Hospital staff more likely to screen minority mothers Anderson, Troy. Los Angeles Daily News, June 29, 2008.Nearly 90 percent of all children in Los Angeles County's foster-care system are minorities, drawing growing concern that hospitals and child welfare agencies are performing the vast majority of drug screening tests on low-income, minority pregnant women who seek public health care.
While only 10 percent of the county's general population is African-American, African-American children make up nearly 36 percent of all children in the county's foster-care system.The county trend mirrors state and national figures that show children of ethnic minorities in foster care - especially African-Americans, Latinos and American Indians - outpace the number in the general population.
Statewide, 75 percent of foster children are minorities, including 27 percent who are black while African-Americans make up just 7 percent of the state's population.
Nationwide, 58 percent of the 513,000 kids in foster care are children of color, although they represent only 42 percent of the child population in the United States.
"There is very strong evidence that hospital staff are more likely to suspect drug use on the part of black mothers and these mothers are more likely to have their children removed and put in foster care," said Dorothy Roberts, the Kirkland & Ellis professor at the Northwestern University School of Law in Chicago and author of "Shattered Bonds: The Color of Child Welfare."
Local, state and national child welfare officials agree that a disproportionate percentage of minority children - especially blacks and American Indians - are in foster care. But they say maternal drug testing is just one of the factors.
"(Hospital drug testing is) one aspect we'll be looking at to see why there are these disparities, but it seems the problem is multifold," Department of Children and Family Services Director Trish Ploehn said.
"The numbers indicate we bring in a large proportion of African-American children, including infants and older children. Whether it's connected directly to substance-abusing moms, I don't know if we have that information. But it's something we need to look at."
While abuse and neglect rates are actually lower among African-American families than in white families, studies have found race to be an important factor in reports to child protective service hotlines, according to a recent Casey Family Programs report.
Additionally, many public and private hospitals have overreported abuse and neglect among blacks while they underreport maltreatment among Caucasians, according to the Casey report.
A study published in the Journal of Women's Health found black women and their newborns were 1.5 times more likely to be tested for illicit drugs as others."There is a strong stereotype that black mothers are irresponsible," Roberts said. "And the entire image of the `crack baby' is that of a black child. So people who have to identify substance-abusing mothers and make decisions about it are influenced by these stereotypes."In two recent lawsuits against Los Angeles County, Beverly Hills attorney L. Wallace Pate alleges social workers took children from two Latino couples without confirming results of initial tests.
"This is an attempt to start a social movement and raise public awareness about the fraud being perpetrated by the county," Pate said.
"It's just another way of profiling minorities and ensuring their kids end up in foster care and are on the fast track to jail, prison and devastated lives."
The cases come as a special California panel focusing on the role of courts in child welfare capped a two-year investigation and released recommendations to help courts improve foster care outcomes.
Among the recommendations is for the courts and child welfare agencies to examine and address why a disproportionate percentage of minorities are in the child protective system.
Ploehn and Juvenile Court Presiding Judge Michael Nash are chairing a group examining the issue. And Casey Family Programs is assisting counties in the research.
"It's an issue that's becoming extremely visible and is taking on a life of its own as far as child welfare professionals focusing on this, starting to do research and craft solutions," Ploehn said.
DCFS Medical Director Dr. Charles Sophy said he believes drug testing of pregnant women is a factor in the disproportionate percentage of minorities in foster care.
"I think that drugs have played a significant role in the phenomena of disproportionality," Sophy said. "I continually remind my staff that they have to have an open mind and it's not a race or culturally oriented issue."
Medical experts recommend hospitals conduct more expensive confirmatory tests to ensure the results are accurate, but officials admit hospitals in the county often don't perform these tests unless requested.
Hospital officials have discretion in deciding who to test, a factor child welfare experts believe plays a role in the disproportionate percentage of minorities in foster care.
"Drug testing isn't automatic," said Dr. Barry Lester, a professor of pediatrics and psychiatry at Brown University in Providence, R.I., who has attempted to convince lawmakers to develop a national policy on the issue."Hospitals have different rules on how they decide who to drug test. Sometimes the rules are medically based .... But a lot of times the decision is based on clinical suspicion. And guess what? Who do we get the most suspicious about? Poor people and people of color."There is a tremendous imbalance of poor people and minorities who end up getting tested."Sherman Oaks attorney Ken Sherman, who has handled dependency court cases for decades, said mothers who have a regular doctor or are more affluent rarely get tested for drugs at hospitals.
"I think there is an element of discrimination in that regard," Sherman said. "But the thing that really bothers me is the fact that (DCFS) has a policy on how they should assess whether a person's substance abuse affects their ability to care for their kids, but I don't think social workers ever look at that policy."
And when an initial urine screen is positive for drugs, poor and minority mothers are often unaware of or unable to afford the more expensive confirmatory tests, experts say.
Under reforms made in recent years, Ploehn said the department now is focusing on trying to keep babies with their mothers.
"We really are focusing on trying to keep them at home whenever possible," Ploehn said. "If we can bring services to the family - whether it's providing child care, drug education or whatever it takes - then the baby will stay with the mom."
Labels: foster care, minority, overrepresentation