parents causes potentially irreversible trauma to a child’s brain. In addition, this type of bill deters pregnant drug users from seeking much-needed medical care for fear of punishment, and denies families the resources to heal from addiction and parent their children to their best capacities.

The North Carolina Urban Survivor’s Union, a harm reduction organization dedicated to protecting the rights of drug users in North Carolina, is doing everything they can to stop this bill from becoming law. They are reaching out to senators, gathering signatories on a letter of opposition (which I joined), and preparing to implore the governor to veto it, failing efforts to stop it from passing. To them and many other harm reduction and reproductive rights advocates, this bill represents a growing national trend to use fear-mongering as a basis for stripping pregnant people of crucial rights, even well beyond pregnancy.

Aly Peeler, advocacy coordinator for the North Carolina Urban Survivor’s Union, notes that although the bill is written to target drug users, it has the potential to affect a much larger population: “It opens the door for prosecuting people who can get pregnant for anything that can harm a fetus. What if you’re not exercising enough, what if you don’t have healthcare when we know that prenatal care is the biggest determinant of fetal health? We are really invested in stopping the bill.”

Allowing the state to define in utero substance exposure as child neglect would permit child services to remove newborn infants from their parents’ custody at birth. Should this pass, North Carolina would join 23 other states in defining prenatal substance exposure as civil child maltreatment. This has a ripple effect: A recent study from the RAND corporation discovered that areas with punitive policies toward drug use during pregnancy, such as conflating it with civil or criminal child maltreatment, saw higher rates of infant withdrawal. Patients who fear being punished for using drugs avoid medical care, whether that means continuing to use drugs instead of engaging in treatment, or avoiding prenatal care altogether.

It is a measure that invites a host of problems, including the traumatic interruption of the dyad between a birthing parent and newborn. Contact between newborns and the parent who birthed them is crucial during the first days of life; this is especially true for infants who experience withdrawal from substances they were exposed to during pregnancy, whether or not those substances were prescribed and taken as recommended. Nursing and skin-to-skin contact have been shown to reduce symptoms of neonatal abstinence syndrome (NAS), or infant withdrawal.

Many hospitals around the country have begun to change their NAS protocols to be more inclusive of families, implementing “mother as medicine” approaches to treating withdrawal symptoms that have led to dramatic decreases in the amount of time infants diagnosed with NAS require medical intervention. The University of North Carolina Children’s Hospital-Chapel Hill recently implemented a new approach to treating NAS called “Eat, Sleep, Console,” which heavily integrates familial support as part of the treatment for infant opioid withdrawal. House Bill 918, however, would undermine that medicine by denying parents access to their newborns, potentially even while the baby is still in the hospital, despite the new protocol’s positive outcomes.

The absolutist attitude toward drug addiction appears to favor stigma over science. It states that in order for a substance exposure-based neglect charge to be substantiated, child services must be able to demonstrate that the parent is “unable to discharge parental responsibilities due to a history of chronic drug abuse.” This would allow a parent’s history of addiction to be weaponized against them, something which is generally not done with other medical conditions unless there is a similar element of stigma involved, such as that which is seen in some cases of intellectual or physical disabilities.

It also opens the door to using addiction treatment history as evidence of an inability to parent. Addiction is defined as a chronic relapsing disorder. It is not uncommon for patients to attend more than one treatment program before achieving long-term remission, or to require long-term medication management with methadone or buprenorphine in the case of opioid addiction. When these histories become confused with the definition of parental fitness, it labels people with substance use disorders as undeserving to parent simply because of their condition.

In an interview for a story published by The Appeal, obstetrician and addiction medicine physician Mishka Terplan described recovery as “finding community connection, purpose, and meaning…Motherhood fits right into that, and yet we have this system that has labeled certain people and populations as being less deserving of that than others, so we are going to even take that away from them, or make it yet another battle in a grossly unfair universe.”

Stating that child services is not required to engage in reunification efforts further codifies this dismissive attitude toward people with substance use disorders. Normally, when a child welfare department opens a case on a parent that involves the removal of a child from the home, the department is required to pursue reunification efforts before moving to forcibly adopt the child to another family.

This means that the department has an obligation to provide referrals and financial assistance for any services the parent is required to complete in order to regain custody. In cases that involve parental drug use, this typically means that the child welfare department must provide timely and appropriate referrals for addiction treatment, and often must also cover the costs of such treatment. But North Carolina’s new bill would remove this burden from the state in cases that involve “exposure to nonmedical substances in utero.”

“[A pregnant person with an untreated substance use disorder] can’t stop using [solely due to pregnancy] because that’s one of the defining features of having a use disorder, and people with a use disorder — they need treatment,” said Terplan, describing with eloquent simplicity the inherent injustice of removing a child due to parental drug addiction, then refusing to provide treatment.

Amber Khan, a senior staff attorney at National Advocates for Pregnant Women (NAPW), has helped oppose bills like this in the past, like a 2017 bill that made substance use during pregnancy civil child neglect in Kentucky and forced mothers to enroll in drug treatment within 90 days of giving birth or face termination of parental rights. Khan said these bills “are counter-intuitive and dangerous and based on misinformation. They certainly do not address a substance use disorder. If the concern is a parent’s substance use disorder, these bills create a punitive system but don’t increase funding for care.”

Finally, North Carolina’s bill also decreases the amount of time it takes to permanently separate parent and child by terminating parental rights, an act that has been dubbed the “civil death penalty.” Currently, federal legislation known as the Adoption and Safe Families Act (ASFA) requires states to file for termination of parental rights when a child has been in foster care for 15 of the past 22 months (it does not necessarily apply in situations of kinship care, when children are living with relatives). Some states have opted to shorten that time, and if HB 918 passes, North Carolina will join them. The bill will shorten the requirement to one year. It also gives foster parents the same rights as relatives, allowing them to petition for custody after only nine months.

“People don’t understand substance use,” said Louise Vincent, the executive director of the North Carolina Urban Survivor’s Union. “I find bills like this really manipulative…You start talking about pregnant women using drugs and people lose their mind. People don’t understand that love doesn’t cure addiction.”

Compounding all of this is the fact that these issues will not be faced by all populations equally. In North Carolina, for example, Black children comprise 33 percent of the foster care population, but only 23 percent of the state’s total population. This law would give the system further leeway to discriminate by race and class, issues already embedded into the child welfare system.

“We know that poor women and women of color are more likely to be suspected of drug use, so they’re more likely to be screened and more likely to be reported,” said Peeler. “The bill is really worrying partially because everyone really values trusting and confidentiality with their doctors and it wouldn’t afford that to people who can get pregnant.”

When legislation perpetuates the idea that addiction can be a chronic relapsing medical condition up until the point of pregnancy — when it becomes a moral failing and representative of a lack of appropriate maternal love — it fails to protect the community, which should be the basic function of the law. HB 918 and other similar laws defy science in favor of stigma and move the government one step closer to repealing reproductive agency in the United States. And, of course, it creates a new avenue for punishing drug users even while the criminal justice system finally, albeit slowly, begins to recognize that punitive measures are ineffective against addiction.

“This is certainly another part of the business as usual for the drug war,” emphasized Vincent.

In 2020, Allegheny will begin applying a similar algorithm to every family that gives birth in the county, with the goal of linking families in need to supportive services before a maltreatment case is opened. But some critics insist that it will be just another way for government to police the poor.

The new program is called “Hello Baby.” The plan is to eventually apply it across the county, but the January launch will begin in only a select few hospitals. Like the Allegheny Family Screening Tool, the Hello Baby algorithm analyzes family data to apply an individual family score.

Emily Putnam-Hornstein, who helped design both programs, told TalkPoverty that Hello Baby uses slightly different data than the child maltreatment algorithm, which was criticized for targeting poor families because much of the data used was available only for people who used public services.

Get Talk Poverty In Your Inbox

“This is a universal program,” explained Putnam-Hornstein. “In the [child services] model the county was being forced to make a decision after an allegation had been received; in this case we’re taking about more proactively using data … so we wanted that to be built around universally available data.”

But these exclusions don’t guarantee that the data will not end up targeting low-income families again. “They rely on data where the county has the potential to have records for every family,” said Richard Wexler, the executive director of the National Coalition for Child Protection Reform. “The county acknowledges they will probably use data from [Child Protective Services], homeless services, and the criminal justice system, so yes, theoretically everyone can be in that, but we know who’s really going to be in it.”

An overview provided by the county online cites “birth records, child welfare records, homelessness, jail/juvenile probation records” as some of the “available service data” incorporated into the predictive risk algorithm, indicating that Wexler’s assessment was absolutely correct. Although that data is potentially available about anyone, several of these systems are known to disproportionately involve low-income people and people of color.

Putnam-Hornstein said via email that the Hello Baby process is “truly voluntary from start to finish.” A family can choose to drop-out of the program or discontinue services at any time.

The option to drop out will be presented at the hospital, when families are first told about the program. A second notification, and chance to opt-out, will then be made by postcard. If a family doesn’t respond to the postcard, they are automatically included in the next phase of the program, which involves running available data through the system to determine how much social support each family needs.

According to Putnam-Hornstein, scores will be generated about four to six weeks after birth for families that do not choose to opt out (or who are too busy to realize they want to). Once a family is scored, what happens next varies based on which of three tiers they fall into.

Under the “universal” tier, the most basic approach, families receive mail notifications about resources available throughout the county. Families grouped in the second, “family support,” tier will receive a visit from a community outreach provider and an invitation to join one of 28 Family Support Centers located around the city of Pittsburgh.

The “priority” tier engages families with a two-person team made up of a peer-support specialist and a social worker who will work closely with the families to identify their needs and partner them with appropriate providers. It is designed to be an individualized program that grants families access to the full range of support services available on a case-by-case basis. That could mean helping a parent navigate the complexities of applying for housing assistance or ensuring timely placement in a substance use treatment program. The county said in its promotional material — which was reinforced by Putnam-Hornstein over the phone and by email — that choosing not to engage with any aspect of the program will not lead to any kind of punitive action.

But parents who need supportive services still have reasons to fear intervention from child services. The reality is that any program putting families in contact with social service and medical providers means, by default, also putting those families at greater risk of being reported to child services by placing them in more frequent contact with mandated reporters.

A mandated reporter is someone who is legally required to report any suspicions of child maltreatment they encounter. The intention is to ensure timely detection of as much child abuse and neglect as possible, but data have not shown that an uptick in mandatory reporting equates to more child safety.

In Pennsylvania, nearly anyone who regularly interacts with children in a professional or semi-professional capacity is legally considered a mandated reporter. An unfortunate side-effect of the mandated reporter system is that even though a referral program like Hello Baby is not directly involved with child services, participating families will always be haunted by the possibility of coming under investigation.

Putnam-Hornstein assured that family’s scores will not be retained or shared with child services, even for families under investigation — but noted that “it is possible that child welfare workers could infer the level of risk if the family has voluntarily agreed to participate in Hello Baby Priority services and a child welfare worker learned that when gathering family history.”

It’s clear that the new program is not designed to get families involved with child services, although it is spearheaded by the Department of Human Services, which oversees the Office of Children, Youth, and Families that conducts child maltreatment investigations and responses. Rather, Hello Baby was created with the goal of offering a more equitable way to expedite service referrals for families with new children who need them.

“Universalizing the assessment of social needs at birth is the only way to avoid discrimination,” said Mishka Terplan, an obstetrician and addiction medicine physician, who was not talking specifically about the Hello Baby program. He observed that patients with obvious social needs, such as those suffering from acute addiction, were often screened and referred for other issues, like postpartum depression or housing assistance, while other parents’ needs were going undetected and unaddressed. “That seemed unfair,” he lamented. Terplan believes that universal screening programs would eliminate both the disparity between services rendered, and reduce the stigma attached to needing behavioral health treatment and other social supports.

Hello Baby’s creators hope that offering families these programs before there is a child maltreatment complaint can help keep them out of the system altogether. But by using imbalanced data points like child welfare history, homeless services, and county prison history to auto-generate scores, it assumes poverty as the main basis for family need. While poverty does generate certain needs, it is not the only indicator for the whole range of unique social supports that new parents require, such as mental health screening or child care assistance.

A system that continues to embed data that target the poor may only end up automating the social inequities that already exist, while placing vulnerable families under increased scrutiny by mandated reporters for the child welfare system — even if it intends to serve as a universal screening process that helps families avoid punitive interventions.

“As long as the system confuses poverty for neglect, any form of such screening is extremely dangerous,” said Wexler.

I learned this early on in my case, which began in April 2018. The services required for me to reunify with my daughters included trauma-based individual therapy, a psychological assessment, substance use treatment, and parenting classes. I remember going to the first of these, my psychological assessment, and spending 20 minutes in the office arguing over paperwork.

In order to complete the mandatory assessment, I had to sign a consent form that would allow the assessors to send their findings to child services. But when I asked what their “findings” included, it was not simply a diagnosis or treatment recommendations. Instead, it could be the full readout of the evaluation.

Get Talk Poverty In Your Inbox

Everything I said during this invasive and highly personal evaluation would be sent to my caseworker, his boss, the state attorney, the guardian ad litem and her attorney, my attorney, my husband’s attorney (and by proxy my husband), and the judge. Any time my caseworker was changed, which had happened once already and would happen two more times, the new stranger would also be privy to the contents of my psychological evaluation.

But the service was mandated. Without this evaluation, I was not allowed to engage in therapy, substance use treatment, or parenting classes. So I had to do it.

This is standard fare for families involved with the child welfare system. It focuses on the collection of parents’ information, and control over what those parents do and how they behave, not, as proponents of the system fervently claim, on ensuring the safety of children. Like probation and parole, child welfare involvement becomes one more way for the government to keep tabs on people.

As it would turn out, the report would not be a transcript of my evaluation. Rather, it was an interpretation, in which the evaluator handpicked which details to include. She described me as eccentrically dressed. (I had worn a floral dress and flats, but have visible tattoos and a facial piercing that can’t be removed.) She detailed that sometimes I answered questions right away, and sometimes I paused to answer them, which sounds normal enough but seemed sinister and awkward when inserted in the context of the psychological evaluation. She wrote that I suffered from insomnia, even though I’d repeatedly told her I was tired on that day specifically because I was worried about my husband, who had been hospitalized earlier that week. She generalized my history with drug use to make it appear that I had been addicted to heroin since I was a teenager, which is not the case.

In the end, the recommendations didn’t include anything besides the talk therapy I’d already been mandated to take — but the inclusion of all her other highly subjective details handed my opposition a slew of quotes they could use to describe me as eccentric, erratic, and ill-equipped to handle the daily realities of parenting.

It was an evaluation I had no choice but to attend, which should have been a doorway to resources and help for my PTSD. Instead, it served as an intelligence-gathering exercise for the people separating me from my two young daughters.

Other parents have experienced similar issues with the services that are supposedly in place to help them. Kim, a mother in Alabama who asked that her last name not be shared, has been involved with child services since January 2019. Kim’s case was triggered by her arrest when she failed to appear for a court date, but she says the crime she is accused of was actually committed by her abusive partner, who forced her to take the blame by threatening her life.

When her caseworker learned Kim was experiencing domestic violence, she told Kim to move into a shelter. Which she did, but only for about a month. She said the shelter had stringent rules, which included nightly curfews and that she report her whereabouts when she left the grounds.

Kim was never told by the shelter that this information was shared with her caseworker, but she figured it out when her caseworker suddenly knew details only the shelter had. “She knew my comings and goings there. Knew when I met with the therapist, left for work; all of it,” Kim said.

“The sheer fact and status of having a child places you in a situation where you can no longer openly and honestly express what’s happening in your life to mandated reporters because you’re facing family dissolution, or, at minimum, family surveillance,” said Erin Miles-Cloud, a former parent defense attorney in New York who is now the co-founder for Movement for Family Power, a parent advocacy group. Exactly who falls under the category “mandated reporter” varies by state, but they are typically frontline workers such as nurses, doctors, therapists, and teachers, who are required by law to report any suspicions of child maltreatment. She specifically cites shelters, hospitals, and schools as some of the “biggest offenders” when it comes to reporting parents who are seeking care to child services.

While speaking with me for a story I wrote for Filter Mag about the way child services targets parents who use drugs, a nurse named Tracy Longbreak told me about her experience with the “mandatory” aspect of mandated reporting. When a mother came into her emergency department with her baby while smelling of marijuana but appearing prepared, competent, and tidy, Longbreak was told by her superiors that she had to call in the report or risk her job.

Ultimately, the best she could do was include her perceptions of the mother in her report and hope that her positive remarks would offset the accusation of neglect via marijuana intoxication (which was not yet legal in the state of Oregon, but is now).

“In North Carolina, the mandatory reporting law is around any abuse that may have taken place by the caregiver,” said Julie Owens, a survivor of domestic violence who now consults with organizations around the country advocating better practices for people who have experienced violence in the home. “The protective parents who go into domestic violence shelters—primarily mothers—are not the abuser, but unfortunately they are reported as or regarded as abusers because they haven’t reported the abuse that their children have been experiencing, and they often end up being punished or deprived of their children as a result of this.”

Put together, this all means that service providers can be forced to act as eyes and ears for child services, even when they don’t want to. But more reports doesn’t equal more child safety. In Philadelphia, for example, mandated reporting laws were drastically expanded after the Penn State child sex abuse scandal. In an article published in Pediatrics in 2017, Mical Raz wrote that “there is no indication that the increase in reporting has improved the safety of Philadelphia’s children, and there is reason to believe it may detract.” Some of these detractions included increased hotline calls resulting in an overburdened system less able to make accurate safety assessments, and a heightened risk of family separation for low-income families. Later Raz noted that “fear of reporting may prevent families from seeking help, whereas assurance of confidentiality has been shown to increase help-seeking behaviors.”

The majority of substantiated maltreatment charges in the child welfare system are for neglect, which typically means issues like lack of food, child care, or weather-appropriate clothing – things that could be fixed with better social supports or a little more money. Creating a system that encourages families to seek help should be the goal for any agency in pursuit of children’s health and safety.

But forcing more and more providers and even laypeople to report on parents whether they want to or not achieves the exact opposite of that goal. Instead, it creates a cyclical, hypocritical system in which parents are afraid to seek assistance for fear of being punished because of the issue for which they need help, then punished for not seeking that help on their own. It also harbors distrust in therapeutic situations, which renders impossible any kind of genuine recovery.

The network of surveillance that child welfare-involved parents become trapped inside will continue to harm families like mine until it is lifted and parents are allowed to seek help and engage with services without simultaneously leaking the most intimate details of their lives.

These numbers are staggering. When you consider the impact of childhood trauma — which tells us that kids who experience or witness abuse are more likely to develop a slew of physical and mental illnesses as adults — those numbers are infuriating. And baffling. Domestic violence can be hard to escape, especially for those who have been in the mire of it for years, but once kids become involved, shouldn’t that be enough motivation to leave?

It’s this question, and the assumed answer, which drives “failure to protect” laws in child welfare programs across the United States. Essentially, failure to protect laws charge a parent with not doing enough to shield their child from witnessing or experiencing abuse. Virtually every state pursues some form of failure to protect charges within the civil child welfare system. These laws are aimed at the non-abusive parent living in an abusive household. Usually, the parent has been subject to intimate partner violence. But the laws can also be used in households in which the child is the victim of one parent but not the other.

Get Talk Poverty In Your Inbox

While these laws were written with the intention of penalizing a parent who neglects the safety and/or well-being of their children, they all too often make unsafe environments even less safe by penalizing non-abusive parents living in an abusive household, and can become the basis for temporarily or permanently removing children from the home. They rarely leave room to consider the complexities of intimate partner violence, instead relying on assumptions and stereotypes that are incapable of capturing the nuanced reality of family bonds.

In January of 1999, Sharwline Nicholson decided to end her relationship with the father of her infant daughter. He lived in South Carolina, and had been crossing state lines each month to visit Nicholson and their daughter in New York. But when she ended the relationship, he responded with violence.

She called 911 and made arrangements with a friend for the care of her two children while she stayed overnight at the hospital. The next day, Nicholson was notified by the New York Administration of Children’s Services (ACS) that both of her children had been temporarily removed from her care on the basis that she had failed to protect them from witnessing the violence that had been inflicted upon her by her former partner. At the time, this was considered a form of neglect.

Nicholson would eventually win back custody of her children, but would be placed on a child maltreatment registry. This action kickstarted a lawsuit that would eventually lead the New York Court of Appeals to rule in 2004 that a parent’s inability to prevent a child from witnessing abuse could not be a sole factor for removing a child. Child welfare reform activists celebrated the decision.

“What Nicholson actually did was not just to change the attitude toward victims of domestic violence,” said David Lansner, a civil rights and family law attorney who represented the plaintiffs in the Nicholson case. “Neglect had to be shown as a serious matter; you had to show that … there was imminent danger of serious harm and not just the possibility of harm. … [Child services] and the court had to balance the harm that would result from removal against the risk of leaving the child at home, so you couldn’t just ‘take the safer course’ because removal was harmful to kids and shouldn’t be done unless it was really necessary.”

Unfortunately, New York is relatively unique in that respect; other states, lacking a case like Nicholson, still remove children for the possibility of harm that caseworkers and judges interpret by a parent’s “failure to protect” her children from being in a household where abuse takes place.

Erin Miles-Cloud, who formerly worked as a parent attorney in New York and is currently one of the co-founders of the advocacy group Movement for Family Power, explained the ways in which some of the better-resourced, urban systems can still fail families, even today. “Because New York has this middle ground of family shelters, ACS sees it as an unreasonable option to stay in a home where intimate partner violence is occurring,” she said.

What many people don’t realize is that — in New York City — parents who access a shelter as the result of domestic abuse will automatically be moved to a different borough, meaning a change in school district for their children, not to mention the loss of access to support networks, such as friends and family or trusted child care, lack of which can easily become another maltreatment charge. There’s also no guarantee as to what type of housing the family will receive or for how long. In some cases this could mean dormitory-style living for a year or longer, with no access to even a personal refrigerator.

But even the most comfortable, “home-like” shelters remain government-funded institutions — which means they come with restrictive rules, such as nightly curfews and rigid limits on how many days a parent can be away from the shelter, even to visit family. They are also a source of constant surveillance for the families housed inside. Miles-Clouds calls shelters and hospitals among the “largest offenders” when it comes to calling in new maltreatment reports, and notes that New York ACS often uses shelters as “second or third eyes on a family” when arguing a related case in court.

Because child welfare agencies self-report their data, and failure to protect  is not an independent maltreatment category in itself (these cases typically fall under the “neglect” umbrella), it is difficult to know exactly how many non-abusive parents end up being investigated because they were victims of abuse who sought help, or because their children reported being harmed by someone else in the household. But we do know that most states do not have even the mild protections enjoyed by families in New York. That means a child can be removed if the state convinces a judge they have been or will likely be psychologically harmed by witnessing the abuse.

Some states will also pursue criminal charges against victims of intimate partner violence who have children in the home. In six states – Oklahoma, Missouri, Nebraska, Nevada, South Carolina and West Virginia – non-offending parents face potential life sentences for failure to protect charges, and in Texas the maximum penalty is 99 years. Last year, the Associated Press reported on the case of Tondalao Hall, a mother whose boyfriend was sentenced to two-years time served (meaning he had already completed his jail time while waiting to be sentenced) for beating her children, including a three-month-old infant. Hall, who was never accused of harming her kids, is currently serving 30 years in prison for not calling the authorities on her boyfriend.

Latagia Copeland-Tyronce, a parental rights advocate and the founder/executive director of the National African American Families First and Preservation Association who spoke to TalkPoverty about her experience, knows first-hand how devastating it can be to be accused of not protecting children from another person’s abuse. She first faced the traumatic confusion of a failure to protect charge in Toledo, Ohio, in 2013.

She was 26 years old and had been involved in an abusive relationship for 10 years. What she did not know, however, was that her daughters’ father was also sexually abusing her three eldest girls. When one of Copeland-Tyronce’s daughters finally disclosed the abuse to her sister, she promptly contacted child services.

Copeland-Tyronce immediately left her children’s father. She also cooperated with the criminal case that would ultimately land him a 30-year prison sentence. But this was not enough for Lucas County child protective services. They claimed she had known about the abuse and had failed to protect her children both from witnessing the violence perpetrated against her, and from the sexual abuse which they had experienced.

“My children never said that I knew anything or that I was involved in the abuse and I was never charged with a crime related to the case,” countered Copeland-Tyronce.

Less than a year after the initial removal, her parental rights were terminated and all six of her daughters were adopted to other families. When she gave birth to a son in 2014, by a different father and with stable housing in place, he was also removed from her custody.

“Because I had a [termination of parental rights] TPR, failure to protect, with my daughters. No other reason,” she said. At the time, the first TPR was still under appeal.

Candis Cassioppi, a mother based in Athens, Georgia, had her youngest child removed from her in the hospital after giving birth, she told TalkPoverty. The removal was prompted by an incident of assault by her child’s father perpetrated against her during her pregnancy.

Although she initially called the police and sought medical attention — causing those injuries to become part of her medical record — she ultimately declined to press charges or testify against her abuser. After her son’s birth, this incident became a reason to claim she was failing to protect her children from harm. Now, she is court-ordered to participate in a slew of activities, including domestic violence groups and parenting classes, in the hopes of regaining custody of her infant.

Like mandated reporting laws, which require certain professionals and institutions to report suspected child maltreatment, failure to protect laws and policies are in place, purportedly, to ensure that child maltreatment does not go unreported. “If a child dies in the home because there was a batterer who was so dangerous that the victim-partner couldn’t protect [the kids] … we’re still liable to make sure that the child stays safe,” explained Mary Nichols, a now-retired administrator at Los Angeles County’s Department of Children and Family Services (DCFS), to the California Health Report in 2015.

But she also admitted in the same article that the laws are confusingly vague: “If you look up California Welfare and Institutions Code 300 and just read the definitions of ‘failure to protect,’ you can see how broad they are … [If] somebody would like to craft legislation to make it more workable, in terms of protections for domestic violence [victims], that would be great. It’s a pretty raw tool that we have.”

As the cases detailed in this article demonstrate, the reality of domestic abuse is far too complex to address with vague, generalized laws. Instead of protecting families, these blanket laws mean that parents who experience domestic violence may end up burdened by a fear of reprisal for reporting that violence. Take Cassioppi’s case, for example. Her baby was born healthy; had she not called the police and sought medical attention after being assaulted during her pregnancy, she likely would have walked out of the hospital with her newborn in arms. And Copeland-Tyronce now asserts that if she were to ever encounter intimate partner violence again, she would “not at all” feel safe calling the police for help.

Lansner said implementation and caseworker attitudes are major problems with the way domestic violence cases are handled within the child welfare system. “The caseworkers just don’t get it,” he said, adding, “the caseworker might go to the home, find the guy there in violation of a protection order and then remove the children instead of calling the police and having him arrested, which is what [the caseworker] should do.”

Parents who experience intimate partner violence also face a number of other complexities that caseworkers and judges don’t always take into consideration when charging these parents as culpable for traumatizing their kids by proxy. For example, one study found that 99 percent of domestic violence survivors had also been subject to economic abuse, a form of financial control that can leave them stranded without the resources necessary to secure independent housing or provide for their children’s basic needs. Because lack of appropriate shelter, clothing, and food also fall under the child services maltreatment category of “neglect,” this leaves many non-abusive partners trapped between the crosshairs of a failure to protect and a failure to provide charge. Either way, they’re ending up on the maltreatment registry for neglect.

By necessitating that caseworkers identify concrete harm toward a child before removing her from the home, New York has found a way to slightly balance a system designed to punish parents simply for being unfortunate enough to experience abuse. Although their system is far from perfect — as Miles-Cloud noted, it funnels parents into a less-than-ideal shelter system, and the law still does not address the caseworker bias that concerned Lansner — it provides a template which other states could use to begin the process of clarifying these laws.

Ideally, however, survivors of domestic violence should be met with compassion and provided with services that help their families heal and thrive intact. It seems, instead, that as long as failure to protect charges exist, the child welfare system will continue to promote a culture of secrecy surrounding intimate partner violence, thus validating the very abuse it claims to condemn.

Unfortunately, it’s very real, and the root cause of many  of the problems in child welfare cases.

“Some people do phrase it as a conspiracy theory,” acknowledged Richard Wexler, executive director of the National Coalition for Child Protection Reform. “When they say the government makes money on foster care, that’s not true … on foster care they still lose money, but they lose less money [than on reunification]. And private agencies do make money on foster care in many cases.”

In the United States, child welfare agencies are tasked with ensuring the health and safety of the nation’s children. Each agency receives a complex web of funding from federal, state, and local sources, leaving it accountable to a hodgepodge of authorities. Although these agencies are often referred to as “child protective services” and considered by many as a cohesive national program, state and local agencies are only linked by a loose set of federal guidelines that provide broad definitions for child maltreatment, along with the Adoption and Safe Families Act (ASFA).

First enacted in 1997 under the Clinton administration, ASFA has undergone several rewrites, but its overarching purpose has remained steady: to ensure “timely permanency planning for children.” Part of the emphasis on “permanency” includes financial reimbursements for foster care programs, as well as adoption bounties, which are lump sums in the thousands paid to states for each child they successfully adopt out after a certain threshold.

Get Talk Poverty In Your Inbox

This starts with the Federal Foster Care Program (Title IV-E of the Social Security Act), which functions as an open-ended entitlement grant. There is no upper limit to the amount of funding that can be provided for eligible foster children each year. States receive reimbursements ranging from 50 cents to approximately 76 cents for each dollar spent on daily child care and supervision, administrative costs, training, recruitment, and data collection.

But when it comes to programs that support family reunification, the budget slims. Title IV-B of the Social Security Act, which governs federal reunification funding, includes a capped entitlement component and a discretionary component. So, unlike foster care funding, these dollars come with a set limit.

And that limited money isn’t all for reunification services. Title IV-B also includes provisions that allow for some of this funding to go toward foster care programs. A portion is also required to go toward adoption promotion.

The result of this imbalanced funding structure? The federal government spends almost 10 times more on foster care and adoption than on programs geared toward reunification.

One of the less-known sources of federal funding for child welfare programs is the Temporary Assistance for Needy Families (TANF) program. TANF is supposed to be a cash-assistance program servicing low-income families with children, In reality, TANF funds can be used to support many services designed to help “needy” children, including child protection agencies. The result is that many states use TANF funds to finance foster care, child welfare investigations, and adoption or guardianship payments.

Because child welfare program data are self reported, it can be difficult to track exactly how each dollar is spent, but Wexler was able to identify eight states using TANF to pay for adoption subsidies, 23 states funding CPS investigations, 27 states funding foster care, and three states diverting TANF money to fund residential treatment facilities for child welfare involved children.

Considering that three-quarters of substantiated child maltreatment cases are related to neglect, which is often the result of poverty, it seems exceedingly unjust that funds supposedly intended to offset the worst effects of poverty are instead being used to finance the separation of mostly poor families.

Under ASFA, states are — with few exceptions — required to file for the termination of parental rights when a child has been in foster care for 15 of the past 22 months. In an attempt to curtail the infamous foster care hopscotch, which leaves children whose parents have lost their rights bouncing from foster home to foster home, the government created adoption payment incentives.

Adoption bounties range from $4,000 to $12,000 per child. As Wexler explained, “the harder the system deems the child to place, the higher the bounty.”

But in order to begin collecting that money, a state must exceed the last year’s number of adopted children, thus incentivizing states to permanently re-home an ever-increasing number of children each year. As can be expected, the number of adoptions increased in the five years after the implementation of ASFA, while reunifications declined. The Bush administration’s Adoption and Promotion Act of 2003 further codified this adoption bounty system by allocating $43 million yearly to states that succeed in increasing the number of adoptions from foster care.

Many states contract with private agencies that oversee out-of-home placements and service referrals for child welfare involved children. Said Wexler, “that agency will probably be paid for each day that child remains in foster care … So the private agency has an incentive to convince itself that the child really, really can’t go home and has to stay with them for a long, long time.”

What does this look like on the ground? Painfully delayed referrals to support services such as parenting classes and addiction treatment, judges hesitant to find fault with the way agencies and providers handle cases, and private agencies eager to deem parents unfit for reunification.

There have been some recent moves at the federal level aimed toward shifting some of these financial imbalances. The Family First Act, signed into law in 2018, now allows federal reimbursements for mental health services, evidence-based substance use treatment, and in-home parenting support. Its purpose is to create similar incentives for helping families stay together.

Unfortunately, the act does not support many of the common needs that lead to family separation, such as housing or child care support. And because the programs it does support must meet stringent requirements in order to be eligible for reimbursement, foster care and adoption subsidies continue to exceed reunification programs by the hundreds of millions.

In the United States, 7 million children are reported to abuse hotlines each year. More than 3 million of those allegations trigger a child maltreatment investigation. But that’s just the beginning of the story: Once a finding of child neglect has been made, parents have to try to correct the issue or issues that led to child protective involvement. Typically, that involves mandates for parents to undergo addiction treatment, find stable housing, secure employment, begin therapy or psychiatric care, and so on.

There’s a problem, however: Taking all those steps and proving they’ve occurred can be a byzantine process, with hard deadlines, ignorant investigators, and unsympathetic judges who work against parents. For parents who are up against the clock set by the Adoption and Safe Families Act — which requires states to file for termination of parental rights if children have been separated from their parents for 15 out of the 22 most recent months — these delays can mean the difference between reunification or the permanent severance of a family.

Get Talk Poverty In Your Inbox

If you rely upon mainstream media to clue you into the state of child rearing in the United States, you could be forgiven for believing that a typical child services case looks like a father throwing his toddler against a wall, or a mother slipping some of her prescription methadone into her infant’s bottle. But physical abuse cases comprise less than a quarter of substantiated maltreatment cases. Neglect accounts for the other three-quarters — and in child welfare terms, “neglect” is a very wide umbrella.

The most basic definition of child neglect is deprivation of something essential, such as food, appropriate clothing, housing, child care, or medical attention. Each state gets to refine the specific definitions of child neglect within that broad federal parameter, but they all generally leave the door open for child neglect to be defined as a lack of financial means, or issues that can result simply from poor parental access to mental health or addiction treatment.

My case began with an accusation of drug use. The investigator — an inexperienced member of the County Sheriff’s Office in Broward County, Florida — did not speak with me before deciding to petition for the state to shelter my kids. She looked at my records from methadone treatment nearly five years earlier and decided she did not need any more information. I found her card in my bedroom when I returned from a trip to Miami. My daughters were given to my in-laws, pending a dependency trial, which began two months later.

By then, I had submitted enough negative drug tests to shift the accusations from active drug use to whatever they could pin on me, which ultimately amounted to poverty and mental health treatment. I was still struggling to secure permanent housing, and because I didn’t qualify for Medicaid without custody of my daughters, I was not in therapy for my post-traumatic stress disorder.

It’s important to note that there is no national “child protective services” agency. Instead, each state has its own child welfare department — sometimes called CPS, sometimes something else — and each jurisdiction within the state governs its own specific proceedings. Service providers generally have to be approved by the local child welfare authority, and jurisdictions are supposed to help parents access them. But the disparity between some jurisdictions’ caseloads and the number of available services can mean long delays or inadequate referrals. And because CPS functions differently in each state and data are self-reported, there are not unified statistics on the number of parents involved in this process in the U.S.

In my case, the judge ordered a slew of services, including a psychiatric evaluation, substance abuse treatment, trauma-based therapy, parenting classes, random hair and urine drug screens, and family therapy, all to be completed maintaining stable housing, income, and paying child support. I was never offered any help with housing or employment, and by the time I received my first referral for mental health services, three months post-trial and six months since the start of the case, it was already time for my October case review. The judge deemed me noncompliant for all of my services, despite the lack of opportunity I had been given to complete them prior to the hearing. Although data does not exist on average wait times for parents involved with child services, social workers agree parents can wait up to six months for referrals and other help.

Far worse than the delays, however, was the quality of care offered to me, especially regarding addiction treatment. Prior to the child services case, I had been living in Seattle and engaged in buprenorphine-based pharmacotherapy for opioid use disorder. I had to taper off my prescribed buprenorphine because I did not know where  to access it in Florida without health insurance. When I was given a referral for an addiction treatment provider, it was to an abstinence based-program that openly espoused punitive practices. By that time, I had been separated from my daughters for six months, granted only one weekly supervised visit. Referral delays had also barred me from engaging with trauma therapy.

After the hearing where I was deemed noncompliant, a sense of hopelessness settled over me. I began to believe that administrative issues would continue to be conflated with bad parenting, and that I was fighting an unwinnable battle. Divorced from all of my supports and motivations, and in a state of deep depression, I finally relapsed, as I had been accused of doing for the past six months.

I spent the night puking over my toilet, regretting the decision to use. When I was drug tested at my evaluation, I learned that I had injected illegal fentanyl, a super-potent opioid that has been popping up in heroin supplies across the country and driving a spike in overdose deaths. But my evaluator was not sympathetic. She demanded that I attend detox, even though a one-time use does not produce a physical dependency that would necessitate a detox, and did not offer me the pharmacotherapy that would have best prevented continued use.

When I asked my case worker for another referral to an evidence-based provider, I was ignored. In late April 2019, more than a year after my case was opened, my attorney notified me about a medication-assisted treatment program that would be financially covered. I enrolled immediately, and recently won a court battle to have it accepted — so long as the buprenorphine was only administered on a temporary basis. (Studies, meanwhile, have shown that buprenorphine is most effective in patients who take it for two years or longer.)

My clock is up in late August. At the beginning of last year, my life was a mess of sleepless nights, playdates, toilet training, and seemingly endless house chores. There never seemed to be enough time in the day. Stress was my baseline.

Now, my life is a series of endless, empty hours broken only by the routine of my court-mandated services. Instead of fixing breakfast and coaching my girls through brushing their teeth and dressing for school, I drink coffee alone before biking through the heat of Florida to three and a half hours of intensive outpatient therapy, five days a week. I am not greeted in the afternoon by my daughters, but with texts from a faceless social worker directing me to take random drug tests. My days are shaped by paperwork, mandates, and a persistent sense of longing. I am haunted by a constant hunger for the chaos of motherhood. I miss stepping on Lego bricks, and bedtime kisses. I miss cajoling broccoli into stubborn mouths, and big shrieking hugs as my girls tumble off the bus from school. Every time I see my daughters now, something has changed: a favorite color, a hair style, a shoe size. I am missing everything, and I have no idea when or if my real life will begin again.

There are currently almost half a million children in foster care in the United States, 123,000 of whom are waiting to be adopted. Child welfare data indicate that approximately 23 percent of children in foster care identify as lesbian, gay, bisexual, or queer, like Alex.

In the state of South Carolina, the U.S. Department of Health and Human Services (HHS) recently waived federal nondiscrimination policy for foster care and adoption. While South Carolina is the only state that has been granted such a waiver to date, there are 10 states — Alabama, Kansas, Michigan, Mississippi, North Dakota, Oklahoma, South Carolina, South Dakota, Texas, and Virginia — that use federal dollars to support private faith-based agencies, even when those agencies discriminate against foster and adoptive parents who do not share their stated religious values.

There has been a lot written on the principles of this policy. But much less has been said about whether these agencies are even able to effectively do their jobs.

Get TalkPoverty In Your Inbox

Delaying, or even preventing, placement with permanent families — which agencies do by default when they restrict the pool of available families — can have life-long consequences for kids in foster care. Every year, about 20,000 youth age out of the foster care system without being adopted, leaving them with fewer educational and employment opportunities, and more likely to experience homelessness, become pregnant early, lack access to health care, and become involved in the criminal justice system.

There is also a more nuanced question as to whether agencies that discriminate against prospective parents are capable of supporting the diverse children  —  children of varying religious backgrounds, races, ethnicities, abilities, gender identities, and sexual orientations  —  that make up the foster care population.

Optimally, the foster and adoptive parents working with states should reflect the same diversity as the children they serve, and most importantly, every foster parent a state works with should be able to support, affirm, and meet the needs of any child in care. The demographics of children in foster care, and foster and adoptive parents, look different in every state. However, children of color and children who identify as LGBTQ+ are disproportionality involved in child welfare systems and experience disparities while there. There is also incredible diversity in the faith needs of children in foster care. Many young people express the desire to be connected to their faith community. This is a critical part of a young person’s identity, and the only faith and spirituality needs that should be taken into account are theirs.

Studies have found that attention to a child’s identity is core to promoting health and well-being — and that doing so has an impact on their success and stability as adults. For example, research has demonstrated that providing children of color with opportunities to cultivate a positive relationship with their ethnic and racial identity can serve as a protective factor, offsetting trauma, increasing self-esteem, and helping to mitigate the effects of racial discrimination. Research also shows that acknowledging and affirming youth’s sexual orientation, gender identity, and expression is critically important to a young person’s health and well-being, and promotes both safety and their success in foster and adoptive homes.

In reference to South Carolina’s new order, Erin Hall, a former provider and the previous CEO of the Palmetto Association for Children and Families, stated, “Finding foster and adoptive homes is about matching a child’s needs with a family. In South Carolina, we have put the preference of one faith-based agency ahead of the mission of child welfare. This is not reflective of what we know is in the best interest of kids or what most of the faith-based service providers in South Carolina believe is right.”

When child welfare agencies prioritize the needs of faith-based agencies over children, that restricts their ability to recruit and license loving and affirming foster and adoptive homes, there are significant negative consequences for children. Alex’s experience is one example.

In Alex’s case, by placing a young child in a home that was not affirming, she grew up without the support that foster and adoptive parents have committed to provide, and the state has committed to establish.

Child welfare experts, including many faith-based providers, know that these religious refusal laws hurt children. Unfortunately, the current political climate, and the too often unchecked power state governors and legislators have over the policies that govern child welfare systems, is likely to lead to more religious refusal in the future. Texas’ attorney general has now asked for a waiver to exempt religious groups in his state. In Pennsylvania, several lawmakers, without going through their governor, sent a request for such a waiver directly to HHS. These actions may respond to the desires of some providers, but is not aligned with the majority of faith-based child welfare providers and is firmly outside of the norms of child welfare best practice.

Lena Wilson, vice president of the children and families division at Samaritas, one of the largest faith-based providers in Michigan, described what she saw as the obligation of organizations like hers in the wake of the passage of a religious refusal law in her state: “We as agencies have to be vigilant to ensure all of our children and families are served without discrimination. Currently discriminatory legislation is being passed in the dead of night, which further marginalizes our LGBTQ youth and families and denies them equal access to services that they deserve.”

*Name was changed for privacy.

But after decades of collecting this data, the government is putting it to use. This information is feeding algorithms that decide everything from whether or not you get health insurance to how much time you spend in jail. Increasingly, it is helping determine whether or not parents get to keep their kids.

Get TalkPoverty In Your Inbox

When someone phones in a report of suspected child abuse — usually to a state or county child abuse hotline — a call screener has to determine whether the accusation merits an actual investigation. Sometimes they have background information, such as prior child welfare reports, to assist in their decision-making process, but often they have to make snap determinations with very little guidance besides the details of the immediate report. There are more than 7 million maltreatment reports each year, and caseworkers get overwhelmed and burn out quickly — especially when a serious case gets overlooked. New algorithms popping up around the country review data points available for each case and suggest whether or not an investigation should be opened, in an attempt to offset some of the individual responsibility placed on case workers.

The trouble is, algorithms aren’t designed to find new information that humans miss — they’re designed to use the data that humans have previously input as efficiently as possible.

“If you give it biased data, it will be biased,” explained Cathy O’Neil, mathematician and author of the book Weapons of Math Destruction, while speaking with me for a story I wrote for Undark last year. “The very short version is that when you’re using the past as a kind of reference for how it works well, you’re implicitly assuming the past is doing a good job of rewarding good things and punishing bad things. You’re training the system to say if it worked in the past, it should work in the future.”

Historically, low-income families have had their children removed from their homes at higher rates than wealthier families. As a result, these new algorithms work to codify poverty as a criteria for child maltreatment. Some of the variables that these tools consider are public records that only exist for low-income parents, such as parents’ poverty status, whether they receive welfare benefits like SNAP and TANF, employment status, and whether they receive Medicaid. Other factors, like previous criminal justice involvement and whether or not there have been allegations of substance misuse in the past, are also dramatically more likely for families living in poverty.

This bias exists even in systems that have been highly praised, like the Allegheny Family Screening Tool currently being implemented in Pittsburgh, where prior arrests and parents’ mental health histories are considered factors in whether a child should be removed. It’s similar in other, less-transparent systems, like one in Florida where tech giant SAS contracted with the Florida Department of Children and Families to research which factors were most likely to contribute to the death of a child by maltreatment. According to press releases by SAS (some of which have been unpublished since they began garnering media attention) the company used public records such as Medicaid status, criminal justice history, and substance-use treatment history.

The results led jurisdictions in Florida to zoom in on factors that apply to huge swaths of families, including mine. In April of last year, an allegation of drug use and child abandonment led Broward County, Florida child welfare investigators to investigate my family. When my drug tests were negative, the investigation pivoted to my recent financial setbacks, which had been caused by my husband’s acute health crisis. My children were ultimately removed from my care, and we have been separated for nine months for reasons that are primarily financial. My case is far from unique. Three-quarters of child protective cases in the United States are related to neglect, not abuse, and that neglect usually means lack of food, clothing, shelter, heating, or supervision: problems which are almost always the result of poverty.

Ira Schwartz, a private analytics consultant, thinks he may have found a way to help re-balance this system. He conducted a research study in Broward County — the same county in which my case is based — that discovered the current approach to child welfare substantiation is highly flawed. According to his research, 90 percent of system referrals were essentially useless, and 40 percent of court-involved cases (which typically involve child removal) were overzealous and harmful, rather than beneficial, to the families. He created his own system that, like the Allegheny tool, predicted the likelihood that a family would become re-involved with the system. But he admits quite openly that predictive algorithms like his target the poor.

“We found in our study that lower socioeconomic status was one of the significant variables that was a predictor [for reinvolvement with the system],” said Schwartz. “The issue with higher-income families is … they just don’t really come into the system because they have other options. With higher-income families, when there’s child abuse or neglect or even spouse abuse and it’s reported, they can afford to go to private agencies, get private mental health services; they can see a psychiatrist or social worker or psychologist … it’s a discrimination factor.”

Schwartz believes that these types of admittedly discriminatory computer programs can still be put to good use when combined with prescriptive analytics, which would determine the services that high-risk families need in order to remain out of the system in the future. Schwartz says this would include services like rental assistance, food assistance, day care funding, and housekeeping services. This would help welfare agencies understand which families need what services, and streamline the process of providing them. (All jurisdictions are legally required to make “reasonable efforts” to help families resolve the issues that brought them under investigation, but how agencies go about meeting that standard varies widely by location.)

The issue with these algorithms is certainly not malice on the part of their creators. Even the more secretive, proprietary algorithms being created by companies like SAS claim to want to create a safer system that results in less child maltreatment. But it’s unclear if that is possible with the data that’s available. Without comparable data from wealthier populations, which are better protected by privacy laws, the new systems cannot produce accurate results — and even if more data were added, it would mean more families are being separated and surveilled.

When most people hear “the state took my kids,” their minds jump to the worst conclusions. These cases are quiet and the courtrooms are closed, so I don’t blame you for assuming I was beating them up, or looking the other way while they were abused, or some other such nightmare scenario you see on the Lifetime channel. Those kinds of cases happen, but far more common are the ones where parents do their very best but still come up short on money for the heat, or the rent, or a licensed babysitter. My case is one of those, in which a little more cash and sympathy would have kept my daughters with me.

Three-quarters of substantiated child maltreatment cases are related to neglect, and the kind of neglect that triggers a CPS case is almost always the result of poverty. Although each state gets to set its own specific definitions for neglect, they typically center around deprivation of things like food, shelter, clothing, or medical treatment, which are problems almost totally exclusive to poor people.

The accusation that brought child services into my family was related to drug use. My mother-in-law, with whom I’ve never really gotten along, called the child abuse hotline and told them she suspected I was out using heroin while she watched the kids.  After a series of urine and hair panels tested negative, child protective services broadened their investigation. They raised concerns about the fact that I was living with my in-laws, and that I had been unable to attend trauma therapy for a month while I waited for my new state insurance to go into effect.

Get Talk Poverty In Your Inbox

The investigation lead to a dependency trial, where the investigator made it clear that my daughters showed no signs of abuse or neglect. I lost anyway. There are no juries involved in child welfare cases, and the burden of proof is lighter than in criminal cases: It only requires a “preponderance of the evidence,” which means the judge’s ruling depends on their personal opinion. In this case, the judge didn’t think I was a credible witness, so she ruled against me.

This means that my daughters now live with my in-laws, and I am legally barred from being in their home after 8 p.m. I get two supervised visits per week while I navigate a web of random drug tests, mental health evaluations, parenting classes, and trauma-based therapy — the details of which get reported back to my case worker, the state attorney, my daughters’ guardian ad litem, and the trial judge — in an effort to win back custody.

If I had been in a different city, or a different state, things might have turned out a lot differently. Child protective services is an umbrella term used to describe individual local agencies. They are governed by standards set at the federal level but operate independently in each state, and city-level jurisdictions set their own policies to manage reports of neglect or abuse. This means that location plays an enormous role in CPS response. Families who live in an area experiencing an economic boom are more likely to receive support, like help turning the water back on if it was shut off for nonpayment, while families in more depressed areas are less likely to have resources available to them. Because of the subjectivity of these cases, it’s likely the politics of the judges and caseworkers play a large role as well.

I’ve experienced this difference first hand. This time last year, I was living in Seattle. When I overdosed during a brief relapse in 2016, the King County child protective agency inquired about my family’s financial difficulties. After learning that the relapse had been prompted by legal difficulties with my abuser — for which I could not afford representation — they referred me to an agency that was ultimately able to provide me with an attorney pro bono. When I disclosed that I was having difficulty accessing trauma therapy because I could not afford child care, they helped secure placement for both of my daughters in a free, comprehensive daycare. And when I told them our utilities were pending shut-off, CPS paid the portion required to keep them running. My daughters did not spend a single day out of our home, and our lives began to improve.

But Seattle is a very wealthy area, with a high cost of living. When my husband had a mental health crisis that prevented him from working, we had to move somewhere more affordable and closer to his family. That somewhere ended up being Broward County, Florida. The economic differences are stark: Seattle’s median household income is almost 50 percent higher than Broward’s, and its minimum wage is nearly twice as high. Although it can be hard to catch your breath in Seattle if you’re poor, there are more avenues for help available than in Broward, and the CPS response between the two areas reflects that. In Seattle, we were given a chance to recover. In Broward, it was assumed we wouldn’t be able to.

Josh Michtom, a Connecticut public defender who represents child-welfare involved parents and children, says that poor families have the most difficulty when they come under CPS scrutiny. “Starting from the beginning…poor people as a general rule live a little closer to the edge. Scrambling to and from daycare, hurrying from job to job or job to home, living in more precarious housing or housing that isn’t as well kept-up…it’s not to say all poor people are neglectful or abusive, but run the simulation a hundred times and it’s going to come out with more things that raise an eyebrow for a teacher or daycare worker or hospital worker [who are mandated to report suspected abuse or neglect to CPS].”

According to Megan Martin, vice president of public policy at the Center for the Study of Social Policy, the “vast majority” of child welfare cases are poverty related. Martin also points out that the numbers may not even fully capture the extent of the relationship between poverty and child welfare involvement. She says that the official figure, which links 47 percent of cases to poverty, measures families who are financially unable to meet their basic needs. (For example, a parent who does not have the means to heat their home in the winter.) But that doesn’t include other issues related to poverty. She uses the example of inadequate supervision, a common factor in child removals that has gained some past media attention.

“If you can’t afford child care and don’t have other resources like family to watch your kids, you might end up with a nine year old watching a two year old,” says Martin. “When kids are removed for inadequate supervision, that’s not necessarily included in that 47 percent.”

In his practice, Michtom also struggles with the huge cultural divide that often exists between mandatory reporters and many parents living in poverty. He describes how something such as a parent deviating from the typical upper- or middle-class vernacular may lead a teacher or pediatrician to subconsciously distrust the parent and therefore ascribe malicious intent to something like a bruised knee or unkempt clothing.

Even using that vernacular can count against parents who don’t look the part. At the end of my trial, the judge cited my “skill with language” as her reason for disbelieving my testimony, adding that I could “sell ice to an Eskimo.” My advanced education and ability to communicate clearly should have benefited my case, but coupled with my poverty and substance use disorder diagnosis, it led her to read me as a con artist instead.

“Middle- and upper-middle-class people have a language and way of talking to professionals that seems ‘good and responsible,’” Michtom observes. “When a kid has a completely not abuse related injury and the school nurse calls the parent and says ‘can you explain this?’ and the parent maybe doesn’t speak English as well or just seems less trustworthy to this middle-class nurse in a way maybe the nurse can’t quantify, then the nurse says ‘I have a duty to report this.’”

Once an investigation is opened, the family’s life is picked apart. Even if the original allegation turns out to be unfounded, a myriad of other factors — issues that may not have been enough to prompt a call on their own — can be used against the parent. In my case, the state obsessed over the fact that I didn’t have my own housing, despite the fact that more than one-third of adults were living with their parents in 2015.

Michtom believes that cultural differences between investigators, judges, and other people involved in the substantiation process directly affect how even small deviations are perceived. “If you don’t know what it’s like to be poor and you don’t know what it’s like to make the compromises poor people have to make,” explains Michtom, “the wrong social worker calls them deplorable or filthy even if it was just messy or cluttered, and that increases the likelihood that it leads to a court petition [for the child’s removal].”

As he says this, I remember the shame and anxiety I felt doing something as simple as going to the playground, where my daughter’s coats, though surely warm enough, looked dingy and stained next to the kids running around in clothes so absurdly bright they looked like something out of a cartoon. My anxiety wasn’t just based on embarrassment; it was also couched in the visceral fear that people would assume I was a bad mom because of something as simple as clothing my daughters in used coats.

Parenting in poverty creates a cycle of factors that compound each other. For my family, an inability to pay for child care or legal aid in 2016 created a snowball of stressors that ultimately led to a relapse and almost killed me. This year, when we were managing to get by, a sudden unexpected health emergency sent us spiraling right back into the system.

As I continue to fight for the return of my daughters, I can’t help but wonder what it would look like to have a uniform child welfare system that recognizes these types of complexities. Maybe my daughters would be with me now. Maybe my husband would be on a road to wellness instead of struggling alongside me to find permanent housing. Maybe the other 3 million families involved with CPS would flourish and thrive. Maybe parenting in poverty would stop being so hard.

Shortly after the investigator entered the home, Truitt says the investigator called to demand she leave work immediately to meet at the department’s local office. While there, Truitt, who takes methadone as part of her addiction recovery treatment, admitted to using marijuana daily for anxiety, and cocaine once in the week prior, but denied using illegal drugs in the presence of her child. After that admission, Truitt says, things went downhill fast.

“I saw she wrote I smoke around my son,” Truitt says of the safety plan her caseworker hand-wrote in pencil during their meeting. “I don’t smoke around my son…[My caseworker] said, ‘it’s the end of the day, we’re not changing it.’” (Due to confidentiality laws, the Delaware Division of Family Services declined to comment.)

Get TalkPoverty In Your Inbox

Safety plans like these are widely used in the realm of child protective services investigations in an attempt to resolve perceived threats to a child’s health and safety without judicial involvement. Though informal, they are signed by both parties and are considered binding within the realm of the department. According to the U.S. Department of Health and Human Services, a positive drug test (or other confirmation of a single act of drug use) is not enough to substantiate child maltreatment accusations, or to determine child placement. But because safety plans are not legal documents, local departments have discretion of how they apply those standards, so long as the parent agrees and signs the plan. It’s up to the department what happens if a family violates an agreement, but the possibility includes showing up with a police officer and a court order to remove the child.

Truitt says she signed the safety plan because she was told the alternative was foster care. What she didn’t know was that the department would have needed to present the case to a judge before placing her son in foster care. Agreeing to a safety plan is not compulsory, nor are these plans technically binding in a legal sense. But parents, who are often pressured to appear compliant, don’t always know this. If they can’t hire an attorney on their own, it’s unlikely anyone will tell them that they don’t have to agree.

For Truitt and her family, this safety plan had devastating effects. As part of the plan, Truitt was asked to place her son in the care of a family member. She says she initially believed it was just for the weekend, but Truitt’s son ended up living with her sister for 30 days.

Because child services agencies are regulated at the state and county levels, we have no way to gauge exactly how many families are separated through these methods: The only data is voluntary and self-reported. In one class-action lawsuit related to safety plan removals, a case that began in the 1990s and covered only the state of Illinois, there were more than 150,000 plaintiffs. Child removals have only risen since that time.

In 2016, child services agencies across the United States received maltreatment complaints for more than seven million children, with close to four million of those children deemed as meeting the initial criteria for abuse, abandonment, or neglect. At least one-fifth were removed from their parents’ care. Rachel Paletta, senior associate at the Center for the Study of Social Policy, says that “the majority of child protective services referrals are for child neglect, so that may be inadequate housing or lack of clothing and food, and all of these things can be related to poverty…[however,] circumstances that are solely a result of poverty and not ill intent on the part of the parents should not be considered neglect or abuse.” Although it’s difficult to place an exact figure on the amount of low-income families that have child welfare involvement, there does appear to be a correlation between child removals and families who require financial assistance.

Safety plans have become the subject of legal scrutiny in recent years, but thus far, attempts to curtail their use have failed. Opponents of safety plans cite their coercive nature—it’s hard to say that a parent is truly volunteering to the terms when the other option presented is long-term separation from their children. Of course, although case workers are advised (and in some states, mandated) to inform parents like Truitt about the possibility that their children will be removed for a longer time by a judge, it’s impossible for these workers to accurately predict the outcome of a hypothetical hearing—especially since the parent could have access to legal counsel and Child Services would be forced to present evidence of maltreatment.

Although their separation was relatively short, Truitt says her family is still suffering the effects. Her son, who will be three in August, constantly screams to be held, which she says is a new behavior. He cries whenever they visit her sister, and he has developed an intense phobia of bugs. Truitt thinks this is because they told him he was staying with his aunt due to an infestation in the home. She is now “constantly paranoid” that child services will try to remove her son without warning again, even though she is actively engaged in addiction and mental health treatment.

Maia Szalavitz, a neuroscience journalist and co-author of The Boy Who Was Raised as a Dog: What Traumatized Children Can Teach Us About Loss, Love and Healing, says that even short-term parental separation can have devastating lifelong consequences for children.

“Every single time a child makes a custody transition it’s an adverse childhood experience so it’s potentially traumatic. The more of these experiences you have, the greater the risk for addiction, mental illness, and physical problems like obesity,” says Szalavitz. She also notes that this goes both ways; once a child adjusts to a new custodial environment and begins bonding with his new caregivers, returning home counts as a stressor. That means that every time a child is placed into temporary out-of-home custody, he is guaranteed at least two adverse experiences. For children bouncing between homes in the foster care system, the number of adverse childhood experiences caused by child services involvement is even higher. One study found that four or more adverse childhood experiences indicated a significantly increased likelihood of physical and mental health problems later in life.

For now, Truitt is happy to be reunited with her son. In the thick of the Delaware summer, she enjoys splashing with him in the kiddie pool she has set up in her backyard. But she remains haunted by the possibility that a social worker could come by once again and, with nothing but a pencil, uproot her family like they did last April.

Ryan’s 2016 agenda—which he says is still his template for benefit cuts—uses Temporary Assistance for Needy Families (TANF or “temporary assistance,” which replaced Aid to Families with Dependent Children in 1996) as a success story and model for future cuts. But evidence is mounting that a growing number of states are outright failures when it comes to meeting the first purpose of temporary assistance: providing assistance to families so that children “can be cared for in their own homes” instead of in foster care or institutions.

Get TalkPoverty In Your Inbox

The number of children in foster care now exceeds the number of children being cared for at home with the support of temporary assistance in at least seven states: Arizona, Arkansas, Indiana, Kansas, North Dakota, and Wyoming.

As the map below shows, in 2016, the ratio of children in foster care to children receiving temporary assistance varied from .07 in California to 2.77 in Wyoming.* In 21 states, this ratio is greater than .5, meaning that for every two children receiving TANF while living at home, there is one or more children living in foster care. In seven states, the ratio is 1:1 or more, and in two states (Wyoming and Indiana) there are roughly two or more children in foster care for every one receiving TANF while living at home.

The ratio of children in foster care to parents and other relative caregivers receiving TANF varies even more: from .11 in Maine to 41.56 in Idaho. The ratio is greater than 1 in 34 states, meaning that for every one parent receiving temporary assistance while caring for children in these states, there is one or more children living in foster care.

Let’s take a closer look at one of these failed TANF states: Kansas. Starting in 2011 under Gov. Sam Brownback, Kansas began implementing a series of cuts that have made it much harder for working-class parents and children to receive temporary assistance, regardless of their financial situation.

As the cuts were imposed, the number of Kansas children and parents receiving temporary  assistance plummeted. At the same time, the number of children in the child welfare system, including the number being cared for in foster homes, increased. By 2016, nearly 11,000 Kansas children were spending time in foster care. That same year, only about 9,200 Kansas children were receiving temporary assistance while being cared for in their own homes. Moreover, a significant number of these children were being cared for in the homes of grandparents or other relatives rather than parents. Less than 3,000 actual parents were receiving temporary assistance themselves in 2016.

To put these numbers in context, nearly 3 million people live in Kansas. Nearly 1 in 3 Kansas workers are paid under $12 an hour, and 1 in 7 Kansans are food insecure. Some 100,000 Kansas children live in families with incomes below the poverty line, and roughly 20,000 Kansas children live apart from both their parents.

Kansas officials claim the rise in children living in foster care is not due to the temporary assistance cuts. Research funded by the Centers for Disease Control and Prevention strongly suggests otherwise. In their preliminary research, economist Donna Ginther and social work professor Michelle Johnson-Motoyama, both at Kansas University, have found that the number of children in the child welfare system, including foster care, increased in Kansas and other states that implemented more restrictive TANF policies. In recent testimony before the Children and Seniors Committee of the Kansas House of Representatives, Johnson-Motoyama said that “restrictions on access to [temporary assistance] appear to have unintended consequences with regard to human costs and costs to Kansas taxpayers.”

Most children end up in the child welfare system not because of abuse, but because officials decide parents aren’t adequately meeting their children’s basic needs. Recent research suggests that when low-income parents receive even modest amounts of additional income each month, their children’s risk of involvement in the child welfare system goes down.

As a practical matter, it will be difficult to definitively prove that cuts in temporary assistance are pushing more children into the child welfare system. But debates about causality shouldn’t distract from the fundamental problem. If a state has more children in foster care than children receiving temporary assistance in their own homes, this should raise searching questions about whether the state is meeting the first purpose of temporary assistance.

Beyond this, temporary assistance in the vast majority of states needs to do more to support parents’ role as caregivers and homemakers. There are no provisions built into the program to make sure it is doing enough to meet families’ needs. The only real accountability provisions for states in TANF direct them to not provide assistance to families, typically because parents aren’t working enough each week. States and the federal government have paid little heed to parents’ more fundamental role—for their children—as caregivers and homemakers.

* The most recent state-level foster care data available from the Department of Health and Human Services are for 2016. Even fewer children are receiving TANF today, so this ratio will have grown in most states.