DCS officials say context is important when looking at 31 child deaths

Sunday, October 7, 2012 at 10:05pm

Tennessee Department of Children’s Services Commissioner Kate O’Day concedes that the news there were 31 DCS-related child fatalities in the first six months of 2012 is shocking and tragic. Data shows that four children died in DCS custody, 10 died while a DCS case file was open and 17 died after a case was closed.

But a closer look at the numbers and the circumstances behind the deaths and investigations, reveals some of the monumental societal challenges facing the state — and ultimately, DCS. 

After receiving pressure from The Tennessean and state Rep. Sherry Jones of Nashville, DCS released the statistics on the deaths of 31 children last month.

“It’s important to look at the whole context. You talk about 31 deaths in six months — that sounds very alarming. I understand that,” O’Day said. “But if you look at the volume of the work that the department does every day ... we’re touching a lot of the state’s most vulnerable families.”

In the past year alone, the DCS received 170,000 calls, formally investigated 65,000 of them and closed 80,000 cases.

And in many of those cases, the DCS is required to meet a “clear and convincing standard” before it can intervene. O’Day said attorneys have told her that “clear and convincing” evidence means “just a little bit shy of what you need to put someone in jail.”

“That puts us in a lot of situations where things are not great ... and we’re trying to work with engaging people and encouraging them to do what they need to do,
because push to shove, we can’t really force it,” O’Day said.

“It’s not an excuse, but it is the environment that we’re doing this work in, and I think it is a context that is getting overlooked.”

The child fatality statistics also shed light on two critical issues facing child and maternal health: unsafe sleeping and drugs. Nine of the 31 deaths reported by DCS were related to sleep issues: either co-sleeping deaths or other instances of “crib death.”

Co-sleeping deaths occur when parents sleep together with their children and accidentally suffocate them.

But in seven of the nine sleeping-related deaths, drugs also played a factor.

“You see drug use, and wow, why don’t you grab those kids and bring them into care? But you’ve got to look beyond that. ... You have the issue that if you bring that child into care, you’re intervening in a stage where the parent and child are bonding together. That’s not something, if you know anything about child development, that you take lightly,” O’Day said.

“You’ve got to make a balanced decision between what is the safety of that very vulnerable infant versus the need to keep that family together so that bonding can happen and that the parent becomes fully competent to take care of that child.”

Prenatal drug exposure is the second most prevalent cause of death in the DCS statistics — and O’Day said it’s possible parent drug use played a role in other deaths on the list, as well. A lot of times, DCS has its hands tied when it comes to intervening in those cases.

“All use is not illegal. It’s not illegal to drink and have kids. It’s not illegal to have prescription narcotic medication and have kids,” O’Day said.

“I don’t have a direct intervention I can do that’s going to reduce co-sleeping or reduce parents using [drugs] around their kids, because that’s constitutionally private behavior. And Tennessee is one of the most family-protective states.”

Three drug-exposed infants younger than 6 months old died while a DCS case file was open, according to the statistics. DCS executive director of safety Carla Aaron said hospitals notify the agency if they find evidence of drug addiction in mothers or children. But often, it’s too late to help.

“There are a lot of issues early on in that child’s life that have to be dealt with pretty quickly,” Aaron said. “Sometimes, the medical condition of that child, it just can’t be overcome.”

O’Day said she plans on partnering with other agencies to increase educational campaign efforts about the leading causes of death.

Despite recent criticism over the child fatality numbers, O’Day says DCS is doing what they can to prevent child deaths.

“[A campaign] is a very indirect way of changing behavior. It’s not like when the [Tennessee Highway Patrol] decides they are going to put more troopers, they’re going to write more tickets — people slow down, and there are fewer fatalities. They can make that happen in enough time to change the numbers before the end of the year,” O’Day said.

“I don’t have that.”

7 Comments on this post:

By: sonny1024 on 10/8/12 at 6:39

The DCS have more excuses than a turkey does own THANKSGIVING DAY.They need to do their job instead of making excuses that so many children died out of custody or IN CUSTODY ONE CHILD'S DEATH IS TO MANY KNOW MATTER WHERE DEATH OCCURRED.I think some of the problem is to many lazy workers who wants to stay in the office instead of going out and making sure the kids are OK.They want drink up all the coffee in the office while you're gone just do your job..

By: Rocket99 on 10/8/12 at 7:36

Bottom line. The Commissioner must GO. She is the absoulte worse thing for the children of Tennessee since George Hadaway. She is not a good leader. She is not a good boss. She attempts to rule by fear. Has no idea what she should really do. She's more into the persumed prestege of the position than doing what needs to be done. Phil Williams from NC5 needs to put her under his microscope.

By: jsabrown on 10/9/12 at 10:11

Dang. How many football games do you two win from your La-Z-Boy every Sunday? Must be a lot.

By: Ask01 on 10/9/12 at 4:04

Context is a condition I find people usually invoke when they know the complete story will shine a very unfavorable light on their actions. The usual desire is for evidence to be presented in a very specific manner to slant the truth.

This is a very human trait, and everyone engages in some sort of spin and context control, usually to save embarassment.

In this instance, however, I believe the entire story should be told with all facts laid out. If the facts bear out extenuating circumstance, absolving DCS of an culpability in the deaths, fine.

If the facts, presented in a straight forward manner, show incompetence and dereliction of duty, then an investigation conducted by outside agencies should be conducted and appropriate action taken, be it fines, dismissal, or even jail time.

By: bobyounts@comca... on 10/10/12 at 7:21

Excuses, excuses, excuses....The people who run DCS are the same people who run the DMV (Division of Motor Vehicles). Would you want them looking after your children?

By: Ask01 on 10/10/12 at 10:07

An excellent observation.

I concede DCS is probably not a major concern for the masses or their elected representatives, therefore not a funding priority until, at least, reports of deaths due to dereliction of duty begin to surface, or perhaps details of former clients falling into a cycle of abuse and/or crime, due to failures of the system emerge, therefore becoming an election year issue.

Until then, the adage, out of sight out of mind seems, in a sick manner, the standard procedure.

My impression of some in government, but especially those who deal with the public, is an overriding attitude of 'you are intruding on my time waiting for retirement.'

I realize many are expected to do more with less, since all cuts seem to come at the customer service end of the equation, and a certain cynicism is a coping method. It is sad the politicians who manipulate the system, holding citizens services hostage are not the ones who bear the brunt of cuts, but they do protect themselves.

This will all go away after a period of time until the next scandal pushes to the fore, requiring spokespersons to spin the tale and minimize the damage.

Just wait and see.

By: spanky206 on 10/20/12 at 11:29

I work for DCS and I am not a case manager. The case managers do a good job despite the obstacles that stand in their way. They are overloaded with cases due to not enough employees to do the job, families who do not want to take their help. Some of these parents care more for their drugs and alcohol, or an abusive parent than they do their kids. You cannot help people who do not want help, no matter how hard they try. Please put yourself in the worker's shoes before commenting negatively. They sometimes get called out in the middle of the night, having to leave their family to investigate an allegation of abuse. They cannot make the ultimate decison on what happens in these cases, there is also judges who do not always make the correct decision. So please before thinking they just want to stay in the office and drink coffee, remember that is where they would rather be. Instead they are out investigating children who have been beaten, not fed, not getting the require medical treatment, or sexually molested.