MATTHEW HEALEY/For The Patriot Ledger
Social Services Commissioner Harry Spence defends the department’s oversight of Rebecca Riley. The fault lies with “the medical professionals,” he says.
Can DSS be fixed?
Reform has failed before
Agency charged to help troubled families has troubles of its own
First of two parts.
The Patriot Ledger
If the story seemed familiar, it was: A child had died under the watch of the Department of Social Services.
Once again politicians and experts were asking what went wrong at the child protection agency.
It’s happened at least four times in the past 18 years. After deaths and serious abuse cases, investigative panels have called for reforms.
Each time, officials pledged changes, but some improvements soon unraveled, child advocates say. The department is spending 59 percent more than it was in 1994 even after adjusting for inflation, but social workers and local agencies say many troubled families have to wait for services.
Now the department is under scrutiny once more. Rebecca Riley, 4, died on Dec. 13 on the floor of her family’s apartment in Hull. Prosecutors say her parents killed her with overdoses of psychiatric drugs. The parents say they gave Rebecca what a psychiatrist ordered for her bipolar disorder, diagnosed when she was 2 years old.
Six months before Rebecca died, the department had dismissed a therapist’s concerns about overmedication.
“DSS was aware of this family. There was a psychiatrist involved,” said attorney Frank Laski, head of a state-funded agency that represents low-income adults and children who need mental health services. “The pieces were there, but nobody was able to put it together.”
Social Services Commissioner Harry Spence strongly defended the department’s oversight of Rebecca Riley. The fault lies with “the medical professionals,” he said in an interview Thursday.
Spence ticked off a long list of initiatives at his agency, some already in place, that he says will improve services to children and families:
Most people don’t realize what the department does every day because they hear about the agency only when something goes wrong, Spence said.
“When I took this job I said that everything I knew about DSS came from the tabloids,” he said.
Rebecca died just eight months after another special panel, convened in response to another notorious child abuse case, had recommended giving social workers more access to mental health and child abuse experts.
Haleigh Poutre, 12, of Westfield was beaten into a coma, allegedly by her foster parents. She’s now recovering in a rehabilitation center.
Despite repeated reports of abuse, social workers failed to step in. They believed her foster parents and therapists who said she hurt herself because of her mental illness.
When caseworkers did try to remove Haleigh, the doctors fought the move, Spence has said. They also wrongly advised the department that the child would never regain consciousness, leading department lawyers to ask a judge to disconnect her from life support. As with Rebecca Riley’s case, the fault lay with medical professionals, he said.
In response to the Poutre case, legislators last year gave the department an extra $1 million to hire doctors and psychiatrists to advise social workers.
Spence said former Gov. Mitt Romney ordered him not to spend the money. Earlier, Spence had said he couldn’t find experts willing to get involved in the department’s inevitably controversial cases.
Whatever the reason, Spence said there was no one to provide an outside opinion when Rebecca Riley’s psychiatrist allegedly told a department caseworker there were no medication problems.
But on Thursday, Spence said the Department of Mental Health was providing part-time psychiatrists to the social services agency at the time of Rebecca’s death.
Social workers investigating abuse allegations, such as the report that Rebecca Riley might be overmedicated, couldn’t consult those psychiatrists because the social workers had to make appointments several weeks in advance. Abuse reports must be investigated within 10 days.
The Department of Mental Health has now agreed to increase the time that psychiatrists spend at six regional offices and make them available on call, Spence said.
Ed Malloy, a 30-year veteran social worker who heads the union representing workers, recalls that 15 years ago the department employed teams of social workers, doctors, nurses, psychiatrists and other experts to handle difficult cases.
“They were called Family Life Centers,” Malloy said. “They actually saw the children.”
Social workers with the teams handled no more than six cases and visited families as often as three times a week, he said.
“That really helped,” Malloy said. One team helped him resolve a thorny case involving suspected mental illness, he said.
“We ended up keeping the kid at home,” Malloy said.
But the program was scuttled. “We were never quite sure why,” he said.
Spence said he admired the concept of the teams, but there were only two, not enough to serve needs today. He said his staff is considering how to offer similar services within its budget.
The budget has grown from $403 million in 1994 to $770 million, yet more money hasn’t produced more services.
Union leaders and advocates question paying private agencies such as Bay State Community Services in Quincy to coordinate and administer services to families and children. Employees from the private organizations work in each area office and their approval is needed for all services.
Advocates worry that the money going to these “lead agencies” is coming out of the budget for the services themselves.
One lead agency director in an area office sent an e-mail to social workers in September ordering them to cut the number of families getting help as much as 50 percent for some programs because of a tight budget.
“Families will be given at least two weeks to terminate appropriately,” said the message obtained by The Patriot Ledger.
Spence said the lead agencies have been around for at least 10 years but a reorganization gives them more responsibilities, especially in keeping children out of institutional care.
This year the department is paying the agencies about $17 million, an increase of $7 million from the previous fiscal year, he said.
In some area offices, their work has already cut spending on residential treatment, creating more money, not less, for services, Spence said.
“In every area office, the level of service is either the same or has increased,” he said.
As for the e-mail ordering cuts, it came because spending exceeded the area office’s budget by 80 percent, Spence said. “The e-mail was completely misinterpreted,” he said.
Long history of problems
The turmoil surrounding the agency is nothing new.
Shortly after the state established the Department of Social Services in 1979, child protection advocates sued the fledgling agency.
They won a settlement that included many of the same reforms proposed later.
“In the 1990s a lot of those reforms were undone within six months,” said Jetta Bernier, executive director of Massachusetts Citizens for Children.
Four years ago, the group issued a comprehensive report repeating many recommendations from the 1980s, such as distinguishing between serious abuse cases and less urgent problems and establishing teams similar to the old Family Service Centers.
Bernier gives Spence high marks. “This is the best commissioner I’ve ever worked with,” she said.
However, Bernier has given up trying to change the department. Her organization now provides educational programs for parents and professionals to prevent shaken baby syndrome and child sexual abuse.
“We began to focus more and more on prevention. We would rather keep kids out of the (department’s) system,” she said.
“The system is never going to be perfect,” Bernier said. “It is always going to be a huge bureaucracy with tremendous challenge.”
Sue Reinert may be reached at firstname.lastname@example.org.