Tag: education

accountability, arrest, child death, child welfare reform, foster care abuse, cps, domestic violence, government, jail, police, psychotropic medications, social services, system failure
Child welfare officer jailed (ACCOUNTABILITY!!!!)

this is what i like to see – this case is a couple years old, but its a good leader to what needs to keep happening – accountability!!!

The Pinellas sheriff’s employee lied about checking on children and filed false overtime claims, detectives say.

By CHRIS TISCH
Published December 10, 2004


Megan Gallagher faces felony charges of grand theft and falsifying records.

LARGO – Pinellas County sheriff’s detectives arrested one of their investigators Thursday, alleging that in a least two dozen cases she failed to visit homes where child abuse had been reported, then wrote fake reports.

Megan Gallagher, 25, also submitted bogus overtime slips for hours she never worked, sheriff’s officials said. She was booked into the Pinellas County Jail Thursday on felony charges of grand theft and falsifying records.

Gallagher, who has worked for the agency since March 2002, was placed on paid administrative leave.

After learning of one case of deceit, supervisors in the Sheriff’s Office’s child protection division found 26 cases where Gallagher falsified documents this year, according to officials. In most of them, she made no visits to families where children were reported to be in danger, said Capt. George Steffen, the division’s commander.

None of those children suffered injuries because of Gallagher’s no-shows, though two children later were removed from a home Gallagher failed to visit, Steffen said.

“It was very disturbing and we acted as quickly as we could,” Steffen said. “This is extremely egregious on her part.”

Steffen said the work of his 77 investigators is important and can save children from harm or neglect. The possibility that Gallagher wasn’t doing that work is alarming, he said.

“If you’re not making contact as you’re required to and they are tasked to do on a daily basis, obviously you’re going to leave children at risk,” Steffen said. “And we were fortunate in all these cases that nothing serious occurred.”

The 26 cases Gallagher is accused of falsifying all occurred this year, though officials intend to look back even further, Steffen said.

He said he couldn’t rule out that there are more cases in previous years, and that children may have been harmed if there was more deceit.

“We are going to go back further,” he said. “It could be growing.”

This marks the third time this year that a child-protection investigator with the Sheriff’s Office has been arrested.

Two other child protection investigators were arrested in August on charges they submitted false overtime slips, though neither was accused of skipping family visits.

Both of those investigators resigned, then entered pretrial intervention programs that could result in criminal charges being dismissed, court records show.

Division supervisors tightened up on overtime procedures and began reviewing spikes in overtime, but found no other people abusing the system. Gallagher’s time slips were not reviewed at that time because she filed for it sporadically, Steffen said.

Sheriff’s officials said the overtime in question this year amounted to about $2,000.

A fellow investigator became concerned during a visit with a family that Gallagher had supposedly visited earlier this year, officials say. When questioned by the second investigator, the family said Gallagher had never called or visited their home. A report filled out by Gallagher said she had.

“This family said they didn’t even know anyone by the name of Gallagher, had never seen her or been contacted by her,” Steffen said. “Of course, this raised a red flag. The information was practically totally fabricated.”

Steffen said he assigned four investigators to meet with the families that Gallagher had failed to visit. Of the 160 or so cases she was assigned in the first eight months of this year, she did not visit 26, sheriff’s officials said.

Officials said they did not know what Gallagher was doing when she said she was visiting with at-risk families.

Steffen said Gallagher used similar descriptions in most of the reports she is accused of falsifying, including often saying that dishes were piled high in the sink. Steffen said supervisors have been reminded to be vigilant when reviewing investigators’ work and to look for such repetitive descriptions.

In 1999, the Sheriff Office replaced the state’s Department of Children and Families in investigating child abuse cases.

Steffen said there are no plans for changes in management practices and said the accusations against Gallagher are not reflective of the division.

“Most of our people are honest,” he said.

[Last modified December 11, 2004, 19:12:00]

children, cps, family, foster care, General, government, law, legal, medicaid fraud, privatization, psychiatry, psychotropic medications, social services, system failure, welfare reform
Privatization

 

Privatization of Public Social Services

A Background Paper

Author(s): Demetra Smith Nightingale, Nancy M. Pindus

Other Availability: Order Online | Printer-Friendly Page

Posted to Web: October 15, 1997

Permanent Link: http://www.urban.org/url.cfm?ID=407023

This paper was prepared at the Urban Institute for U.S. Department of Labor, Office of the Assistant Secretary for Policy, under DOL Contract No. J-9-M-5-0048, #15. Opinions expressed are those of the authors and do not necessarily represent the positions of DOL, the Urban Institute or its sponsors.

The views expressed are those of the author and do not necessarily reflect those of the Urban Institute, its board, its sponsors, or other authors in the series


1. Introduction

The purposes of the paper are to provide a general overview of the extent of privatization of public services in the areas of social services, welfare, and employment; rationales for privatizing service delivery, and evidence of effectiveness or problems. Examples are included to highlight specific types of privatization and actual operational experience. The paper is not intended to be a comprehensive treatment of the overall subject of privatization, but rather a brief review of issues and experiences specifically related to the delivery of employment and training, welfare, and social

services.

The key points that are drawn from a review of the literature are:

  • There is no single definition of privatization. Privatization covers a broad range of methods and models, including contracting out for services, voucher programs, and even the sale of public assets to the private sector. But for the purposes of this paper, privatization refers to the provision of publicly-funded services and activities by non-governmental entities.
  • Privatization is not a new concept. The current rationales for privatization and their implementation strategies differ very little from earlier privatization initiatives (even as early as the 1930s). Perhaps the biggest single change in the current privatization environment in the area of social and human services is the possibility of private companies being contracted with to administer entire public-funded systems (e.g., all of welfare, all of child support, all of workforce development).
  • The real issue is not so much public vs. private–it is monopoly vs. competition. A key issue in the current trend towards what is commonly referred to as “privatization” is the introduction of competition (e.g., public-public competition, public-private competition, competition between public-private ventures, public-nonprofit competition) to increase efficiency, reduce costs, and improve quality and customer satisfaction.
  • Privatization is not inherently good or bad–the performance or effectiveness depends on implementation. The little empirical analysis comparing the effectiveness of public versus private service delivery shows no clear evidence that private service delivery is inherently more effective or less effective than public service delivery, although the public, private, and nonprofit sectors each have their own relative strengths and weaknesses. There are examples of success and failure in both sectors. Most of the research suggests that the key factor is whether there is clear accountability for results, clear criteria in contracts, and clear public objectives. The government is responsible for assuring that public services are effective, whether or not the services are publicly delivered.
  • Privatization does reduce the number of public employees if services formerly performed in the public sector are shifted to the private sector. But it is not clear that workers are necessarily worse off in terms of employment, wages, morale, or job satisfaction. There are many examples of negotiated arrangements for transferring public employees to private employment or to other public agencies. There is undoubtedly, though, a clear reduction in public employee members of unions, although some number of privatized workers may join other unions.
  • It is still too soon to know whether the most recent and highly-publicized privatization efforts will be effective or not. There are, however, many potential problem areas (e.g., profit motivation to cream and minimize costs) that, if unaddressed in the public contracts, could reduce service quality. There are many reasons for cautiously scrutinizing the process.

2. Current State of Privatization

Similar to trends in the private sector, there is some indication that public agencies are increasingly considering downsizing and outsourcing as ways to address both financial constraints and a desire to improve performance. The Government Management Reform Act of 1994 (P.L. 103-356) states:

To be successful in the future, government must, like the private sector, adopt modern management methods, utilize meaningful program performance measures, increase workforce incentives and flexibility without sacrificing accountability, provide for humane downsizing opportunities and harness computers and other technology to strengthen service delivery.

However, privatization is not a new phenomenon. Gurin (1989) notes that privatization of government social services has, in fact, increased at major watershed points in the history of social policy (the Progressive era in the late 19th century, New Deal, Great Society, and Reagan years), both at times of expansion and during contraction of government services. For example, during the 1970s, federal funding for social services increased greatly under Title XX of the Social Security Act, and for human development and employment services under the Economic Opportunity Act and the Comprehensive Employment and Training Act (CETA). Nonprofit organizations and for-profit businesses both emerged to fill the need for government contracted service providers. In contrast, during the early 1980s when federal funding for social programs was dramatically reduced, there was also some increase in contracting out services (in some locales) as one way to reduce unit costs and gain efficiencies despite reduced overall funding.

More recent interest in privatization of public social services is stimulated by both expansion and contraction of publicly funded programs. Federal funding for employment and training declined during the early 1990s, and this was one motivation for workforce development system redesign, which includes considering new ways to deliver services. At the same time, the 1996 welfare reform legislation increases the responsibility states have for redesigning their welfare systems and, at least in the short run, provides more federal funding for both income support and programs that promote employment. Privatization is one of the various welfare system redesigns that are being considered.

The recent dramatic emergence of large private corporations into the welfare field (discussed below) has raised many concerns about the appropriateness of this degree of privatization. The traditional approach to contracting in social services had been noncompetitive, quasi-grant arrangements, primarily with non-profit organizations (Hatry and Durman 1985). The increased emphasis on competition and performance contracting for the delivery of social services is consistent with private sector initiatives focusing on efficiency and customer service. Some organizations, such as the Reason Foundation, have been promoting the benefits of privatization for decades, and recently their efforts are gaining new momentum, providing technical advice and guidance to businesses and public officials on how to develop business ventures and effective public/private partnerships. In addition to welfare reform, several other recent federal initiatives also encourage more privatization, most notably in one-stop career centers and child support enforcement.

One-Stop Career Centers

The federal One-Stop Career Center initiative encourages an expanded use of vouchers and competitive selection of administrative entities (e.g., for one-stop centers). Although national regulations do not specifically endorse privatization of services, they do encourage expanded competitiveness for the selection of center administrative and service delivery agents, allowing public and nonprofit organizations as well as private for-profit companies to compete openly for one-stop service contracts.

The Massachusetts’ One-Stop Career Center Initiative is a current example of the trend toward privatization in the one-stop and workforce development area. The state plan allows private firms to compete with public agencies for contracts to manage career centers, which serve as gateways to the states’s new workforce development system. However, the initiative has run into opposition on several fronts due to competition for funds among rival employment and training agencies, high demand for services at the career centers, and concerns expressed by public employee unions (Boston Globe, 2/11/97).

Child Support Enforcement

Federal child support enforcement legislation also supports an expanded role for non-profit and private contractors. The 1986 child support legislation specifically encourages states to consider contracts with private companies for technical activities such as locating absent parents and maintaining tracking and payment systems. The Reason Foundation reports that, in 1995, there were twenty states and dozens of local governments that had privatized one or more child support services, and that five more states were planning to do so in 1996. These states contract out for activities such as location, collection, payment processing, distribution of payments, and fully privatized offices. Georgia and Virginia give full caseload responsibility to private providers.

The success of the private sector in increasing collections of child support payments is attributed to several factors: first private firms can bring technology and equipment to the tasks that governments typically cannot afford; second, private firms can expand or contract operations quickly as they are not bound by government personnel systems; and private firms use performance incentives, such as bonus pay, to increase collections per employee. (Reason Foundation pp 45-46)

A 1996 General Accounting Office Report (GAO, October 1996) found that in the fifteen states with some privatization of child support, there was a tendency to especially contract out collections of child support payment from hard to locate absent parents and parents with past-due support.1 Many contractors receive payment only if they collect, often retaining a percentage of the collection (ranging from 8 to 24 percent). In general, GAO found that both the federal and state governments benefitted financially (net) from contracts that were targeted on cases that might not otherwise be worked–in effect, the private contracting supplemented what the public agency could do. The net benefit is derived from collections on AFDC cases and from federal performance incentives attached to child support collections for both AFDC and non-AFDC collections.

Welfare Reform

Increased requirements under welfare reform, coupled with spending restrictions that limit the amount of hiring that can occur in public agencies, have led some states to more seriously consider outside service contractors for welfare service delivery functions. For example, welfare officials in Nebraska and Arizona plan to increase their use of outside contractors (both for-profit and non-profit) to deliver services such as job placement and parenting skills training. (ETR 11/27/96) Other states may make similar decisions. “Private industry buzzwords such as ‘streamlining’ and ‘cost-containment’ have spilled over to the public sector, and welfare officials are moving to share risk and cut costs.” (ETR 10/9/96)

The recent welfare reform law, The Personal Responsibility and Work Opportunity Reconciliation Act of 1996, is the latest federal policy that contributes to the privatization trend. The 1996 law removes previous restrictions that essentially prohibited states from contracting out initial welfare (AFDC) intake and eligibility determination functions. This has apparently opened a new market for private companies. In the past, service delivery contracting in the social welfare arena was mainly for direct service delivery such as job training, job search instruction, and day care provision; and service providers were mostly non-profit, although some for-profit companies have provided job training or other employment services. Large for-profit companies were mainly involved as contractors for data systems. Intake and eligibility determination for welfare programs remained with public agencies.

Now that welfare agencies can contract out the entire welfare system, including intake and eligibility determination, large for-profit companies are moving into the welfare service delivery market (e.g., EDS, Lockeed Martin, IBM). States are also more seriously considering privatization options because of concerns over cost and the need to meet specific federal goals fairly quickly. Large companies had already gained a foothold into some of the human service agencies, primarily through health care and child support enforcement, for data systems and, more recently in child support, for service delivery functions. “Before the new welfare law, moving people from welfare to work was the domain of nonprofit organizations and three relatively small businesses (America Works, Curtis and Associates, and Maximus). Now, some large companies see a potentially multibillion-dollar industry that could run entire welfare programs for states and counties.” (Bernstein, 1996)

The three small for-profit companies referred to in the New York Times article (Bernstein, 1996) are:

  • America Works: $7 million in contracts in New York City, Albany NY and Indianapolis; provides supportive services for the first four months a welfare client is on a job. The client receives minimum wage, but the employer pays America Works a higher wage, similar to the arrangement with temporary employment agencies. In addition, the government agency pays America Works $5000 per successful placement (defined as one that lasts 4 months).
  • Curtis & Associates: $9.2 million in business last year in selected sites in 11 states, including California, New Jersey, Indiana, Vermont and Wisconsin; provides a job club model for agency clients; sells training manuals and materials.
  • Maximus, Inc.: $100 million total government contracts, much but not all in the welfare area; has contracts for child support enforcement activities in 6 states, a $10 million contract in California to recruit recipients into HMOs, and welfare-to-work contracts in selected sites in California, Massachusetts, and Virginia; has also had many contracts for data systems development in the human services area.

The most recent development, in fact, is a dramatic increase in the extent to which larger companies are seeking out welfare business on a major scale, going beyond their traditional contracts related to information systems and technology to work preparation, and now possibly including contracts for entire welfare systems including intake and eligibility determination as well as employment and social services.2 “Big companies are concentrating on lucrative contracts that require …large scale participation.” (ETR 10/9/96) The New York Times article (Bernstein, 1996) offers the following information about these “giant” private corporations now seeking welfare contracts:

  • Andersen Consulting: $4.2 billion global management and technology consulting company that is an affiliate of the big accounting firm; now has contracts in 14 states, mostly for child support and child welfare activities. Marketing a profit-sharing approach to welfare, and recently won contracts for running welfare in two Canadian provinces.
  • Electronic Data Systems: $12.4 billion information technology services company. Began with computerization of Medicaid billing and welfare reporting systems. Now has contracts in 20 states. EDS was recently awarded a new contract by the state of Texas which focusses on reengineering eligibility determination and service delivery for health and human services programs and securing a new computer system for the state.3
  • Lockheed Martin Information Management Services: a nonmilitary division of the $30 billion dollar Lockheed Martin Corporation; has child support enforcement contracts in 16 states plus the District of Columbia; also has contracts in 20 states to convert various welfare benefits to an electronic debit card system. Now launching a major new “welfare reform/self-sufficiency line of business.” (Bernstein 1996).

Wisconsin and Texas are the most prominent examples today of the privatization trend in welfare.

Wisconsin‘s latest major welfare reform effort, called W-2 (Wisconsin Works), for example, is based on market competition for delivery of services. Public, private and non-profit entities can compete for contracts to deliver the entire welfare system in specific localities. In the initial round of competition, proposals were submitted not by individual companies or agencies, but by consortia. Four (or five) consortia were formed to bid on the W-2 contracts and each consortium included at least one major private company, and public or non-profit agencies. The initial round did not produce many proposals, though, in part because of the very complex and inflexible criteria and requirements included in the state solicitation. Nonetheless, four contract consortia have been selected, and each will be responsible for the entire welfare administration in the four geographic areas within Milwaukee.

It is still unclear whether there will be a sharp increase in private companies assuming major responsibilities for work-welfare programs though, even in a state like Wisconsin. Wisconsin had, even before the latest reforms, already moved more towards privatization of welfare services, especially for work-related activities. In Milwaukee, for example, Manpower Temporaries, Inc. was, until recently, a primary contractor for administering a Welfare Job Center, delivering job placement services and coordinating services provided by other, mainly non-profit and public contractors. While the nature of the work was similar to Manpower’s traditional business, the private firm’s role has gradually shrunk in part because of the difficulty it had working with clients with serious employability barriers and collaborating with a disparate network of public and private organizations. (Employment and Training Reporter, 9/18/96)

Texas has received considerable attention recently because of its proposed privatization of the Texas Integrated Enrollment System (TIES). The TIES system was intended to integrate and streamline eligibility determination for fifteen programs, including AFDC/TANF, Food Stamps, and Medicaid. Officials in Texas emphasized that their objective was not to contract out government functions arbitrarily, but rather to improve efficiency and customer service in government through increased competition. Contracting with private, for-profit companies for Medicaid claims processing, child support payment tracking, and other information systems requirements are already accepted practices in Texas government.

The proposed privatization of TIES differed from other privatization initiatives because the eligibility determination functions to be contracted out were traditionally carried out by state employees. This change raised two concerns: the potential loss of jobs for state employees; and the appropriateness of having private rather than public employees make decisions related to program eligibility. The TIES privatization was strongly opposed by public employee unions, which launched a major public relations campaign to gain public support to oppose the state’s plan ( Houston Chronicle, April 14, 1997 ). The potentially large size (estimated at $2.8 billion over 7 years) of the TIES privatization contract attracted major private corporations such as EDS and Lockheed-Martin, each in partnership with state agencies as part of the bidders’ teams (Texas Department of Human Services [TDHS] with EDS and Texas Workforce Commission [TWC] with Lockheed-Martin).

Implementation of the contracting process for TIES was delayed for nine months pending federal approval of the state’s draft “Request for Offers.” The 1996 federal welfare reform did not prohibit non-government employees from determining eligibility for TANF, as had been the case for AFDC. However, the historic restriction still remained for other federal assistance programs, particularly Food Stamps and Medicaid, which were unaffected by the 1996 legislation. The state privatization plan, therefore, required special federal approval as an exception to policy. In May 1997, the Clinton administration ruled that privatization of Food Stamp and Medicaid eligibility was not allowable under federal law.

At about the same time as the federal administration’s decision, the Texas legislature was reshaping the TIES project. HB 2777, which was enacted in June 1997, directed the Texas Health and Human Services Commission to coordinate the TIES effort in consultation with TDHS and TWC. As a result, these state agencies have terminated their teaming arrangements with private sector vendors. Recommendations developed by TDHS in partnership with EDS during the bidding process will serve as a starting point for the reengineering efforts required in the $3.7 million 15-month contract awarded to EDS (Kinsey, 1997). Thus, Texas has turned to an incremental approach for integrating and improving eligibility systems, and will build upon lessons learned and innovations proposed during planning of the TIES procurement.

Employment and Training

Throughout the history of employment and training programs, contracting has been a common model for delivering services, often including intake and eligibility determination as well as training, job placement and other employment-related services. MDTA, CETA, YEDPA, Job Corps, and now JTPA all involve extensive contracting for service delivery–Job Corps is totally contracted, and Center operators include some small and large for-profit companies (e.g., ITT Industries; BDM International/Vinnell; ResCare, Inc.). In fact, the majority of federally-funded E&T services since the 1960s have been contracted out by the administering public agency. Most of the E&T service contractors have been non-profit or public entities (e.g., community colleges, public school districts, vocational schools, employment service). In some localities, for-profit companies have also provided services under contract (e.g., proprietary training institutions and schools, for-profit companies operating job clubs or job placement services). The best-known for-profit companies today that have contracts to provide job placement services to welfare recipients are America Works and Curtis and Associates.

Ironically, Job Corps is the only major federally-administered E&T program and the only one that is totally contracted out. It has also been found to be among the more effective programs. In part the success of Job Corps is attributed to its mix of public direction, oversight, monitoring, and clear competitive contracting with performance expectations (Gurin 1989). The government role in policy development, planning, monitoring and oversight is a critical factor in the Job Corps success. Job Corps centers can’t affect their performance measures by screening applicants (i.e., “creaming”) or by securing jobs for applicants because they have no control over this (Donahue 1989).

The Job Corps program operates through a partnership of government, labor and the private sector, at 111 Job Corps Centers in 46 states, D.C. and Puerto Rico. Private corporations and private nonprofit organizations– including Teledyne, ITT, Vinnell, Management and Training Corporation, Career Systems Development Corporation, Res-Care, and MINACT–operate 81 Job Corps centers under contracts with the U.S. Department of Labor (DOL). An additional 30 Job Corp Centers are operated by the U.S. Departments of Agriculture and Interior–called civilian conservation centers–on public lands throughout the country under interagency agreements with the U.S. DOL. A nationwide network of other public, private, nonprofit, business, and labor union subcontractors provide services for Job Corps, ranging from intake and application to occupational training, job placement and post-program support services.

Child Welfare

Child Welfare privatization of service delivery also expanded greatly in the 1970s and 1980s as caseloads of child abuse and neglect rose, budgets were increasingly constrained, and public agencies’ flexibility in staffing up was severely limited by personnel policies and state or local restrictions on spending. Agencies contract for various services from investigation to substitute care and therapeutic services. For example, in New York City, contract agencies take care of 70 percent of the city’s children in foster care (Giuliani 1996). In fact, the majority of publicly financed social services programs in New York City are delivered through contracts. These private suppliers, mostly well-established non-profit service agencies, both secular and religiously affiliated, have provided an ongoing source of political support for the city’s human service activities (Bendick 1989).


3. Models of Privatization

As the brief discussions above suggest, there is no single definition of privatization. But for the purposes of this paper, privatization refers to the provision of publicly-funded services and activities by non-governmental entities. There are also various methods by which services can be privatized, including contracts, formal agreements, vouchers, grants, subsidies, public/private partnerships, and collaborative service delivery. In general, though, the common use of the term privatization refers to formal contracting out of services by the government to the private for-profit or non-profit sector. One way to think about privatization is to consider two separate but related dimensions:

    (1) degree of market competition–ranging, for example, from open competition for all or public services, to government contracting for specific services; and (2) role of the public sector vis a vis other sectors–for example, government oversight of private services versus separate systems of services operated by government, for-profit and/or non-profit entities, versus public-private partnerships.

Market Competition. Osborne and Gaebler in Reinventing Government (1992) quote Gov. Mario Cuomo, who stated that (p. 30) “It is not government’s obligation to provide services, but to see that they’re provided.” Their conception of a reinvented government would involve broader service options, including using a competitive process for selecting deliverers of public services. “Competition will not solve all our problems. But perhaps…it holds the key that will unlock the bureaucratic gridlock that hamstrings so many public agencies,” by encouraging innovation, flexibility, efficiency and performance. This would mean ending the tradition that certain public agencies be presumptive deliverers of services. Public agencies would have to compete against each other and against non-profit and for-profit providers for a particular services market. Even within the public sector, competition can be introduced through the establishment of franchise funds which provide certain administrative services to “customers” within the public agency.

Some of the most recent examples of privatization in the welfare and workforce development area, such as in Texas, Wisconsin and Massachusetts have adopted versions of such a broad-based competitive model where public-private teams compete for contracts. In Indianapolis, public employees are required to compete against privately owned businesses for contracts to deliver all services with the exception of police, fire, and zoning operations. Initially, city employees and their union opposed the privatization initiative and feared losing their jobs. After negotiating changes to “level the playing field,” such as consulting assistance to prepare bids and streamlining the city workforce by reducing middle management, unionized employees have gone on to win 37 of the 86 contracts put out for bid by the city (Jeter 1997).

Sectoral Roles. A second dimension of the privatization concept relates to activities or functions performed by the governmental and non-governmental sectors, regardless of whether funds actually are exchanged and regardless of whether there is a formal contract or agreement. Much of the current discussion about privatization refers to for-profit businesses, but as Starr (1989) explains, there are actually four types of “private” providers: (1) personal, informal, mutual aid; (2) voluntary non-profit sector; (3) small businesses, entrepreneurial companies; and (4) corporate for-profit sector. The responsibilities and services of each may or may not result from contractual arrangements or exchange of funds.

For example, the welfare reform law of 1986 included strong language that would encourage community-based and faith-based organizations to be formal providers of services, presumably with government contracts. But underlying welfare reform’s focus on individual and family responsibility is that the informal community, charities, and neighbors are also an important source of support for persons in times of need.


4. Effectiveness and Potential of Privatization

There are strong and vocal advocates and opponents of privatization, but little empirical evidence about whether the public sector or the private sector is more effective.

Arguments For and Against Privatization

Arguments for Privatization. There are major advantages generally put forth for contracting for services with private (non-profit and for-profit) organizations, as indicated in Exhibit 1. In general, the strongest arguments for privatization of public services are:

    1. Increased flexibility resulting from a reduction of bureaucratic complexity and procedures, and 2. Reduced costs resulting from improved efficiency, especially if there is a truly competitive process with clear performance criteria.

Public decisions to privatize have in fact been motivated by a number of factors, (Hatry and Durman 1985) such as:

  • discontent with the performance of the public sector;
  • desire for more flexibility (e.g., personnel, operations, innovations);
  • desire to reduce costs; and
  • desire to “empower” service intermediaries (e.g., CBOs).

GAO (1996), for example, found that the primary reason state and local child support enforcement agencies contract out services is because of general state fiscal pressure that makes it difficult to hire more agency staff despite growing caseloads and sometimes even despite increased program funding. Motivation of public officials to privatize resulted from (1) “a desire to improve child support services,” (2) “need to serve soaring caseloads,” and (3) “inability to deploy additional staff.” (p. 6) Some states also wanted to expand child support services in areas not well-covered in the past, or to assume operations when a public agency withdrew (usually district attorney’s office). The increasing speed with which computer equipment and information systems require upgrading also provides an incentive for privatization. Equipment provided by a private contractor is not budgeted as a capital expenditure for the public agency. Contractors that provide similar equipment and software to several public agencies or state administrations can spread their costs over several projects and achieve economies of scale, which may enable them provide the service to each client at a lower cost.

Exhibit 1
Reasons for Using the Private Sector
      • Source: Adapted from Allen, et al, The Private Sector in State Service Delivery.
        Washington, D.C. The Urban Institute Press, 1989

Arguments Against Privatization. The major concerns, summarized in Exhibit 2, voiced in opposition to privatization in the social services area relate mainly to quality of service and the impact on public sector jobs. In terms of service delivery, there are concerns that the profit motive of private companies will result in a reduction in services and a propensity to “cream,” or serve those who are most easily served and most likely to succeed. Every contract has the problem of unintended adverse impacts on individuals, especially if payment is based on a fixed cost per client. The more vulnerable the client and the more involuntary the client’s participation (e.g., hospitals, prisons, child welfare), the higher the risk; but a well-structured contract can cover these issues and protect those who are to be served (Hatry 1989).

The strongest opposition to privatization comes from public employees and unions representing public employees, stemming essentially from a fear that public sector jobs will be lost. The prospect of massive layoffs of government workers is one of the barriers that “keeps governments from moving into a more catalytic mode regarding privatization,” according to Osborne and Gaebler (1992)–a fear, they note, that is “legitimate.” The federal Office of Personnel Management (OPM) recently reported that executive branch employees covered by union agreements dropped by 13 percent between 1992 and 1997. Almost all of the decline in union representation can be attributed to the government’s downsizing, particularly base closings and cutbacks at the Defense Department (Barr and McAllister 1997).

Exhibit 2
Major Arguments for Opposing Privatization
      • Source: Adapted from materials prepared by the AFL-CIO, Public Employee Department

Evidence of Effectiveness

Thus, there are strong reasons for privatization and some equally-strong concerns and fears (see Exhibit 3). Most analysts, though, concur that each sector may actually have certain relative strengths, and private sector delivery of services is not inherently better or worse than public service delivery. “Business does some things better than government, but government does some things better than business. The public sector tends to be better, for instance, at policy management, regulation, ensuring equity, preventing discrimination or exploitation, ensuring continuity and stability of services, and ensuring social cohesion… Business tends to be better at performing economic tasks, innovating, replicating successful experiments, adapting to rapid change, abandoning unsuccessful or obsolete activities, and performing complex or technical tasks. The [non-profit] sector tends to be best at performing tasks that generate little or no profit, demand compassion and commitment to individuals, require extensive trust on the part of customers or clients, need hands-on, personal attention…, and involve the enforcement of moral codes and individual responsibility for behavior.” (Osborne and Gaebler 1992)

Bendick (1989) agrees, noting that private contractors are well-suited for straightforward or specialized services such as refuse collection, processing payments, data processing, and computer systems design. But, as one moves to “more complex, undefinable long-range, and ‘subjective’ services characteristic of the social welfare field, the record of successful experience rapidly thins.” (e.g., training ex-offenders, drug addicts, mentally ill, least employable welfare recipients) (p. 15) He attributes this mainly to the “limited ability of privatized systems to tackle the most difficult cases or to pursue the most complex objectives.” (p. 16) Bendick further notes the nonprofit sector is better able than the for-profit sector to deal with complex and high risk cases, mainly because it is less motivated by profit. But nonprofit deliverers are not noticeably better or worse than the public sector (p. 18) because of high risk and/or high cost associated with complex cases.

Exhibit 3
Major Potential Advantages and Problems with Delivery of Public Services by For-Profit Companies
      • Source: Adapted from Allen, et al. The Private Sector in State Service Delivery,
        Washington, D.C.: The Urban Institute Press, 1989.

Unfortunately, there is very little empirical research on the relative effectiveness of the private sector versus the public or nonprofit sector in the delivery of services. Hatry conducted one of the few studies comparing public and private delivery of services, based on matched pairs of public and privately administered prisons as a case study. He found that while quality was somewhat higher in the private systems, cost results were mixed. He explains that research findings on the relative costs and quality of services between public and private systems may be biased in favor of private sector delivery. The primary reasons governments decide to privatize services relate to less than satisfactory performance by the public sector. In general, if there are no perceived problems with the public sector (e.g., high cost and/or low performance), there is usually little incentive for public officials to consider privatization. Furthermore, whenever there is a shift, either from the public sector to the private sector or vice versa, there is improvement. Therefore, studies that compare a newly privatized system to the pre-existing suboptimal public system will be biased in favor of privatization.

The only other study identified that compared public systems to private systems was conducted by the General Accounting Office and had similar findings. A December 1996 GAO report examined state contracting of full-service child support enforcement operations in selected local sites in 15 states. “In the three comparisons of performance we conducted, fully privatized officers performed at least as well as or, in some instances, better than public child support programs in locating noncustodial parents, establishing paternity and support orders, and collecting support owed.” However, the cost-effectiveness results were more mixed for the periods reviewed.

A separate issue concerns the impact privatization has on public employees. The most vocal opposition to privatization comes from public employee unions and their concern about the dislocation of public workers (and, presumably–although unstated–the reduction in union membership). A report by the National Commission for Employment Policy (1989) found:

  • Contracting out public services has caused a shrinkage in the rate of growth of the public sector work force since the mid-1970s.
  • Job loss in the government is generally offset by job gains in the private sector–for every 10 jobs lost in that state and local government sector due to privatization, about eight or nine new jobs were created in that same occupational field in the private sector
  • Layoffs of public employees due to privatization are uncommon; most affected workers take jobs with contractors or transition to jobs in other public agencies, usually through an agreement initiated by the government. Moving from the public sector to the private sector generally means a reduction in employee benefits, but a modest increase in wages.

While it is clear that public employee unions are unequivocally opposed to privatization, it is not as clear whether the workers themselves are opposed, in large part because employment arrangements are often part of the privatization package. (Reason, 1996) A study of privatization cases in Britain similarly found that there had been opposition from union leaders, but not necessarily union members, mainly because workers have been offered alternative and often better deals from private contractors. (Pirie, 1985)

Finally, one of the strongest messages that can be drawn from the analytic literature is that there are successes and failures in all three sectors–public, for-profit, and non-profit. “The determining factors have to do with the incentives that drive those within the system. Are they motivated to excel? Are they accountable for their results? Are they free from overly restrictive rules and regulations? Is authority decentralized enough to permit adequate flexibility? Do rewards reflect the quality of their performance?” (Osborne and Gaebler, 1992)

Hatry and Durman agree that the key to successful privatization comes from careful public administration and understanding the potential problems inherent with contracting to a profit-motivated private business. “An agency that is capable of sophisticated administration, and explicitly addresses service quality issues, can minimize the difficulties of implementing a competitive contracting process. In none of the examples [of successful cases] of competitive contracting examined did contracting agencies report deterioration of service quality. The contracting agencies were sensitive to the issue and took specific steps to prevent it. Carefully implemented competitive contracting can achieve modest cost saving or a slowing of cost increases.”

Privatization is encouraged in Reinventing Government, but Osborne and Gaebler, like other analysts, caution that “[p]rivatization is one answer, not the answer…Services can be contracted out or turned over to the private sector. But governance cannot…” (Osborne and Gaebler, 1992, p. 45) “There is no inherent reason why for-profit firms could not compete for most, if not all, social service delivery activities.” (Hatry and Durman, 1985) But the government is responsible for assuring that public services are effective, whether or not the services are publicly delivered. Public decisionmakers need to look at the long-term capacity of government agencies to monitor and the costs of monitoring. They need an objective way to assign criteria to determine appropriate cost–the public sector does not know how to determine cost and does not understand well how the concept of risk relates to the private sector’s incentives and disincentives in business ventures.


5. Conclusions

The limited empirical research comparing the effectiveness of service provision by the public and private sectors suggests a few conclusions:

  • There is no empirical evidence that the service provided by private contractors is inadequate.
  • There is some evidence from research studies that the quality of services may be higher in private service delivery systems than in public systems, but very mixed evidence on whether the private sector is more cost-efficient. However, for many reasons, the findings may be biased in favor of the private sector.
  • When public services are privatized, there is a reduction in the number of public employees, but there is not necessarily a reduction in total employment nor are workers always worse off.
  • There are success stories and examples of failure in all sectors–public, non-profit, and private. No one model is inherently “better” than another. The key factor is whether there is clear accountability for results, clear criteria for performance, and clear public objectives.

Privatization is a way to bring the advantages of competition and flexibility to the delivery of public services. These advantages include greater efficiency, increased responsiveness to the needs of customers, and encouraging innovation. These advantages are more difficult (but not impossible) to achieve within government due to restrictions on hiring public employees and budgeting issues related to capital expenditures. As Rainey (1991) points out, “The nature of public organizations, their public character, often subjects them to more external intervention and constraint. In turn, this often imposes on them greater challenges in trying to perform efficiently and effectively.”

While there is clear potential for improved efficiency, privatization also involves risk and requires careful management on the part of the public agency. The research reviewed emphasizes the importance of clear goals and accountability. Some of the highly visible problems recently encountered in large system-wide contracts probably at least partly reflect lack of accountability and performance criteria . Effectiveness tends to be very situational–it depends on the implementation of the contracting process, the contract itself, performance criteria, and ongoing monitoring.

To achieve the potential benefits of privatization, public agencies will need to clearly specify the roles of contractors, determine appropriate costs, and develop performance criteria that are tailored to the client population being addressed. Public agencies will need to consider their long-term capacity to structure and monitor privatization initiatives in order assure cost effectiveness and quality in the delivery of publicly funded social services.


References

AFL-CIO, Fax Communication, April 1997 Allen, Joan W., Keon S. Chi, Kevin A. Devlin, Mark Fall, Harry P. Hatry, and Wayne Masterman. 1989. The Private Sector in State Service Delivery: Examples of Innovative Practices. Washington, D.C.: The Urban Institute Press.

Barr, Stephen and Bill McAllister.. “Downsizing Cuts Federal Union Representation; More Postal Employees Covered.” The Washington Post, June 11, 1997.

Bendick, Marc. 1989. “Privatizing the Delivery of Social Welfare Service.” Privatization and the Welfare State, edited by Sheila B. Kamerman and Alfred J. Kahn. Princeton: Princeton University Press.

Bernstein, Nina. “Giant Companies Entering Race to Run State Welfare Programs.” The New York Times. Sunday September 15, 1996, section 1, page 1.

Butler, Stuart M., ed. 1985. The Privatization Option: A Strategy to Shrink the Size of Government. Washington, DC: The Heritage Foundation

Center on Public Policy Priorities, Austin Texas. Welfare Reform Working Group, April 10, 1997.

Donahue, John D. 1989. The Privatization Decision: Public Ends, Private Means. New York: Basic Books, Inc.

Giuliani, Rudolph W. 1996. Protecting the Children of New York: A Plan for the Administration for Children’s Services. December 19.

Government Management Reform Act of 1994 (S. 2170)

Grumwald, Michael. “Squabbling Erupts Over Jobs Initiative.” The Boston Globe. February 11, 1997.

Gurin, Arnold. 1989. “Governmental Responsibility and Privatization: Examples for Four Social Services.” Privatization and the Welfare State, edited by Sheila B. Kamerman and Alfred J. Kahn. Princeton: Princeton University Press.

Hatry, Harry P. 1983. A Review of Private Approaches for Delivery of Public Services. Washington, D.C.: Urban Institute Press.

Hatry, Harry P. and Eugene Durman. 1985. Issues in Competitive Contracting for Social Services. Falls Church, VA: National Institute of Governmental Purchasing, Inc.

Hughes, Polly Ross, “Ads Seek to Block Welfare Privatization,” Houston Chronicle, April 17, 1997, page A1.

Jeter, Jon. “A Winning Combination in Indianapolis.” The Washington Post, September 21, 1997.

Kinsey, Marcia. Privatization. Austin, TX: Center for Public Policy Priorities, September 1, 1997.

Magnusson, Paul, “Why Privatizing Welfare Could Actually Work,” Business Week, October 21, 1996, p. 94.

“Manpower to Redefine Role at Milwaukee One-Stops, Officials Say.” Employment and Training Reporter (ETR). 9/18/96, Pp. 53-54

National Commission for Employment Policy, “The Long Term Employment Implications of Privatization: Evidence from Selected U.S. Cities and Counties” Washington, D.C.: NCEP, March 1989.

“Officials Turn to Retraining, Outsourcing to Handle Caseloads,” Employment and Training Reporter, November 27, 1996, pp. 277-278.

Osborne, David and Ted Gaebler. 1992. Reinventing Government: How the Entrepreneurial Spirit is Transforming the Public Sector. Reading, Mass.: Addison-Wesley Publishing Co., Inc.

Personal Responsibility and Work Opportunity Reconciliation Act of 1996

Pirie, Madsen. “The British Experience.” in Butler, Stuart, ed. The Privatization Option. 1985. Washington, DC: The Heritage Foundation.

President’s Commission on Privatization. 1988. Privatization: Toward More Effective Government. Washington, DC

Rainey, Hal G. 1991. Understanding and Managing Public Organizations. San Francisco: Jossey Bass, Inc.

Reason Foundation. 1996. Privatization 1996: Tenth Annual Report on Privatization. Los Angeles CA: Reason Foundation.

Rein, Martin. 1989. “The Social Structure of Institutions: Neither Public nor Private.” Privatization and the Welfare State, edited by Sheila B. Kamerman and Alfred J. Kahn. Princeton: Princeton University Press.

Starr, Paul. 1989. “The Meaning of Privatization.”Privatization and the Welfare State, edited by Sheila B. Kamerman and Alfred J. Kahn. Princeton: Princeton University Press.

Texas Comptroller of Public Accounts. 1996. Disturbing the Peace: The Challenge of Change in Texas Government, Volume 2. Austin, Texas: Texas Performance Review, December.

U.S. General Accounting Office. 1996. Child Support Enforcement: Early Results on Comparability of Privatized and Public Offices. Washington D.C.: USGPO, GAO/HEHS-97-4, December.

U.S. General Accounting Office. 1995. Child Support Enforcement: States and Localities Move to Privatized Services. Washington, D.C.: USGPO, GAO/HEHS-96-43FS, November.

U.S. General Accounting Office. 1996. Child Support Enforcement: States’ Experience With Private Agencies’ Collection of Support Payments. Washington, D.C.: USGPO, GAO/HEHS-97-11, October.

“Welfare Experts Lend Clout to Private Companies New to Reform.” ETR, October 9, 1996, Pp. 110-112.

Yates, Jessica, “Privatization and Welfare Reform,” Welfare Information Network World Wide Web Site, “http://www.welfareinfo.org/jessica.htm” accessed April 22, 1997.

Notes

1. GAO reported that in 1996, 15 states had contracted out for full service child support collection services in one or more localities: AZ, AK, CO, GA, IA, MD, MS, NE, OH, OK, SC, TN, VA, WV, WY)

2. There is some evidence of problems with most of these (large and small) private companies (with the exception of Curtiss & Associates), including several newspaper articles chronicling various cost-overruns, delays, or poor performance. One must be cautious, however, in assuming that such problems are unique to the private sector or that they imply the private sector is ineffective. Issues of effectiveness and problems in the public and private sector are discussed in a later section.

3. Kinsey, Marcia. September 1997. Privatization. Center for Public Policy Priorities, Austin, TX.

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child death, child welfare reform, foster care abuse, cps, domestic violence, family, foster care, government, law, legal, psychiatry, psychotropic medications, reform, senate, social services
What is Senate Bill 6?

Senate Bill 6 amends the Education Code, Family Code, Government Code, Human Resources Code, Penal Code, Code of Criminal Procedure, and Texas Probate Code to make a number of reforms to the children’s protective services and adult protective services programs, certain related guardianship issues, and other family law matters. It requires the Health and Human Services Commission (HHSC) and the Department of Family and Protective Services (DFPS) to adopt a transition plan for the privatization of certain child welfare functions by March 1, 2006, and requires that all substitute care and case management services for children in DFPS managing conservatorship be provided by child-care institutions and child-placing agencies by September 2011.

It also requires enhanced training and reduced caseloads for child protective services caseworkers. The children’s protective services reforms in the bill include provisions relating to tuition and fee exemptions for foster and adopted children, continuing education and other requirements for attorneys ad litem, medical assistance under the Medicaid program for children adopted out of DFPS conservatorship, criminal penalties for certain false reports of child abuse or neglect, response time requirements for certain reported cases based on immediacy and severity of harm to a child, a system for screening less serious cases of abuse or neglect without investigation, the exchange of information with other states, a Texas foster grandparent mentors initiative, funding for various community-based services and programs, facility and agency foster home inspection procedures, conditions under which an application for a license to operate a nonresidential child-care facility may be denied, a caseworker replacement program, requirements for providing certain informational materials, including the development of a child placement resources form, requirements relating to the family service plan, and requirements that the DFPS employ child safety specialists, colocate with local law enforcement agencies that investigate child abuse, and encourage the establishment of a children’s advocacy center in certain counties.

Senate Bill 6
sets out requirements for medical care and educational services for children in foster care, including provisions relating to consent for medical care, parental notification of significant medical conditions, the provision of care in emergency situations, and the development of health and educational passports. The bill directs DFPS to develop and deliver cultural awareness competency training, expand court-appointed volunteer advocacy programs, develop a relative and other designated caregiver placement program, improve quality of investigations, eliminate delays, and establish a drug-endangered child initiative.

The bill requires DFPS to license and register child-placing agency administrators and to enforce related regulations and includes several provisions relating to licensing procedures, requirements, and penalties for administrators and facilities. In addition, the executive director of HHSC is required to establish an investigations division to oversee and direct children’s protective services investigations. The bill also includes several conditions and restrictions related to employment at certain residential facilities, requires a criminal history background check for a prospective employee, and requires facilities to establish a drug-testing policy for facility employees.

Among the provisions relating to the privatization of substitute care, Senate Bill 6 includes regional implementation requirements and a transition plan and goals to be achieved through privatization. The bill transfers certain duties from DFPS staff to independent administrators and requires hiring preference to be given to DFPS employees whose positions are eliminated as a result of the privatization of services. The bill authorizes the DFPS to continue to provide substitute care and case management services beyond the deadline for privatization in certain emergency cases.

The adult protective services reforms in the bill include provisions relating to coordination between DFPS and the Texas Higher Education Coordinating Board regarding the development of curriculum and degree programs in fields relating to adult protective services, a statewide public awareness campaign designed to educate the public about the abuse, neglect, and exploitation of the elderly and disabled persons, and the use of technology to improve the effectiveness of the adult protective services program. The bill requires DFPS to maintain an investigation unit for adult protective services, develop and implement a training program and continuing education program for newly hired or newly assigned adult protective services workers and a case management training program for supervisors, develop and implement a quality assurance program, and develop procedures for investigating complex cases.

Senate Bill 6 requires the executive commissioner of the Health and Human Services Commission to develop risk assessment criteria to determine whether an elderly or disabled person is in a state of abuse, neglect, or exploitation, to develop and implement, subject to the availability of funds, a caseload management reduction plan that provides specific annual reduction targets, and to create a pilot program for monitoring unlicensed and illegally operating long-term care facilities. In addition, the bill authorizes DFPS, subject to the availability of funds, to contract with protective services agencies for the provision of services particularly to elderly or disabled persons in certain rural or remote areas. It also includes provisions relating to the filing of a petition to a court for an emergency protective order based on certain physical and psychological health assessments performed at the direction of the department.

Senate Bill 6 amends the Government Code, Human Resources Code, and the Texas Probate Code to transfer the powers, duties, functions, programs, and funds of the Department of Family and Protective Services relating to guardianship services to the Department of Aging and Disability Services. The bill includes provisions relating to the specific conditions that must be met for an individual to be referred for guardianship, procedures relating to court-initiated guardianship, and the creation of the guardianship certification board to provide for the certification and regulation of guardians.

Finally, Senate Bill 6 amends the Family Code and Penal Code to clarify provisions of the law relating to the offense of bigamy and to increase the penalty for the offense from a Class A misdemeanor to a felony of the third, second, or first degree depending on the age of the person to whom an actor purports to marry or with whom the actor lives under the appearance of marriage.

family, General, letters, tips and tricks, writing
Tips on how you can be heard – letters to editor

Writing a Letter to the Editor (source: Texas Freedom Network)

Studies show that Letters to the Editor sections are among the most-read parts of a newspaper. You can be sure that elected officials – or their staff members – read those sections regularly. In addition, letters to the editor are free and relatively easy to submit to newspaper editors. As a result, such letters can be effective ways of influencing public opinion (and the votes of policymakers who pay close attention to public opinion).

Don’t be discouraged if your letter isn’t published. Numerous letters on a particular topic can alert editors to the importance of a particular story and improve the chances that at least one of the letters on that topic will be published.

Writing Your Letter

  • Follow the newspaper’s guidelines for length. Ideally, keep your letter shorter than 150 words.
  • Focus on one point and state it clearly at the beginning of your letter.
  • Make sure your letter is timely. Try to tie your point to a recent news item, editorial, letter or event.
  • If you are responding to someone’s comments, don’t waste your limited space by repeating them. Focus on your own point.
  • Keep it simple. Avoid using complicated sentences and big words.
  • Avoid personal attacks, offensive language and political name-calling (e.g, “far right,” “extremist”). Such language will turn off the average reader.


Submitting Your Letter

  • Newspapers typically list on their editorial pages or Web sites the postal and email addresses for submitting letters to the editor. Submit your letter by email (preferred) or by fax. If neither is possible, send by mail as soon as possible to lessen the time between possible publication and the event about which you are writing. If you don’t find an address, you can call the newspaper’s main number for the information.
  • Include your contact information (daytime and home phone numbers, address and email, if available) so that the newspaper can verify that you sent the letter.


After Publication

  • Clip your letter and the header of the page on which it is printed – including at least the name of the newspaper and the date. Then photocopy the letter and header together on one page and fax your copies to your elected officials. Include a personal note indicating that you are a constituent.
child death, child welfare reform, foster care abuse, cps, government, medical, system failure
Children Killed In The Care Of The Government

(Source:Connecticut DCF Watch)

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Please take and have a moment of silence for the children below, and pray for these brave children that have given their all in this war. All of these deaths have happened with the support of your tax dollars, and after much protest and begging the government for help in stopping this.

I want to announce and declare the holocaust this is – going on in America today!

Please support us in stopping this

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This is in memory of children who died after social service agencies removed them from the care of their parents, placing them with fosters, adopters, group homes, or psychiatric facilities.

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As you read this list, and cry for these innocent lives that are stolen from them, please do not forget that these are only children that died!

  • This does not include the countless children that are abused in foster care that you never hear about.Also consider how many of these children were taken by mistake or as the result of false allegations.

  • How many of these children would be here with us today were it not for the mistakes of overzealous or negligent social workers/law enforcement officers?

  • How many of these children would be here were it not for the spite referrals called in by embittered ex-spouses or in order to get standing in a custody battle?

  • How many of these children were taken for reasons that could’ve been remedied with in-home services such as substance abuse cases where no abuse/injury to the child existed or because poverty was confused with neglect?

  • How many of these children did not have to die?

ONE child death is too many!


1.. Genesis Acosta-Garcia, Las Vegas Nevada, three months old, November 19, 2005, septic shock

2.. Travis C Adams, Salem Oregon, August 8 2000, December 16 2002, wandered into creek

3.. Kayla Y Allen, Richlands North Carolina, November 10 1995 – August 24 2003, poison

4.. Martin Lee Anderson, Panama City Florida, fourteen years old, January 6 2006, beating/sickle cell

5.. Richard L (Ricky) Aragon, Albuquerque New Mexico, January 24 1991 – April 12 1993, battered

6.. Shirley Arciszewski, Charlotte North Carolina, April 19 1992 – September 11 2004, restraint

7.. Miguel Humberto Arias-Baca, Westminster Colorado, two years old, February 2 1999, battered

8.. Ian August, Sevier Desert Utah, June 21 1988 – July 13, 2002, exhaustion

9.. Denzel Bailey, Los Angeles California, eleven months old, April 2001, malnutrition

10.. Jeffrey Baldwin, Toronto Ontario, December 20 1996 – November 30 2002, malnutrition/pneumonia

11.. Casey Paul Barrow, West Valley Utah, eighteen months old, October 22, 2003, battered

12.. Anthony Bars, Indiana, four years old, January 20 2004, starvation, battered

13.. Shelly Bash, Midland Michigan, eight years old, March 2005, transplant rejection

14.. Nadine Catherine Beaulieu, Dauphin Manitoba, twenty three months old, February 1996, battered

15.. Teddy Bellingham, Smiths Falls Ontario, sixteen years old, August 1992, beaten

16.. Jerome Bennett, Oshawa Ontario, fifteen years old, February 3 2006, homicide

17.. Maria Bennett, Lancaster Ohio, two years old, October 23, 2002, battered

18.. Modesto Blanco, Lubbock Texas, twenty two months old, March 2 2002,battered

19.. Christian Blewitt né sik, Halesowen England, three years old, December 2002, poison/battered

20.. Deondre Bondieumaitre, Florida, sixteen months old, April 16 2003,battered

21.. Timothy Boss, Remsen Iowa, ten years old, February 23 2000, battered

22.. Alex Boucher, New Port Richey Florida, January 25 1997 – September 25 2000, asphyxiation

23.. Ashley Boyd, LaFayette Georgia, twelve years old, December 13 2005, hit by car / suicide

24.. Kerry Brooks, Los Angeles California, nine years old, February 10 2001, suicide

25.. Talitha Brooks, Colorado, one year old, July 1998, heatstroke

26.. Amira Brown, Reading Pennsylvania, twelve years old, September 4 2005, battered / restraint

27.. Diminiqua Bryant, Dothan Alabama, two years old, May 1999, battered

28.. Scott Buckle, Swansea Wales, twelve years old, February 6 2005, hanging

29.. Latasha Bush, Manvel Texas, January 2 1987 – February 28 2002, restraint

30.. Michael Buxton, Miami Oklahoma, five years old, July 5 1998, battered

31.. Eduardo Calzada, Bakersfield California, three months old, March 2004, battered

32.. Chris Campbell, Toledo Iowa, thirteen years old, November 2, 1997, restraint

33.. Gladys Campbell, Philadelphia/New Jersey, two years old, ca 1988

34.. Edith Campos, Tucson Arizona, fifteen years old, February 4 1998, restraint

35.. Latasha Cannon, Boston Massachusetts, seventeen years old, April 2001, slashed throat

36.. Mario Cano, Chula Vista California, sixteen years old, April 27 1984, untreated blood clot

37.. Joshua K Causey, Detroit Michigan, March 21 1998 – March 18 2003, battered

38.. Sherry Charlie, British Columbia, nineteen months old, September 4 2002, battered

39.. Sarah Angelina Chavez, Alhambra California, two years old, October 11 2005, battered

40.. Felix Chen, Bloomington Indiana, August 27 1997 – April 1 2004, treatment withheld

41.. Sky Colon Cherevez, Paterson New Jersey, three months old, August 6, 1998, battered

42.. Tiffany H Clair, Fort Worth Texas, September 6 1985 – May 4 2001, heroin

43.. Brian Clark, New Jersey, three years old, January 2002, untreated pneumonia

44.. Angelic Clary, Bakersfield California, three months old September 14 2003

45.. Roshelle Clayborn, San Antonio Texas, sixteen years old, August 18 1997, restraint

46.. Casey Collier, Westminster Colorado, seventeen years old, December 21 1993, restraint

47.. Desiree Collins, Los Angeles California, fourteen years old, February 10 2002, gunshot

48.. Nicholas Contreras, Queen Creek Arizona, January 15 1982 – March 2 1998, untreated infection

49.. Adrianna Cram, Veracruz Mexico (US supervision), August 25 2000 – June 13 2005

50.. Christopher Henry Cryderman, Springfield Missouri, July 27 2004 – November 22 2004, untreated infection

51.. Dirk D Dalton, Clarkston Washington, June 7 1989 – May 1 1994, battered

52.. Arieale Daniels, Naples Florida, fifteen years old, 1999, car crash

53.. Tajuana Davidson, Phoenix Arizona, three years old, November 3 1993, battered

54.. China Marie Davis, Phoenix Arizona, March 23 1991 – October 31 1993, battered

55.. Sabrina Elizabeth Day, Charlotte North Carolina, July 4 1984 – February 10 2000, restraint

56.. Tyler Jospeh DeLeon, Stevens County Washington, January 13 1998 – January 13 2005, dehydration

57.. Kameron Justin Demery, Long Beach California, two years old, October 14 1996, battered

58.. Connre Dixon, Ridgefield Township Onio eleven years old, October 18, 2004, stabbing

59.. Mark Draheim, Orefield Pennsylvania, October 10 1984 – December 11 1998, restraint

60.. Charmaria Drake, Cleveland Ohio, twenty months old, March 13 2003, battered

61.. Stephanie Duffield, Manvel Texas, July 14 1984 – February 11 2001, restraint

62.. Willie Lawrence Durden III, Citrus County Florida, seventeen years old, October 2005, unknown/died in cell

63.. Brian Edgar, Overland Park Kansas, nine years old, December 30 2002, asphyxiation

64.. William Edgar, Peterborough Ontario, thirteen years old, March 1999, restraint

65.. Tiffany Eilders, Rancho Cucamonga California, fourteen weeks old, December 7 2005, battered

66.. Kayla Erlandson, King County Washington, two years old, April 1991, battered

67.. Luke Evans, Lowell Indiana, sixteen months old, November 30 2001, malnutrition/battered

68.. Roberta (Berta) Evers, Bayfield Colorado, six years old, June 13 1998, restraint

69.. Sara Eyerman, California, twenty months old, ca 1986, untreated pneumonia

70.. Miranda Finn, Lake Butler Florida, nine years old, January 25 2006, traffic accident

71.. Laura Fleming, Palmdale California, October 11 2004 – November 21 2004, cause unknown

72.. Sarah Jane Forrester, Woodlawn Maryland, October 30 1985 – found May 13 1999, battered and stabbed

73.. Kameryn Fountain, Bibb County Georgia, two months old, November 20 2005, unknown cause

74.. Henry Gallop, Boston Massachusetts, two years old, 1987, poison

75.. Alexander Ganadonegro, Albuquerque New Mexico, March 10 1998, February 4 1999, battered

76.. Christening (Mikie) Garcia, Ingram Texas, twelve years old, December 4 2005, restraint

77.. Dylan George, Fremont California, April 16 2002 – October 4 2004, battered

78.. Corese Goldman, Chicago Illinois, two years old, 1995, drowning

79.. Mollie Gonzales, Jefferson County Colorado, ten years old, November 18 2002, drug overdose

80.. Julio Gonzalez, Glendale California, May 10 1995 – December 29 1996, battered

81.. Elizabeth (Lizzy) Goodwin, Coeur d’Alene Idaho, March 22 1996 – October 22 2002, drowning

82.. Anthony Green, Brownwood Texas, fifteen years old, May 12 1991, restraint

83.. Sabrina Green, New York City, nine years old, November 8 1997, burned and battered

84.. Lamar D Greene, Jacksonville Florida, sixteen years old, 2001, car crash

85.. Corey Greer, Treasure Island Florida, four months old, ca 1985, dehydration

86.. Gage Guillen, Boston Massachusetts, three years old, 1995, strangulation

87.. Darvell Gulley, Lincoln Nebraska, thirteen years old, April 27 2002, restraint

88.. Savannah Brianna Marie Hall, Prince George British Columbia, September 9 1997 – January 21 2001, malnutrition/restraint

89.. Latiana Hamilton, Jacksonville Florida, seventeen months old, July 18 2001, drowning

90.. Mykeeda Hampton, District of Columbia, two years old, August 1997, battered

91.. Kelly M Hancock, Malden Massachusetts, November 6 1985 – July 18 2000, stabbed

92.. Laura Hanson, West Palm Beach Florida, May 17 1981 – November 19 1998, restraint

93.. Jerrell Hardiman, La Porte Indiana, four years old, October ca 1993, exposure

94.. Diane Harris, Seguin Texas, seventeen years old, April 11 1990, restraint

95.. Jessica Albina Hagmann, Prince William County Virginia, two years old, August 11 2003, smothered

96.. Letia Harrison, Akron Ohio, October 23 1999 – September 19 2002, baked in attic

97.. Jordan Heikamp, Toronto Ontario, May 19 1997 – June 23 1997, starvation

98.. Eric Hernandez, Cedar Hill Texas, January 6 1999 – March 7 1999, suffocation

99.. Zachary Higier, Massachusetts, May 24 2000 – August 15 2002, battered

100.. Dwight Hill, Tucson Arizona, four months old, November 16 2005, cause unknown

101.. Nina Victoria Hilt né¥ Vika Bazhenova, Manassas Virginia, thirty three months old, July 2 2005, battered

102.. Steven A Hoffa, Des Moines Iowa, February 4 1993 – May 18 1996, battered

103.. Richard (Ricky) Holland, Williamston Michigan, September 8 1997 – July 2005, battered

104.. Michael Anthony Hughes, Choctaw Oklahoma, March 21 1988 – September 12 1994, kidnap/missing

105.. Joseph (Joey) Huot, Philadelphia Pennsylvania, two years old, January 27 1988, battered

106.. Dion Jack, Sproat Lake British Columbia, six years old, March 1 2006, untreated seizure

107.. Walter Jackson, Chicago Illinois, ten months old, August 9 2005, battered

108.. Dominic James, Springfield Missouri, June 4 2000 – August 21 2002, battered

109.. Billie-Jo Jenkins, Hastings East Sussex England, thirteen years old, February 1997, battered

110.. Demetrius Jeffries, Crockett Texas, seventeen years old, August 26 1997, strangulation

111.. Dontel Jeffers, Boston Massachusetts, four years old, March 6 2005, battered

112.. Stephanie Jobin, Brampton Ontario, thirteen years old, June 21 1998, restraint

113.. Aaron Johnson, Boston Massachusetts, fifteen months old, 1987, poison

114.. Xolani Nkosi Johnson, Cape town South Africa, twelve years old, June 2 2001, AIDS

115.. Elijah James Johnson, Los Angeles California, three years old,May 10 1999, scalded

116.. Lorenzo Johnson, Queen Creek Arizona, 17 years old – June 27, 1994, drowned during escape

117.. Quartrina K (Snappy) Johnson, Pikesville Maryland, December 25 1988-July 20 2004, beaten and choked

118.. Christal Jones, New York City (Vermont ward), May 24 1984 – January 3 2001, suffocation

119.. David L Jones, Chicago Illinois, April 15 1992 – March 7 1998, battered

120.. Dennis Jurgens né Serry Sherwood, White Bear Lake Minnesota, three years old, April 11 1965, battered

121.. Marissa (Shorty) Karp, Pompano Beach Florida, December 6 1985 – August 19 2002, gunshot

122.. David Ryan Keeley, New Haven Connecticut, six years old, August 12 1998, battered

123.. Ashley Keen, Lake Butler Florida, thirteen years old, January 25 2006, traffic accident

124.. Cassandra Killpack, Springville Utah, November 29 1997 – June 9 2002, water therapy

125.. Ahmad King né ‘awls, Alma Georgia, three years old, January 24 2006, homicide

126.. Heather Michell Kish, Berlin Township Michigan, September 15 1987 – found October 6 2002, murdered

127.. Noah Knapp, Marysville Washington, six years old, May 30 2005, automobile collision

128.. Zaire Knott, Newark New Jersey, September 16 2005 – October 20 2005, cause unknown

129.. Anatoli Kolenda, Westfield Massachusetts, May 20 1991 – October 20 2002, stabbing

130.. Yana Kolenda, Westfield Massachusetts, December 31 1990 – October 20 2002, stabbing

131.. Anthony Lamb, Lake Butler Florida, twenty months old, January 25 2006, traffic accident

132.. Keisha Shardae Lane, Hagerstown Maryland, fifteen years old, August 17 2005, gunshot

133.. Shawn Lawrence né ndy Mohler, Shelton Washington, ten years old, October 9 1999, drowning

134.. Brittany Legler, Millcreek Pennsylvania, fifteen years old, May 9 2004, battered

135.. Jacob Lindorff, Franklin Township New Jersey, five years old December 14 2001, battered

136.. Christian Liz, New York City, three weeks old, November 29 2004, suffocation

137.. James Lonnee, Guelph/Hamilton Ontario, sixteen years old, September 7 1996, beaten by cellmate

138.. Gregory Love, Florida, twenty three months old, April 2005, head injury

139.. Nikki Lutke, Cheyenne Wyoming, five years old, August 28 2003, drowning

140.. Zachary James Lyons, Winston-Salem North Carolina, January 24 1992 – October 8 1996, battered

141.. Shaquella Mance, Belton South Carolina, seven months old, March 27 2005, battered

142.. Elizabeth Mann, Lake Butler Florida, fifteen years old, January 25 2006, traffic accident

143.. Heaven Mann, Lake Butler Florida, three years old, January 25 2006, traffic accident

144.. Johnny Mann, Lake Butler Florida, thirteen years old, January 25 2006, traffic accident

145.. Cynthia Nicole (Nicki) Mann, Lake Butler Florida, fifteen years old, January 25 2006, traffic accident

146.. Logan Marr, Chelsea Maine, October 14 1995 – January 31 2001, asphyxiation

147.. Stephanie Martinez, Pueblo Colorado, five years old, December 31 2001, untreated burns

148.. Tiffany Laverne Mason, Folsom California, June 11 1986 – August 9 2001, battered

149.. Viktor Alexander Matthey né – Sergeyevich Tulimov, Hunterdon County New Jersey, six years old, October 31 2000, hypothermia

150.. Dominic Matz, Osawatomie Kansas, July 6 2002 – February 15 2004, treatment withheld

151.. Jamie Mayne, Atascadero California, March 24 1995 – February 10 2000, battered

152.. Kristal Mayon-Ceniceros, Chula Vista California, sixteen years old, February 5 1999, restraint

153.. Emily Ann Mays, Tucson Arizona, sixteen months old, August 24 2005, battered

154.. Andrew McClain, Bridgeport Connecticut, December 6 1986 – March 22 1998, restraint

155.. Cory Bradley McLaughlin, North Carolina, four years old, July 4 1997, battered

156.. Jerry McLaurin, Brownwood Texas, fourteen years old, November 2 1999, restraint

157.. Maria Mendoza, Katy Texas, fourteen years old, October 12 2002,restraint

158.. Caleb Jerome Merchant, Edmonton Alberta, thirteen months old, November 26, 2005, battered

159.. Denis Merryman né .ritsky, Harford County Maryland, eight years old, January 2005, starvation

160.. Jacob Miller, Georgia, twenty two months old, November 20 1997, battered

161.. Clayton Miracle, Georgia, three years old, August 11 1993, battered

162.. Hanna Denise Montessori, Santa Ana California, March 16 1988 – January 19 2004, homicide/head-injury

163.. Alfredo Montez, Auburndale Florida, two years old, July 1 2002, battered

164.. Zachary Moran, Charlotte North Carolina, fourteen months old, August 8 2003, battered

165.. Christina Morlan, Scott County Iowa, September 3 2003 – November 30 2003, unknown

166.. Carlyle Mullins, Nashville Tennessee, five years old, May 27 2005, battered

167.. Cedrick Napoleon, Killeen Texas, June 26 1987 – March 7 2002, restraint

168.. Candace Newmaker né¥ C Tiara Elmore, Colorado, November 19 1989 – April 19 2000, re-birth asphyxiation

169.. Jonathan Nichol, Cook County Illinois, two years old, June 16 1995, drowning

170.. Trevor Nolan, Mono County California, five years old, April 12 1997, treatment withheld

171.. Sierra Odom, Arlington Texas, three years old, August 11 2005, battered

172.. Keron Owens, Walterboro South Carolina, three years old, January 19 1992, battered

173.. Sean Paddock né ?ord, Johnston County North Carolina, four years old, February 26 2006, battered

174.. Omar Paisley, Miami Florida, seventeen years old, June 2003, untreated appendicitis

175.. Terrell Parker, Buffalo New York, two years old, 2003, battered

176.. Travis Parker, Cleveland Georgia, thirteen years old, April 21 2005, restraint

177.. Alex Pavlis, Schaumburg Illinois, six years old, December 19 2003, battered

178.. Dawn Renay Perry, Manvel Texas, sixteen years old, April 10 1993, restraint

179.. Angellica Pesante, Seneca County New York, four years old, April 18 1997, battered

180.. Terrell Peterson, Atlanta Georgia, five years old, January 16 1998, battered

181.. Cynteria Phillips, Miami Florida, December 10 1986 – August 14 2000, rape/murder

182.. Marguerite Pierre, West Orange New Jersey, five years old, December 2005, poison

183.. Emporia Pirtle, Indiana, six years old, November 11 1996, battered

184.. Jason Plischkowsky, Southampton England, May 25 1985 – December 19 1986, head injury

185.. Huntly Tamati Pokaia, New Zealand, three years old

186.. David Polreis, Greeley Colorado, two years old, February 6 1996, battered

187.. Maryah Ponce, Rialto California, December 5 1997 – June 29 2001, baked in car

188.. Constance S Porter, Kearney Missouri, July 20 1998 – February 12 2001, battered

189.. Dakota Denzel Prince-Smith, Lancaster California, five years old, July 8 2003, baked in car

190.. Nehamiah Nate Prince-Smith, Lancaster California, three years old, July 8 2003, baked in car

191.. Karen Quill, St Louis Saskatchewan, twenty months old,September 13 1997, internal injuries

192.. Rodrigo Armando Rameriez Jr, Victorville California, eighteen months old, July 6 2001, drowning

193.. Stephanie Ramos, New York City, eight years old, July 9 2005, dumped in garbage can

194.. Bobby Jo Randolph, Houston Texas, seventeen years old, September 26 1996, asphyxiation

195.. Jacquelyn Reah, Grand Rapids Michigan, ten years old, November 27 2004, runaway / hit by car

196.. Latayna Reese, Bradenton Florida, fifteen years old, April 1996

197.. Caprice Reid, New York City, four years old, June 1997, starved and battered

198.. Jonathan Reid, Gardena California, nine years old, June 9 1997treatment withheld

199.. Matthew Reid, Welland Ontario, three years old, December 15 2005, suffocation

200.. Dustin Rhodes, Litchfield Park Arizona, nine years old, August 13 2003, battered

201.. Eric Roberts, Keene Texas, June 16 1979 – February 22 1996, restraint

202.. Ana Rogers, Sparks Nevada, four months old, July 2005, pre-existing injury

203.. Genevieve “Genny” Rojas, Chula Vista California, four years old, July 21 1995, starvation, scalded

204.. Paola Rosales, Milton Ontario, fourteen years old, July 3 2001, suicide

205.. Kyle Anthony Ross, Massachusetts, September 7 1995 – June 9 2001, rottweiler

206.. Marlon Santos, Worcester Massachusetts, five months old, November 5 1998, missing

207.. Andres E Saragos, Warm Springs Oregon, August 5 1995 – July 13 2000, baked in car

208.. Gina M Score, Plankinton South Dakota, May 7 1985 – July 21 1999, baked by boot camp

209.. Caprice Scott, Florida, infant, 1999, mother in foster care

210.. Ryan Scott, Sheffield Lake Ohio, two years old, March 27 1998, battered

211.. Krystal Scurry, Aiken County South Carolina, February 1989 – November 2 1991, rape/murder

212.. Andrew (Andy) Setzer, California, April 27 1995 – August 2 1999, battered

213.. Ariel Shaw, Bibb County Georgia, nineteen months old, January 26 2000, battered

214.. Vivan Uk Sheppard, Jacksonville Florida, eight months old, May 15 1999, suffocation

215.. Joseph H Shriver, Pennsylvania, March 2 1997 – October 5 1997, battered

216.. Quincey L Simmons, Omaha Nebraska, August 21 1997 – March 24 2001, battered

217.. Christopher Simpson, Michigan, seven years old, November 14 1998, fire

218.. Jordan Simpson Howell Morrison II, Howell Michigan, five years old, November 14 1998, fire

219.. Nicole Simpson , Michigan, seven years old, November 14 1998, fire

220.. Devin A Slade, Milwaukee Wisconsin, October 23 2000 – June 19 2001, asphyxiation

221.. John Smith, Fishersgate England, four years old, December 24 1999, battered and bitten

222.. Mikinah Smith, Cincinnati Ohio, one year old, March 18 2003, battered

223.. Tristan Sovern, Greensboro North Carolina, sixteen years old, March 4 1998, restraint

224.. Jushai Spurgeon, North Las Vegas Nevada, fourteen months old, April 3 2005, scalding

225.. LeRon St John, Detroit Michigan, fifteen years old, March 1 2003, untreated tuberculosis

226.. Lloyd Stamp, Edmonton Alberta, seventeen years old, September 29, 2005, suicide

227.. Tommy Stacey, Carmichael California, three months old, January 3 2005, SIDS

228.. Elizabeth (Lisa) Steinberg né¥ Launders, New York City, May 14 1981 – November 4 1987, battered

229.. Yasmin Taylor, Paterson New Jersey, seven months old, May 8 1994, virus

230.. Lakeysha Tharp, Irmo South Carolina, six months old, April 7 2004, asphyxiation

231.. Adam Michael Thimyan, Riverview Florida, October 2 1986 – April 3 2004, gunshot

232.. Timithy Thomas, Banner Elk North Carolina, nine years old, March 11 1999, restraint

233.. Liam Thompson né “mitry S Ishlankulov, Columbus Ohio, October 3 1999 – October 3 2002, scalding

234.. Michael Tinning, Schenectady New York, two years old, March 2 1981, asphyxiation

235.. Kelly Ann Tozer, Egg Harbor City New Jersey, eighteen months old, July 30 2005, drowning

236.. Patrick Trauffler, Phoenix Arizona, six weeks old, February 18 2003, battered

237.. Demetrius Tyler, Johnson City Tennessee, six months old, November 10 2004, drowning

238.. Tyler Vanpopering, Southgate Michigan, September 23 2003 – April 14 2004, battered

239.. Jacqueline Venay, Philadelphia Pennsylvania, six years old, September 21 1998, battered

240.. George Walker III, DeKalb County Georgia, ten months old, November 7, 2002, choking

241.. Michelle Walton, Boston Massachusetts, October 6 1994, asphyxiation

242.. Erickyzha Warner, Utica New York, July 19 2002 – May 31, 2004, untreated burns

243.. Shane Devell Washington, Fresno California, fifteen months old, circa 1996, drowning

244.. Evan Watkins, Las Vegas Nevada, twenty one months old, July 11 1996, battered

245.. Devin Wilder, Cleveland Ohio, July 29 1998 – April 21 2001, battered

246.. Dominic J Williams, Saint Louis Missouri, June 8 1987 – June 3 2004,strangulation

247.. Andrew Wilson, Owensboro Kentucky, three years old, August 7 2005, drowning

248.. Lorenzo J Wilson, Seattle Washington, January 29 2004 – October 22 2004, battered

249.. Rilya Wilson, Florida, born September 29 1996, disappeared 2001

250.. Michael Spencer Wiltsie, Silver Springs Florida, September 18 1987 – February 5, 2000, restraint

251.. Jimmy Allan Wood, Adams County Colorado, fourteen years old, November 13 2002, drug overdose

252.. Jonnie Wood, Springdale Arkansas, eight years old, August 13 2005, drowning

253.. Braxton D Wooden, Missouri, May 15 1997 – June 2 2005, gunshot

254.. Donte L Woods, West Palm Beach Florida, February 25 1986 – May 27 2002, gunshot

255.. Thomas (T J) Wright, Providence Rhode Island, three years old, October 31 2004, battered

256.. Willie Wright, San Antonio Texas, fourteen years old, March 4 2000, restraint

257.. Rufus Manzie Young Jr, Michigan, four years old, April 6 2003, battered

258.. Rebecca Brittany Bacon, Orlando, FL gastro-reflux (infant left alone with bottle)

259.. Anastasia (Staci”Space Cadet”) Herbert and Larry Alexander Herbert (Baby Larry), Orlando, FL Killed in a fire

children, General, health, medicine
Government Advisers: Don’t Use Cold Medicines in Children Under 6

Cold medicine

 

Concentrated Tylenol Infants’ Drops Plus Cold & Cough, right, and Pedia Care Infant Drops Long-Acting Cough, left, is shown in a medicine cabinet of the home of Carol Uyeno in Palo Alto, Calif., Thursday, Oct. 11, 2007. Cold Drug makers voluntarily pulled cold medicines targeted for babies and toddlers off the market Thursday, leaving parents to find alternatives for hacking coughs and runny little noses just as fall sniffles get in full swing. The move represented a pre-emptive strike by over-the-counter drug manufacturers – a week before government advisers were to debate the medicines’ fate. But it doesn’t end concern about the safety of these remedies for youngsters. (Paul Sakuma/AP Photo)

 

 

WASHINGTON – Cold and cough medicines don’t work in children and shouldn’t be used in those younger than 6, federal health advisers recommended Friday.

 

Video

No More Kids Cold Medicine

The over-the-counter medicines should be studied further, even after decades in which children have received billions of doses a year, the outside experts told the Food and Drug Administration. The FDA isn’t required to follow the advice of its panels of outside experts but does so most of the time.

“The data that we have now is they don’t seem to work,” said Sean Hennessy, a University of Pennsylvania epidemiologist, one of the FDA experts gathered to examine the medicines sold to treat common cold symptoms. The recommendation applies to medicines containing one or more of the following ingredients: decongestants, expectorants, antihistamines and antitussives.

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The nonbinding recommendation is likely to lead to a shake up in how the medicines – which have long escaped much scrutiny – are labeled, marketed and used. Just how and how quickly wasn’t immediately clear.

In two separate votes, the panelists said the medicines shouldn’t be used in children younger than 2 or in those younger than 6. A third vote, to recommend against use in children 6 to 11, failed.

Earlier, the panelists voted unanimously to recommend the medicines be studied in children to determine whether they work. That recommendation would require the FDA to undertake a rule-making process to reclassify the medicines, since the ingredients they include are now generally recognized as safe and effective, which doesn’t require testing. The process could take years, even before any studies themselves get under way.

FDA Says Over-the-Counter Med Need Further Study

Simply relabeling the medicines to state they shouldn’t be used in some age groups could be accomplished more quickly, FDA officials said.

Indeed, the drug industry could further revise the labels on the medicines to caution against such use. The Thursday-Friday meeting came just a week after the industry pre-emptively moved to eliminate sales of the nonprescription drugs targeted at children under 2.