No-Hit zones in place in pediatric wards of Kosair and U of L children's hospitals

Health professionals and other employees at Kosair Children's Hospital and the University of Louisville pediatrics unit were given an unusual tool this week when it was announced that their facilities are now No-Hit Zones. A program developed to maintain a calm, safe and caring environment for children and their parents, the No-Hit Zone initiative works to educate staffers on how to keep everyone on the ward safe from those who would lose their tempers while everyone around them is already in a stressful situation.

The policy is quite clear. No adult shall hit another adult. No adult shall hit a child. No child can hit an adult. And no child can hit another child while in the hospital environment.

The Kosair Children's, Kosair Children's-Brownsboro and U of L hospitals are now among only 30 children’s hospitals nationwide to implement the No-Hit Zone program. The Louisville effort has been led by Erin Frazier, M.D., FAAP, associate professor of pediatrics at the Uof L Children & Youth Project, and the Kosair Children’s Hospital Child Abuse Task Force, which Dr. Frazier chairs.

To learn about the No-Hit Zone, go here.

More child-welfare indicators added to Kids Count data site

Kentucky Youth Advocates has added four new child welfare indicators to the agency's Kids Count Data Center. These four new indicators provide Kentuckians and those who report on them with more information on vulnerable children and families in the state.

One new indicator shows the prevalence of certain risk factors -- substance abuse, mental health issues, and income -- in cases where child abuse or neglect was found to have occurred after an investigation was done. Another new indicator include the numbers of children community members bring to the attention of the state Department for Community Based Services due to suspicions of child abuse or neglect. (Read more)

Kids Count provides information across states and for Kentucky counties and school districts on many measures of child well-being, including economic well-being, education, health, and safety. To find the data center, go here.

New state web portal eases non-emergency reporting of child and adult abuse and neglect

The state Department for Community Based Services has launched a web-based portal for reporting child and adult abuse and neglect in non-emergency situations. According to DCBS Commissioner Teresa James, the new system should enhance the current intake system, especially for those situations that do not require an immediate response from the department's staff.

Law enforcement and judicial officials, medical professionals, educators, child and senior caregivers and other advocates have been using the program since July, giving feedback to DCBS staff to help refine the system for the general public. According to the Cabinet for Health and Family Services press release, "Users of the portal are required to enter an email contact and will receive an immediate, automated response that their online report has been made. Centralized intake staff will review reports as they are submitted. Users will receive a response message within 48 hours only if their report has not been accepted because it doesn’t meet criteria for investigation. Reports that are accepted do not generate a follow-up email message. The reporting portal has several mandatory input fields so that intake staff can get adequate information about the incident, the alleged victim, the alleged perpetrator and any safety issues in order to screen reports effectively."

The site, https://prd.chfs.ky.gov/ReportAbuse/home.aspx, will be monitored from 8 a.m. to 4:30 p.m. ET Monday through Friday. Reports will not be reviewed during evenings, weekends or state holidays.

If situations arise during these times indicating a child or adult is at risk of immediate harm, these should be reported to 911, local law enforcement or 877-KY SAFE1. Calls are anonymous. If the report meets the criteria for abuse, an investigation is conducted within 24 hours in most cases or, if the child is suspected to be in immediate danger, they are conducted within the hour. Callers should try to know the child's name, approximate age, address, parents' names and location of the child when the call is made. They should also have names and phone numbers of other people who have information about the suspected abuse.

 

Under scrutiny and criticism, cabinet changes way it handles reviews of children who die or nearly die from abuse or neglect

The Cabinet for Health and Family Services is now using a standard form when conducting internal reviews involving children who died or nearly died from abuse or neglect. Staff are now also being instructed to focus on specific topics in the reports. These are some of the ways the cabinet has changed how it handles the reviews since it came under "intense scrutiny from the state's largest newspapers," reports Beth Musgrave for the Lexington Herald-Leader.

A recent Herald-Leader analysis of 84 reviews from 2009 and 2010 showed there were vast disparities between how they were conducted in different parts of the state, with some of them lengthy and detailed and others just one-page reports that sometimes didn't even include the facts of a child's death.

Teresa James, acting commissioner of the Department for Community Based Services, said the standard form allows for "a greater amount of consistency." Recommendations that stem from the reviews, which are meant to zero in on ways the cabinet could have helped avoid the outcome, will also now require action plans.

Terry Brooks, executive director of Kentucky Youth Advocates, praised the effort. "This is a critical and significant step forward in terms of accountability, transparency and quality assurance," he said. (Read more)

Six of 41 child-abuse fatalities show improper follow-up by Cabinet for Health and Family Services, Herald-Leader analysis finds

The way child-abuse deaths are reviewed in Kentucky continues to be problematic. Looking at the 41 child fatalities in 2009 and 2010, Lexington Herald-Leader reporters Beth Musgrave and Bill Estep found at least six cases in which the Cabinet for Health and Family Services "did not do an internal review even though there were previous reports involving the family before the child died."

State law requires the cabinet to conduct such a review when a child dies or nearly dies because of abuse or neglect and the cabinet had prior involvement with the family.

That didn't happen in the case of 2-year-old Derek Cooper, whose father placed his hands over the crying boy's mouth "until the child was silent," a state report said. Cooper's father, Brandon Fraley, had had contact with the cabinet when he was a child himself, and in 2006 there was an allegation of domestic violence against him, Musgrave and Estep report. Cabinet spokeswoman Jill Midkiff said the cabinet doesn't do internal reviews when the contact with the cabinet occurred when the alleged abuser was a child, but Midkiff "provided no explanation about why the 2006 domestic violence investigation of Fraley didn't trigger an internal review," the newspaper reports.

The analysis also showed vast differences in the way internal reviews are conducted in different parts of the state. "Some of the reviews appeared to be thorough, but in others, child-protection workers produced only one-page reports with little detail on what happened to the children and no assessment of potential improvements," Musgrave and Estep report.

"The cabinet for so long has hidden everything it could," said state Rep. Susan Westrom, D-Lexington, who tried earlier this year to pass a bill that would create an external child-fatality review panel. Gov. Steve Beshear has issued an order to create such a panel, whose members will review cases and make recommendations. The panel will not have cabinet staff as members.

Westrom's bill got hung up partly over the cabinet's attempt to impose further restrictions on the sort of information it is required to make public. The newspaper's analysis the result of a long fight the Herald-Leader and The Courier-Journal have waged to make the child-abuse documentation available to the public. C-J lawyer Jon Fleischaker said on KET yesterday that the cabinet continues to redact more information that it should, in an effort to protect its own interests. The fight continues in the appellate courts. (Read more)

Beshear to have outside panel review cases of children killed or life-threatened by abuse

An independent panel of experts will review cases of children who have been killed or severely hurt by child abuse or neglect, Gov. Steve Beshear announced Monday. The panel will have 17 members and be based in the Justice and Public Safety Cabinet. Its aim will be to assess if the state's child-protection workers did all they could to protect children who died as a result of abuse. It will also determine causes of death.

The Cabinet for Health and Family Services "released thousands of pages of documents Monday that detail the state's involvement with dozens of children who were killed or nearly killed as a result of abuse of neglect," reports Beth Musgrave for the Lexington Herald-Leader. "Still, the cabinet continues to withhold some case files and has redacted large portions of others."

The release is the result of a lengthy court battle between the cabinet and the state's two largest newspapers, the Herald-Leader and The Courier-Journal. The newspapers argued documents pertaining to these cases were subject to open record laws and Franklin Circuit Court Judge Phillip Shepherd agreed. The cabinet released 76 of about 140 files, but with key information omitted. In February, Shepherd ruled the cabinet had 90 days to hand over remaining case files, fined the cabinet $16,000 for withholding the records and ordered it to pay $57,000 in attorney fees for the newspapers.

The cabinet appealed the ruling in the Court of Appeals, but on July 9, the court sided with the newspapers, refusing to allow the documents from being withheld. More than 40 similarily-redacted cases were released yesterday but the cabinet filed an appeal with the Kentucky Supreme Court. "We disagree on how much personal information about the children and private individuals included in caseworker files should be made public," Cabinet Secretary Audrey Haynes said.

Also yesterday, Beshear issued an order to create the panel, which will meet four times a year and will issue an annual report that details issues it finds. "When a child dies or is critically injured because of abuse or neglect, we must carefully review the practices of all government entitites involved to make sure that our system performed as it was supposed to — and if not, that review allows us to take disciplinary action," Beshear said.

Panel members will include law enforcement, prosecutors and medical experts, Musgrave reports. While the meetings will be open to the public, the records consulted during them will not be subject to open records laws. (Read more)

Beshear vetoes parts of budget, but health spending is intact

Though Gov. Steve Beshear vetoed 45 parts of the state budget yesterday evening, health-related spending was safe from the cut.

The budget will help reduce caseloads for social workers who investigate child abuse and neglect, funds colon cancer screenings for 4,000 uninsured Kentuckians, substance-abuse treatment for Medicaid recipients and includes funding for an elder abuse registry to protect senior citizens from unscrupulous caretakers.

"This is the most difficult budget I have ever drafted, and it will also be a challenge to implement and manage over the next two years," the governor said in a statement.

In the two-year, $19 billion budget, Beshear voted more than three dozen line-item appropriations, including "portions of the General Fund budget that limited his ability to manage the state's budget or spent money that doesn't exist," reports Beth Musgrave of the Lexington Herald-Leader.

He also cut some earmarks, including $100,000 for Actors Theatre of Louisville and $150,000 for the International Mystery Writers' Festival in Owensboro. "I am vetoing these parts because they identify new spending earmarks yet the General Assembly failed to appropriate additional funds to finance them," Beshear said. (Read more)

This is Child Abuse Awareness Month; tips for prevention

April is child abuse awareness month, and the state Cabinet for Health and Family Services is reminding Kentuckians that it's the law to report suspected child abuse or neglect.

"Protecting our children should be everyone's number one priority, and during the month of April, we are raising awareness about the warning signs of child abuse and how to report it," Gov. Steve Beshear said. "The cabinet works year round to educate our families and investigate every aspect of abuse. Together, we can make Kentucky a safer place for all our children."

To report child abuse, Kentuckians should call 800-KYSAFE1. Calls are anonymous. If the report meets the criteria for abuse, an investigation is conducted within 24 hours in most cases or, if the child is suspected to be in immediate danger, they are conducted within the hour.

Callers should try to know the child's name, approximate age, address, parents' names and location of the child when the call is made. They should also have names and phone numbers of other people who have information about the suspected abuse.

The ultimate goal is to reunite families when circumstances improve. "We want children to return home to a stronger, safer family," said Jim Grace, assistant director of the Department for Community Based Services' Division of Protection and Permanency.

The cabinet's handling of child abuse investigations and its reluctance to release records pertaining to child abuse deaths and near deaths has been a hot-button issue in the past year. The Courier-Journal and Lexington Herald-Leader both sued the cabinet for refusing to turn over records and a judge twice ruled the cabinet was wrong not to do so. Since, it has released hundreds of pages of records, but has chosen to redact, or omit, some of the information therein. In January, Beshear acknowledged the cabinet had been accused of "operating under a veil of secrecy in a supposed attempt to protect inept workers and a poorly designed system."  Legislators have since heard hours of arguments about the issue, and a bill that would create an external panel to review child abuse cases involving fatalities and near-fatalities, while imposing more secrecy, is one of the few measures that could pass the General Assembly when it re-convenes for one day next Thursday to end its legislative session.

In its effort to increase awareness about child abuse, the cabinet offered strategies for parents to prevent abuse, including:

• never discipling a child when a parent's anger is out of control

• never leaving a child unattended, especially in a car

• learning the signs of physical abuse, nothing bruises, cuts, burns or other injuries a child can't explain

• teaching children the difference between "good touches," "bad touches" and "confusing touches"

• listening to a child when he or she doesn't want to go with something

• noting a change in a child's behavior or attitude

• teaching children what if he or she gets lost

• teaching children the correct name for private body parts

• being alert for talk that indicates premature sexual understanding

• paying attention when someone shows an unusual interest in a child

• making sure a child's school or daycare will only release him or her to a designated person
(Read more)

House committee approves panel to investigate child-abuse deaths; findings would be closed to public

An independent panel of experts would look into the deaths of abused and neglected children and then give recommendations to state officials for how to improve its child-protection system. That was the proposal that was approved unanimously Thursday by the House Health and Welfare Committee.

In House Bill 200, "the group's meetings would be closed to the public, and its documents would remain secret," reports Beth Musgrave for the Lexington Herald-Leader. Jon Fleishchaker, a lawyer for the Kentucky Press Association, said there was no reason why the business of the panel should be secret. "We are all for a statewide panel," he said, "but the public needs to be able to see what the recommendations are."

The bill would also outline what information the Cabinet for Health and Family Services would be responsible for releasing to the public when "abused children who have had previous contact with the cabinet die or are severely injured," Musgrave reports. The legislation would allow the cabinet to "keep the names of children who suffered serious, non-fatal injuries and information that would identify siblings in the home," Musgrave reports.

The Cabinet for Health and Family Services has been embroiled in a lawsuit with The Courier-Journal and the Lexington Herald-Leader, which sued the cabinet in order to seek documents pertaining to child abuse deaths or near-deaths. A Franklin Circuit Court judge has twice ruled that the cabinet turn over its files, but it has appealed. (Read more)

Judge orders Cabinet for Health and Family Services to speed up its release of child-abuse records

The state Cabinet for Health and Family Services has been given 90 days to release thousands of pages pertaining to about 180 cases of children who died or were badly injured from abuse or neglect. The order was issued Thursday by Franklin Circuit Judge Phillip Shepherd, who called the cabinet's reluctance to comply with state open records laws an "utter failure," reports Deborah Yetter of The Courier-Journal.

The ruling is the latest in the cabinet's fight with the Louisville newspaper and the Lexington Herald-Leader. Shepherd's ruling replaces a previous order that told the cabinet to release 1,000 pages a week, which it started doing Jan. 27. The documents released so far — which have been "heavily redacted" at the cabinet's discretion and against Shepherd's ruling — represent 15 cases.

The cabinet argued it should not be obligated to release the records since it is appealing Shepherd's decision, but the judge rejected that argument. He also said the cabinet had to list reasons for why it was redacting some information "and be prepared to defend them in court after releasing the files," Yetter reports. (Read more)

More children are victims of abuse than of SIDS, study finds

As the state's major newspapers and the Cabinet for Health and Family Services battle over how public records pertaining to child abuse and neglect should be handled, children continue to be victims across the country. A study published Monday in the journal Pediatrics has found child abuse affects more babies in the U.S. than SIDS. (Photo by Getty Images)

The rate of hospital admissions for SIDS, or sudden infant death syndrome, is 50 per 100,000 for children under the age of 1. In the same age bracket, 58.2 per 100,000 babies are getting hurt as a result of abuse, reports Bonnie Rochman for Time's Healthland.

"These kids are physically vulnerable because they're small," said Dr. John M. Levanthal, leader author of the study and professor of pediatrics at Yale Medical School. "They are challenging for some parents to take care of because they cry, it's hard to understand what they want and parents can get frustrated, exhausted and angry."

Indeed, abuse most often stems from parents. Previous research shows men, including fathers, stepfathers and boyfriends, are the "largest single group of perpetrators," Rochman reports.

Research conducted at Yale found that in 2006 4,569 children under the age of 18 were brought to the hospital as a result of abuse, 300 of whom died. The resulting death rate of 6 percent was "substantially higher than for children who were admitted for other kinds of injuries or medical or surgical problems," Rochman reports.

The most common injuries included abusive head trauma, fractures, burns, abdominal injuries and bruises. Those hospitalizations cost about $73.8 million and lasted twice as long as children who suffered other kinds of injuries.

Children living in poverty were the victims of abuse much more often, getting hit at six times the rate of children not on Medicaid.

A report showed 18 Kentucky children died from child abuse or neglect last year, down from 33 in 2009, but those numbers have since come into question. A survey in Kentucky and three other states showed child abuse rates have risen significantly since the economy went into recession — from 8.9 per 100,000 children from 2004 to December 2007 to 14.7 per 100,000 during 2008 and 2009. (Read more)

Judge rails against state's handling of child-abuse records, Beshear's defense of cabinet

The judge who handled the case of 9-year-old Amy Dye, who was beaten to death last year by her adoptive brother, sent an op-ed piece to several newspapers criticizing Gov. Steve Beshear's move to back the Cabinet for Health and Family Services in its battle to prevent full disclosure of child-abuse death records.

"The publicity surrounding recent tragic deaths of children in Kentucky, and the now public shenanigans of the cabinet — caught lying about what it knew and when it knew it — have triggered a rare public anger," writes Circuit Judge Tyler Gill, left. "Openness should always be the rule where government is involved."

The Lexington Herald-Leader and The Courier-Journal sued the cabinet last year to obtain records about children who died from abuse or neglect. Though Franklin Circuit Judge Phillip Shepherd ruled in three cases that files should be released, the cabinet long refused to do so. "Shepherd said that in cases of children killed or badly hurt, the public has a legitimate, overriding interest in access to information that could show how the cabinet performed its job of protecting children," reports Bill Estep for the Herald-Leader.

In an order issued Jan. 19, Shepherd ruled the cabinet could omit very limited information, including the names of children who are hurt but don't die and the names of people, such as teachers, who report suspected abuse. The cabinet has appealed, saying it should be allowed to redact more information than that. Since Shepherd's ruling, the cabinet has released the internal reviews of 85 cases in which children were hurt or died in 2009 and 2010, along with extensive case files — though it has redacted information it sees fit on all of the documents.

Gill rails against the cabinet's appeal. "Do not be misled," he writes. "The cabinet's appeal of the Franklin Circuit Court ruling is not a high-minded effort to protect the privacy of persons who report child abuse. It is to protect the cabinet."

Kerri Richardson, spokeswoman for Beshear, said Gill is wrong about the cabinet's motivations. If it meant to protect itself, it would not have released hundreds of pages of records. "The cabinet is not just protecting those who report child abuse," she told Estep. "The cabinet is trying to protect innocent victims of abuse or neglect and the innocent families of victims of abuse or neglect."

But, given his handling of Amy Dye's case, Gill sees it differently. "The people of Todd County are painfully aware of the likelihood that a multitude of reports of suspected abuse were made by teachers and school officials about Amy Dye in the years before her death, several of which may have been mishandled or misplaced. I seriously doubt any of those who made reports would have allowed fear for their personal safety to keep them from speaking out. Their fear was for Amy," he writes. (Read more)

Health and family cabinet continues to withhold more information in copies of child abuse records than judge allowed

The state Cabinet for Health and Family Services released three more death and near-death cases involving child abuse or neglect Friday under court order, but continued to withhold critical information. It has appealed the order.

The 2009 cases involve two babies who died from suffocation while the parents were impaired. A third case involves a 2-year-old girl from Lawrence County, who was injured after she was reportedly kicked in the head by a horse while unsupervised.

The cabinet "continues to withhold, or redact, far more information" than was allowed under the Jan. 19 order of Franklin Circuit Judge Phillip Shepherd, reports Deborah Yetter of The Courier-Journal. Shepherd said the cabinet could withhold the names of children seriously injured by abuse or neglect, names of private citizens who report suspected abuse, the names of minor siblings in the home and the names of minor perpetrators.

But the cabinet is withholding more information than that. "For example, in the case of the girl injured by the horse, the cabinet deleted the name and relationship of the adult who was watching her, even though the adult is named and identified as her grandfather in a separate internal review of the case," Yetter reports. "The cabinet also withheld juvenile and family court records in that case and the names of all adults involved." The girl recovered from the skull fracture sustained by the horse.

Gavin Villarreal never woke up after he was found with a plastic bag over his head in his crib, possibly placed over the 5-month-old's head by other young children in the home. His parents both tested positive for drugs on the day of his death and were convicted. In the third case, a month-old baby died after his father apparently rolled over him in his sleep. Both parents admitted they had been drinking and used marijuana before they went to bed. (Read more)

Cabinet files appeal to prevent releasing full child abuse records; Beshear backs decision

On the day the state was supposed to release unadulterated records on deaths and near deaths from child abuse, under a court order, it filed an appeal to stop the process. And though Gov. Steve Beshear had ordered the Cabinet for Health and Family Services to release the records, yesterday he sided with its officials, saying in an op-ed piece sent to Kentucky newspapers he did not "think the judge's order was protective enough" of informants who often want to remain secret, such as relatives, health-care providers, teachers and law-enforcement officials. (Getty Images photo)

“You teach in a small community and suspect a student is being abused,” Beshear wrote. “Can you come forward without the newspaper naming you as the accuser?" Jon Fleischaker, attorney for The Courier-Journal and the Kentucky Press Association, said Beshear was “fear-mongering,” and noted that Shepherd’s order to release records applies only in cases in which children were killed or nearly killed from abuse or neglect, following a state law designed to hold the cabinet accountable for its child protective services.

Beshear wrote, “The cabinet has been accused of 'operating under a veil of secrecy' in a supposed attempt to protect inept workers and a poorly designed system. But this is not about shielding the system from scrutiny. We understand the need to be more transparent than in years past.” In December, the cabinet handed over 353 pages of records, but the names of at least eight children who died from abuse or neglect had been redacted, along with all the names of children who had been seriously injured, as well as much other information. The Courier-Journal, the Lexington Herald-Leader and the Todd County Standard had sued the cabinet for refusing to release the records. Twice before, Franklin Circuit Judge Phillip Shepherd ordered the cabinet to turn them over. Last week, Shepherd fined the agency $16,000 for its secretive treatment and delays. He also found the cabinet should pay more than $57,000 in legal fees for the newspapers. (Read more)

Yesterday, the cabinet filed its motion with the state Court of Appeals and "asked the court to block Shepherd's Jan. 19 order to release records, starting today, with limited redactions," reports the C-J's Deborah Yetter. In the meantime, the cabinet released about 90 internal reviews of child deaths and serious injuries incurred by abuse but with deletions it feels is necessary "to protect the best interests of the state's child welfare system," its motion read. (Read more)

More transparency, accountability needed regarding child abuse, group plans to tell legislators

To decrease the number of children who are killed or nearly killed by abuse and neglect, there needs to be improved transparency and accountability at the Cabinet for Health and Family Services. This was the top recommendation made by a group of social workers, legislators, judges and child advocates who gathered at the Summit to End Child Abuse Deaths, put on by Kentucky Youth Advocates Saturday.

The other recommendations were to increase funds for services such as "appointed advocates, substance abuse programs, in-house services and parent advocate programs," increase funds for more social workers and support; and improve collaboration between child welfare agencies, reported Linda Blackford of the Lexington Herald-Leader. The group will send a letter to the General Assembly listing these recommendations.

Child abuse became a major issue for the state's largest newspapers after the Herald-Leader and The Courier-Journal sued the cabinet to gain access to records in which children had died or nearly died because of abuse. The cabinet had long fought to keep the records closed, even after Franklin Circuit Judge Philip Shepherd repeatedly ruled the records be released. In November, Gov. Steve Beshear likewise ordered the release of the records, but the cabinet tried to backtrack.

"Instead of lies, we need leadership," said Sen. Julie Denton, R-Louisville, at Saturday's meeting. Denton has repeatedly been outspoken about the issue, even asking for the resignation of Cabinet Secretary Janie Miller. Miller briefly attended Saturday's session, praising the efforts at collaboration, but saying the cabinet is being hit hard by budget cuts. She said the cabinet has lost $80 million in funding the past four years, but has asked for $20 million in new money over the next two years to pay for 300 more positions in its Department for Community Based Services. (Read more)

Child abuse reviews show failed communication in agency

A picture of failed communication is developing as reporters sift through 86 internal reviews of incidents of child abuse, says an editorial in today's Lexington Herald-Leader. The Cabinet for Health and Family Services released the reviews last week under court order.

"This pattern of failed communication only came to light because this newspaper and Louisville's Courier-Journal have aggressively pursued these records in court and Franklin Circuit Judge Phillip Shepherd has relentlessly pushed the cabinet to open the records," the editorial reads.

The piece highlights several instances where communication breakdown led to tragic events, beginning with the case of 9-year-old Amy Dye, right, in which a school nurse had written six reports about suspected abuse or injuries. The cabinet's file only contained three of them.

Madaline Grace Reynolds died when she didn't get the medicine she needed to treat her cystic fibrosis. The review found the child-protection worker did not look into whether or not her parents had filled her prescriptions.

"But the faulty communication doesn't stop there," the editorial reads, referring to Tuesday's hearing by the Interim Joint Health and Welfare Committee in which legislators came down hard on the cabinet for "failing to inform them about regulations that prevented it from investigating abuse by a sibling, such as in Amy Dye's case," the editorial reads.

"The cabinet, indeed the entire executive branch, has shown it won't fully address these issues without the hot, bright light of outside pressure," the editorial concludes. "The courts have acted responsibly and forcefully. Now, the legislature must take up the painstaking and painful job of examining the cabinet's work, finding the missed connections and fixing them." (Read more)

Lawmakers grill state officials at hearing on child abuse and records of it; one says health secretary should resign

Janie Miller, secretary for the Cabinet for Health and Family Services, should resign, said one key legislator at a committee hearing yesterday. The frustration of Sen. Julie Denton (Lexington Herald-Leader photo) stemmed in part from the manner in which the cabinet has dealt with child abuse records.

"This cabinet treats everyone as an adversary," said Denton, a Republican from eastern Louisville and co-chair of the Interim Joint Health and Welfare Committee. "I'm tired of lies. I'm tried of deception. I'm tired of the tap-dance routine. I'm tried of the shroud of secrecy. We should be partners, not adversaries."

Denton spoke near the end of a committee meeting at which Pat Wilson, retiring commissioner of the Department for Community Based Services, testified about a recently released report on child fatalities and near fatalities, as well as last week's public release of child-abuse records. Miller did not attend the meeting.

The report showed 18 Kentucky children died from child abuse or neglect in the past year, but did not include the names of the victims or the case of 9-year-old Amy Dye, who died at the hands of her adoptive brother. The release of child-abuse records has likewise been controversial, with the cabinet fighting the state's two largest newspapers, The Courier-Journal and the Lexington Herald-Leader, in court for years to avoid having to do so.

Wilson said her department "wholeheartedly supports being open and being accountable," but asked legislators to consider the pitfalls of having too much information available to the public. "I've done this work, I've knocked on the doors, I've interviewed the people and I've been in the houses," she said. "Almost inevitably, the person that you're talking with, not so much the professionals but the family members, the neighbors next door, will say, 'If I tell you this, will you promise me no one ever will know I said it?' You know, up until now, (we've say yes) and that has been the hallmark of this department."

Since the release of records, Wilson said her staff has already told her "individuals are telling them, 'I don't think I want to talk to you.'" She added she worries about the safety of her staff, saying there are larger ramifications when details of near-fatalities become public in a small town or rural community. "If you can for a minute, think about how it's going to feel when you're that worker, knocking on the door of that house and you're saying to those individuals I'm here to help you," she said. "I think it's going to be very tenuous."

Wilson explained Amy Dye's case was not included in her report because she was killed by a sibling, not her custodial parent. Though the cabinet had been contacted twice by school officials who suspected Dye was being abused in the home, the suspicions had been deemed unwarranted, Wilson said. Nevertheless, records released after Dye's death "include a letter from the school nurse that lists six reports from school officials about suspected abuse or suspicious injuries to Amy," reports Beth Musgrave of the Lexington Herald-Leader. "However, only three of the reports are contained in the cabinet's file on Amy."

Before her death, three years passed in which the cabinet did not receive any complaints of Dye's well-being. "We did know her but we knew her in 2006 and 2007," Wilson said. "In 2008, 2009, 2010, there was no communication." Dye had reportedly been sent out of state in the years preceding her death, but Todd County School Supt. Michael Kenner said the school did not know what had become of her, since there was little communication with the cabinet. "We didn't even know if she was in school," he said.

Many legislators took issue with the omission of Dye from the report, with Sen. Joey Pendleton, D-Hopkinsville, asking "How many others were killed by siblings that's not in this report that we don't know about?"

Wilson said state law only requires the report to contain information about deaths or near deaths that occurred at the hands of the primary caregiver, but Rep. Susan Westrom took issue with that. "Nobody from the cabinet has ever come to us and said, 'You know what? We have a statute that is too confining. We are still not able to protect our children from even siblings. The only people we can protect them from is the caregivers, which leaves a gaping hole in the safety net.'"

Legislators also asked why the report, released earlier this month, was three months late. Wilson said she took full responsibility for the tardiness. "It wasn't what I thought it needed to be," she said. "It's late because I had to redo the report." (Read more)

Legislators to discuss child abuse report Monday; chilling stories emerging about abuse trends

After a wave of stories pertaining to child abuse records made front-page news this week, the Interim Joint Health and Welfare Committee will meet Monday to discuss the Cabinet for Health and Family Services' recently released report on child-abuse fatalities and near-fatalities.

The meeting will be held at 1 p.m. in room 129 of the Capitol Annex. Click here to see live video streaming of the meeting provided by KET.

This year's report was released earlier this month and showed 18 Kentucky children died from child abuse or neglect in the past year, down from 33 in 2009. But critics say the report is incomplete, just 15 pages long compared to the 29-page report last year. Terry Brooks, executive director of Kentucky Youth Advocates, called the report "a failure," saying it made it difficult to compare findings from past years. It was also three months late in being released.

On Monday, the cabinet released 86 internal reviews of cases in which children had either been killed or nearly killed from abuse, though in many instances did not release the names of the children who were affected. The records were handed over by the cabinet after years of litigation and two weeks after Gov. Steve Beshear ordered the release.

The documents show there is a lack of protocol in handling the case reviews, the Lexington Herald-Leader's Bill Estep and Beth Musgrave reported.

Another Herald-Leader analysis that ran in today's edition showed more communication is needed between doctors and social workers. Reporter Valarie Honeycutt Spears cited one instance in which a 22-month old girl came to the University of Kentucky Medical Center with hair loss and an ulcer in her mouth.

"While at the hospital, the toddler developed bruises, and she cried when her mother came into the room," she reports. On Feb. 19, the girl died, with an autopsy showing she had broken bones, multiple bruises, a detached aorta, and a laceration to the liver. Her hair had also been pulled so hard she had a large hematoma on the top of her head.

In their review, cabinet officials determined UK did not report its concerns because there had been no history of abuse. "This has already been addressed with UK, and their policies have changed as a result of this incident," the report reads.

The toddler's case is one of 14 that involved children who had died or nearly died in 2009 and 2010 "that cited a need for better communication between medical professionals and child-protection workers," Spears reports. (Read more)

Child abuse records released, but without names of victims

Though the state on Monday released 85 internal reviews of cases in which children had either been killed or nearly killed from abuse, in many instances it did not release the names of the children who were affected. The reviews also show considerable variability in terms of how thoroughly the investigations were conducted.

The records were handed over by the Cabinet for Health and Family Services after years of litigation and two weeks after Gov. Steve Beshear ordered the release. Twice before, Franklin Circuit Judge Phillip Shepherd ordered the cabinet to turn over the documents to The Courier-Journal and the Lexington Herald-Leader, which had sued the cabinet for failing to provide the records.

But while 353 pages were handed over Monday, the names of at least eight children who died from abuse or neglect had been redacted, along with all the names of children who had been seriously injured, report Bill Estep and Beth Musgrave of the Herald-Leader. "That is totally contrary to the letter and the spirit of the judge's ruling," said Robert Houlihan Jr., a lawyer for the Herald-Leader. "Where there has been a fatality, there can be no justification that I see to redact that name of the dead victim."

The documents show there is a lack of protocol in handling the case reviews. "Some reviews are lengthy and thorough, including an analysis of what social workers could do differently to prevent similar deaths," Estep and Musgrave report. "But some internal reviews consist of one page that doesn't even say whether the child died."

"If children dying does not demand a formalized process, you have to ask yourself, what does?" said Terry Brooks, executive director of Kentucky Youth Advocates. (Read more)

Still, the records do paint some harrowing pictures, with Estep, Musgrave and Valarie Honeycutt Spears reporting Tuesday about one little boy who fell off a deck in Lincoln County while his mother and boyfriend were drunk. "There was no food in the filthy house, but there were pill bottles, beer cans and needles lying around, and blood on the child's bed," they write, noting more than half of the internal reviews show there was either involvement or suspected involvement of substance abuse. (Read more)

Regardless, the redacted documents prompted a scathing editorial in The Courier-Journal, saying "the result produced Monday afternoon is unacceptable and flies in the face of the spirit of Franklin Circuit Judge Phillip Shepherd's court orders."

The editorial also questions Beshear and his "belated" attempt to step in. "Whose cabinet is it, anyway?" it reads. "Is the governor saying one thing in public — 'Our children deserve our protection' and 'Transparency will be the new rule' and 'It's time for the balance to tip toward openness' — and another in private? How else to explain the gulf between what the judge ordered, what the cabinet lawyers said would be released, what the governor said, and what the cabinet produced on Monday? If Gov. Beshear does not approve of the cabinet's latest obfuscations, he must not only say so, he must act on that disapproval." (Read more)

Head of state social services steps down amid controversy

In the wake of controversy about how her state agency handled child-abuse investigations, Kentucky's commissioner of social services has stepped down. No other details were confirmed about the resignation of Patricia Wilson, who was a career social-services employee. Her salary was $111,348.

"The cabinet has been buffeted by recent reports over its role in child abuse cases, most recently that of Amy Dye, a 9-year-old Western Kentucky girl fatally beaten by her brother in the adoptive home where the cabinet placed her at age 5," notes Deborah Yetter of The Courier-Journal.

Franklin Circuit Judge Phillip Shepherd ordered the Cabinet for Health and Family Services to make records pertaining to the case public, saying the cabinet turned a "blind eye" torward the abuse. The cabinet had repeatedly argued in court that it was not obligated to release the records.

Last week, Gov. Steve Beshear ordered the release of the records, calling the details of Amy Dye's death "horrifying." The cabinet immediately sought to undercut the move. "Key lawmakers also have expressed growing dissatisfaction over how the cabinet handles cases of child abuse deaths and serious injuries," Yetter reports. (Read more)