Infant’s death sparks child welfare debate

WASHINGTON — The death of a 7-month-old infant in September is shining a light on a growing problem in Iowa’s foster care system.

The infant, who has been identified only by the initials LD, was formerly in a Washington family’s foster care. The infant’s death comes six years after another high-profile death, of a 17-month-old girl — with initials AM — in rural Riverside, whose death was ruled a homicide.

That girl’s biological mother, Ambrashia Chrzan, was sentenced to 50 years in prison for the case in 2018. AM’s father, Anthony McCoy, was sentenced to nine years for involuntary manslaughter and child endangerment. An autopsy report in Chrzan’s trial said “malnutrition and neglect” contributed to AM’s death in her biological parents’ care.

In the case of LD, the cause of death was “unexplained sudden death,” and the manner of death was classified as undetermined, according to the State Medical Examiner’s Office. But caregivers for LD said the child’s family raised red flags.

“We tried to teach and coach the 14-year-old (birth parent) to be a mother, but by May, we had to get the mom removed because she was not safe around her own son,” said John Gish — a former foster parent to LD, and prosecutor of AM’s parents, as Washington County Attorney — in a now-deleted Facebook post. “DHS began setting up visitations with mom and the dad … but after each visit, L.D. returned unfed, unchanged, and unhappy.”

The Gish family said they made several alerts to the state, but were disregarded.

After 143 days in their care, LD was relocated.

“L.D.'s doctor wrote a letter to DHS and the court to voice concerns of malnourishment during visits with his mom … We also filed our own letter with the court and submitted 12 pages of concerns,” Gish said in the same Facebook post. “It was at this time that L.D. was removed from our home so that L.D. could be ‘closer to his family.’”

On Sept. 30, LD died in Central City, according to his obituary.

John Gish said he had suspicions about the death.

“My experience suggests the autopsy will conclude sudden unexpected infant death,” he wrote in another since-deleted post, the day after LD’s passing. “But I have no doubt the ongoing trauma from family visits and defects caused by drugs and smoking while in utero will have contributed to the death of this beautiful child.”

Gish’s family has since stepped out of the system, withdrawing their license as a foster home.

“We’re not going to return to foster parenting, not in the current state of the system,” he said in an interview. “There appeared to be a general distrust of foster parents, and unwillingness to receive our input.”

Signs of coming change for state’s child protection

Officials from Iowa Health and Human Services (HHS) — the still-merging agency comprised of the state’s Department of Human Services (DHS) and Department of Public Health (IDPH) — said they could not comment on LD’s, or any other specific case, but that reforms to the state’s child welfare system were on the horizon.

In October, the agency announced plans for an updated foster parent information-sharing system, and a “child protective services assessment,” bid out to Change & Innovation Agency, a contractor whose timetable plans for a final report in August of 2023, expected to cost the state just under $1.297 million.

Janee Harvey, director of the Family Well-Being and Protection Division of HHS, said the agency was aware of problems in the system, especially the issue of overburdened social workers unable to catch every concern. She said the role of the assessment was not to outline problems, but identify solutions.

“The question started to emerge: with caseloads this high, how can our workforce get to the place that every family is better off when HHS knocks on the door?” Harvey said. “We are quite sure that the answer is, ‘no,’ right now. We know that we can do better, but what will it take condition-wise to lay out those expectations? It became clear that we needed some sophisticated support doing it.”

Harvey was announced as the division’s director — a newly created position — on Nov. 14. She said the realignment of IDPH and DHS highlighted a need for coordination between people involved in families’ well-being.

“We are integrating, organizationally, our policy teams, and our teams doing the work, the practice side,” she said. “It is really hard to keep policy and practice integrated, it is even harder when organizationally, you have different leaders … child welfare is very much being impacted by our realignment.”

Critics accuse state of censorship

After voicing their complaints publicly on social media following LD’s death, at least two families in Southeast Iowa said they were threatened with legal action if their posts weren’t taken down. One of those contacted parties was John Gish. Another was a family in Johnson County that declined to comment on the matter.

The state contests any accusation of a threat, but confirmed that officials did contact families, telling them their posts violated confidentiality laws for children in the foster system.

Iowa Attorney General’s Office DHS Division Director Chandlor Collins provided copies of those legal communications, in response to a public record request.

“No demand was made to Mr. (Gish) to remove social media content and the Department has no authority to do so,” Collins wrote in a letter to Gish’s personal attorney. “The communications, including this one, are intended to provide information about the existing confidentiality laws. To the extent that Mr. and Mrs. Gish or anyone else wants to use their social media or any other platform to critique the Department of Health and Human Services, they are welcome to do so.”

Gish’s legal team disagreed in their response, citing the family’s decision to forfeit their foster care license, along with its associated obligations to the state. The firm argued that the DHS communication amounted to a violation of the First Amendment.

“The predecessor foster family has made numerous social media posts to facilitate a fundraising campaign for the child’s mother,” the letter said. “These posts and the information about the child contained within them have apparently elicited no response from your office. This leads to the conclusion that the Department is only interested in stifling criticism … it is a serious matter when a governmental official uses his authority to suppress speech.”

The state fired back with legal references and its own opinion.

“There is the overarching expectation of Iowa Courts that matters involving children in foster care are confidential,” Collins wrote. “The theme of confidentiality as it relates to foster care children is clear and encompassing in the theme that these children should have their privacy maintained. In this case that privacy extends to both the foster child and the foster child’s mother.”

The Facebook posts from both families that prompted a state response are no longer visible to the public.

Advocates call for more reform

Concerns about Iowa’s foster system, and its ability to miss warning signs, extend well beyond Southeast Iowa. A 2020 report from the state ombudsman drew public attention when it was published in 2020, detailing the death of 16-year-old Sabrina Ray in Perry. The investigation found that the DHS received but did not act on 11 child abuse reports involving foster children with that family.

In that 153-page report, Ombudsman Kristie Hirschman said she worried abuse would get worse in future years, enabled by the rise of remote learning.

“The fact is, the potential for child abuse to occur is much greater when children fall outside the reach of conscientious and inquisitive school officials,” she wrote. “A month after schools were first closed due to COVID-19, statistics showed that child abuse reports to DHS had fallen by half when compared to 2019 … I am fearful that those who try to hide abuse will now have an easier and greater opportunity to do so.”

Gish said he hoped the department would change its handling of child protection matters, but that he wasn’t optimistic.

“I think there is a cultural problem within the department,” he said. “It will take a long time, if ever, to address those cultural issues … there are good people working for the Department of Health and Human Services. This is in no way me saying that they’re all this way or that way.”

Joined by Washington County Supervisor Richard Young, Gish met with IDPH Director Kelly Garcia and Chandlor Collins in early December. The County Attorney’s office shared a news release after that meeting, in which Gish said the state agency had a “defensive culture” with employees “rarely receptive to suggestions or input from the outside.” He also criticized the department’s failure to respond to warning signs.

“Too often, DHHS rejects legitimate reports of abuse,” the news release said. “DHHS should be going inside parents’ homes to visit children, instead of seeing children at court and considering that a good enough visit … Sometimes, a social worker will ‘investigate’ an allegation and only report to law enforcement after DHHS concluded their own review. This has resulted in suspects of sexual or child abuse being interviewed by a social worker before a trained investigator ever has a chance to get involved.”

Gish said he believed Director Garcia was interested in protecting children, but called on changes from the state legislature, rather than within HHS. Specifically, he advocated for increased involvement of law enforcement, communication with county attorneys and general oversight for the child welfare system.

“The legislature represents the people, and the legislature can make a law based on what it sees as appropriate, which may contradict what DHHS sees as appropriate,” he said in a follow-up interview. “Other times my wife and I have run into issues as foster parents, (and) as a county attorney … in my area experience of Washington County, it is hard to have a constructive, critical conversation.”

Garcia’s office did not reply to repeated requests for comments.

Harvey said there was no way to act on every complaint. Between foster children, foster families, biological families, legal representatives and mediators between all of the above, each decision faces conflicting interests.

“We are never going to be a system where everybody co-signs the decisions being made,” she said. “Families are very complicated, they’re very messy … there is no way to resolve every complaint we hear, depending on who we’re hearing from.”

Some complaints from foster families are overlooked not out of negligence, but because they fundamentally break from the foster system’s mission. Harvey said the state had legal obligation to aim for reunification of almost every family in the foster system.

When suggestions contradict that mission, they’re difficult or impossible to act on.

“We have a number of foster parents who raise complaints about things like, ‘The bio-parent is getting to see their kids through things like family interactions, and I don’t like that,’” she said. “And, ‘I don’t think that parent should ever be reunified with the child in my home.’ We hear lots of concerns like that … If a child’s legal goal is reunification with their parents, even if that may make a foster parent very angry, and they may disagree, that is not their decision.”

The system helps more than it hurts, according to Harvey. She said the data showed reunification as the best outcome for the mental health and long-term well-being of everyone involved in the overwhelming majority of cases.

Most people know parents facing challenges, or whose parenting practices they question. It is neither illegal nor disqualifying for parents to struggle.

“Since we have been implementing our family-first approach, we have 20% less kids in foster care today in Iowa, and that’s good news,” Harvey said. “What we historically would have done in child welfare (was) an overreliance, probably, on foster homes. And so, an outcome was frequently splitting up siblings, and having no way of bringing these families back together.”

But when the system doesn’t work — like in the case of AM, or allegedly, LD — the outcome is tragedy.

“Ambrashia Chrzan and Anthony McCoy were responsible for A.M.'s death, for which they faced justice in 2018,” John Gish said. “But I think about A.M. all the time and what could have happened if DHS did more than just take the word of A.M.'s parents and actually dedicated some time to look into A.M.'s health.”

Comments: Kalen.McCain@southeastiowaunion.com