Desperate Choices: Giving Up Custody For Care In Connecticut

Ten years have gone by, but Lisa Vincent and her son, Jose, flash back to their goodbye with fresh anguish and faltering voices.

He is 21 now, but the 11-year-old boy he was back then easily re-surfaces, all anger and confusion.

“I didn’t understand. I was under the assumption I was going back to her,” Jose says. “For a long time, I felt that whole ‘she gave up on me like everyone else did.’ Now, I realize it wasn’t her. It was the system.”

After she turned him over to state custody, Lisa lost track of him until he turned 18 and found her.

“They tell you, ‘Just sign the piece of paper.’ Like if you sign it, your child will be OK,” says Vincent, who had adopted Jose through the state Department of Children and Families (DCF) when he was 5, and agreed to give up her parental rights after failing to access treatment to stop his violent aggression. “They’re not OK. They’re the furthest thing from OK.”

Vincent, a Torrington lawyer, is among two dozen parents and children’s advocates across the state who have formed a grassroots network that is challenging DCF’s handling of cases involving children with complex trauma-related disorders, many of them adopted. They cite case after case of parents being forced into a situation they call “trading custody for care” – coerced into letting DCF deem their children “uncared for” or neglected and to take over custody, in order to get them into intensive mental health treatment programs.

The parents charge that DCF has left them to manage violent, unstable children on their own, with only limited in-home counseling, and will not provide specialized congregate care or residential treatment. When they cannot access or afford high-level mental health care, or when they refuse to take their children home from hospital emergency rooms because they fear for the safety of their families, they end up in a situation they say is untenable: Relinquishing custody to DCF, which means losing control over treatment decisions and, in some cases, losing track of their children entirely.

Even then, they say, their children often don’t get the help they need; some are simply “re-homed” with other families.

The group, which came together in the past year, is talking to legislators about tightening state rules to eliminate custody relinquishment as an option for accessing intensive mental health services. The group met with DCF officials recently to air their concerns and is considering a class-action lawsuit against the state to contest the practice of using so-called “uncared for” petitions for children with complex behavioral needs who need residential care.

The parents and lawyers allege that financial considerations are prompting the custody-for-care pressure by DCF workers, as the agency reduces funding for children not legally in its care and limits residential placements.

State Child Advocate Sarah Eagan said her office has fielded complaints from families in recent months about DCF employees telling parents of children with highly specialized needs that the only way to access out-of-home treatment is to give up custody. She has spoken to DCF officials about those issues, she said.

DCF officials deny that financial considerations factor into decision-making about custody, and insist that the only instances where “uncared for” petitions would be used to remove children are when the child’s welfare is in jeopardy. The notion that giving up custody is “a requirement or expectation or a norm for accessing congregate care or residential treatment is not in fact” a practice or policy of DCF, said Kristina Stevens, the agency’s administrator for clinical and community consultation and support.

“When you’re facing a crisis, it can be very hard to get through what feels like a very daunting system,” Stevens said. “There may be families who say, ‘I don’t want any of the services being offered.’ (But) our goal is to work with those families,” not to remove children.

The custody-for-care issue is not new. In 2003, the investigative arm of Congress issued a report on the practice of parents placing their children in the custody of the child welfare system solely to obtain mental health services. Of the 19 states that responded to queries from the U.S. Government Accountability Office, Connecticut reported the second-highest number of such cases — 738, or 20 percent of the total.

Child welfare advocates say the practice subsided in 2004, after former DCF Commissioner Darlene Dunbar directed agency staff not to file “uncared for” petitions or otherwise seek custody of children with mental health problems “for the sole purpose of accessing services for the child.”

But in recent years, as budget cuts and a reorientation by DCF have brought reductions in group and institutional care, advocates say the practice has re-emerged.

“They just do not want to pay for intensive out-of-home treatment,” said Bet Gailor, an attorney with Connecticut Legal Services who is working with the parents’ group. “It’s beyond belief what they are doing to families of kids with severe behavioral needs.”

For Jose, who spent his adolescence in group homes, foster homes and residential treatment programs after he was removed from Vincent’s family, the sense of loss is never far away. One day he was part of a family, with birthday celebrations and sibling squabbles; the next, he wasn’t. Sometimes he blames himself for the episodes of rage and violence that led his mother to turn to DCF for help – which ultimately led her to sign away her parental rights, in hopes he would get higher-level care.

He has been in trouble with the police, but says he is working hard to control his anger and depression.

“If somebody had just helped us when I was little, so I could have stayed with my Mom, things could have been so different,” he said.

“I love that kid,” Lisa Vincent said. “None of it was his fault in the least.”

“I Did Them A Favor”

Like other parents who have adopted troubled children through DCF, Susan Russell assumed the state would assist her in getting her son the help he needed for what she was told was attention deficit hyperactivity disorder.

The Barkhamsted single mother, who works in the health insurance industry, adopted five-year-old Kevin and his older sister eight years ago, unaware at the time that Kevin had been abused in a former foster family.

As soon as she met the children, she recalled, “I just fell in love with them.”

But as the years went on, her son’s tantrums turned into violent outbursts; he set fires, stole money and destroyed their house. Russell’s legs were covered with bruises from his kicks, each time she tried to hold and comfort him. He was diagnosed with reactive attachment disorder, a complex psychiatric illness that affects some children who have been neglected, abused or traumatized at an early age.

Russell reached out to DCF for help, through a program known as Voluntary Services, which is intended for children with serious emotional disturbances who are in families not found to be abusive or neglectful. The program rules say DCF “may provide, on a voluntary basis (at the request of the family), casework, community referrals and treatment services for children who are not committed to the Department.” The rules make clear that parents “do not have to relinquish custody or guardianship” under the program.

Russell said Kevin received a number of DCF-sanctioned services, but most were limited in scope and lasted only four to six months. He underwent five rounds of a program dubbed “IICAPS” (Intensive In-Home Child and Adolescent Psychiatric Services), which provides a few hours a week of in-home counseling, she said.

After especially violent episodes, when he landed in hospital ERs, Russell would push for intensive specialized care, armed with recommendations that he receive residential treatment. Instead, he was referred to short-term sub-acute programs or sent home.

His behavior continued to deteriorate.

In April 2015, after Kevin had two violent outbursts and hospitalizations, DCF workers talked to Russell about either taking him home or giving up custody, she said. She rejected both options, concerned about the safety of her two other children – her older daughter and a five-year-old girl she had adopted as a baby.

After Kevin was placed in a short-term treatment program in Hamden, she told him that he couldn’t come home.

“It was the hardest day of my life,” Russell said, tears welling in her eyes. “He just sat there emotionless. I was rubbing his back and asked him for a hug … and he just held onto me for 20 minutes.”

For the next few months, she resisted agreeing to an “uncared for” petition and giving up custody, despite warnings from her lawyer that she could be charged with neglect. She remained hopeful that DCF would help her to access specialized residential treatment.

“When I look into those brown eyes, I can’t walk away,” Russell said in June. “I vowed when I signed my name and made him a full-blown Russell, that I was going to care for him and follow him through this journey.”

On August 24, Russell stood in front of a judge in Torrington, crying as she did the unthinkable:

She gave Kevin back.

“I am his mom. I will always be his mom,” she said. “I have done nothing wrong. I have tried to put this child back together.

“I did them a favor – I took one of their children. And they failed him.”

“A Hobson’s Choice”

State officials do not keep a count of how many parents allow DCF to take custody of their children in an effort to secure mental health care.

Often, parents in Russell’s position are reluctant to speak out because of the “shame and blame” they face from the child welfare system, said Maureen O’Neill-Davis, a Torrington parent advocate who organized the network, which has grown to include families and lawyers from across the state.

Susan Russell on caring for Kevin.

Children in stable adoptive or biological families come to DCF’s attention in a variety of ways. Among the most common: Parents reach out for help from Voluntary Services, often when their insurance does not cover the high costs of residential care; or hospitals summon DCF when a parent does not want to take a child back home.

Although DCF is primarily a child protection agency, in Connecticut, the department also is charged with providing “a comprehensive and integrated” statewide program of services for children and youth with mental illness.

State law makes clear that “commitment to . . . the department shall not be a condition for receipt of services or benefits delivered or funded by the department.”

But in recent years, O’Neill-Davis and others say, as DCF under Commissioner Joette Katz has moved away from residential treatment programs, reports of parents being pressured to give up custody have surfaced, for what the advocates believe are financial and practical reasons.

When states take custody of children, they are able to access federal funds to provide mental health services, the advocates say — and the state no longer has to heed parents’ demands for expensive residential treatment.

Eagan, the child advocate, said DCF policy is “very clear that parents who have children with complex and unmet needs and who meet eligibility for Voluntary Services may receive help to access any public or private community services ‘as needed’ to carry out the case service plan.” She said DCF regulations “contemplate that the child may need out-of-home treatment as part of the service plan.”

Russell, Vincent and other families in O’Neill-Davis’ group describe a patchwork of ER visits, short-term hospitalizations and failed in-home counseling as the mainstays of their children’s mental health care. While they understand DCF’s move away from residential care, they say children with severe trauma-related disorders need specialized settings.

“There is no ‘higher level of care’ in Connecticut, so parents are told to take their children home and are given IICAPS,” a few hours a week of in-home counseling, O’Neill-Davis said.

A June 2016 report from DCF shows 226 children were receiving Voluntary Services, with IICAPS as the most common service. None had primary or secondary diagnoses of reactive attachment disorder.

Stevens said the number of children receiving help through Voluntary Services has declined sharply – down from 992 in July 2004 – largely because of expanded access to community mental health services. She acknowledged that the department’s priority is to “maintain children in their homes and communities,” rather than residential programs, and she recommended that parents who are “struggling at the (social) worker level” to access appropriate treatment bring their concerns to a DCF supervisor or regional administrator.

“Rarely do I hear families say, ‘Give me the high-end institutional setting,’” she said.

Stevens said the department has made strides recently in expanding community treatment options for children with trauma-related disorders.

The parents and lawyers cite a number of cases in which hospitals have called in DCF on allegations of neglect when parents dispute a discharge recommendation and seek residential care. They said DCF or judicial officials present the option of an “uncared for” petition as a way of helping a child access specialized residential treatment.

Some parents have resisted giving up custody. Eileen Bronko of Naugatuck, a former DCF social worker herself, took in her sister’s two young sons seven years ago, after raising her own four children. The younger boy needed intensive behavioral therapy for reactive attachment disorder, she said. Instead, after he received multiple rounds of IICAPS, her request to Voluntary Services for specialized treatment was denied.

After the boy was arrested for assault last winter, Bronko continued to push for intensive treatment. The guardian ad litem assigned to the case told her the way to access residential treatment was to agree to an “uncared for” petition, she said.

She refused.

“We are good parents. We don’t deserve to be treated as anything less than good parents,” she said. “What kind of a world is this where you cannot access intensive therapy without giving up custody of your children?”

Mickey Kramer, the state’s associate child advocate, said some families have resorted to hiring lawyers, calling the governor’s office and applying other pressure to secure residential treatment.

“If we make parents scrounge and beg for highly-skilled services, what does that do to these families?” she asked.

Gailor, the legal services lawyer, said DCF has reduced funding for Voluntary Services and has “badly curtailed its continuum of placements.” She said the dual roles of Connecticut’s DCF — as the state’s child protection agency and its child mental health overseer — are “problematic.” Some families who turn to Voluntary Services become subject to intrusive and unwarranted child-protection oversight, she and O’Neill-Davis said.

Jay Sicklick, deputy director of the Center for Children’s Advocacy, said persuading parents to give up custody for care is “a patent violation of the statute that was enacted to prevent this,” referring to the law ensuring that parents can access appropriate services without committing a child to DCF.

Sicklick questioned Katz’ 2014 directive that she must personally approve requests for children to be placed in congregate or residential facilities. DCF has saved millions of dollars in the last five years by reducing congregate-care placements by 66 percent and out-of-state placements by a full 98 percent.

“It’s disconcerting that someone would paint these children’s situations with such a broad brush,” Sicklick said. “It creates a desperate situation for families of kids with the most severe acuity. If you’re told, ‘We won’t approve an acute-level program,’ what do you do? It’s a Hobson’s choice.”

Eileen Bronko talks about her efforts to get care for her son.

Revolving Doors of Foster Care

In early September, Gov. Dannel P. Malloy accompanied Katz at a news conference in Middletown to laud DCF for a record number of “kinship” placements — placing children with either direct relatives or those who have pre-existing relationships with them.

While experts say such placements are preferable to foster homes, they may matter little to children with severe behavioral health problems who need specialized services.

The Bronkos took in their two nephews through a kinship placement. O’Neill-Davis and her husband took in their two nieces, ages 2 and 3, after her husband’s sister was murdered.

Both faced giving up custody in exchange for care, they said.

O’Neill-Davis’ younger daughter, now 12, was diagnosed with attachment disorder at age 3 and increasingly became destructive and violent, she said. O’Neill-Davis said she reached out to DCF’s Voluntary Services program in 2011 in hopes of accessing an inpatient program, but was denied services. In 2012, after a series of incidents including her daughter slapping another student on a school bus, DCF removed the girl from her home through a “neglect” petition, citing parenting flaws. The child was placed in multiple foster homes in the first 90 days, O’Neill-Davis said.

“It was anguishing,” she said. “We were blamed. She got no treatment. She was told we didn’t love her or want her.”

O’Neill-Davis hired a lawyer to get her daughter back – an effort that she said forced her family into bankruptcy. After the girl returned home in 2014, her aggressive behavior continued. In September 2015, after a string of ER visits and brief stays in the Institute of Living, O’Neill-Davis gave up custody to DCF, fearing for her family’s safety and hoping to get her daughter into intensive specialized treatment, she said.

Instead, the girl spent 10 months in a foster home.

“We have her back now, but we still don’t have appropriate treatment,” she said.

She noted that, if her daughter had medical needs, state custody never would have become an issue.

”Can you imagine telling parents of a child with cancer that they have to give up custody so they can get the care they need?” she asked.

Bronko tells a similar story – years of pushing for appropriate care for her nephews, now 15 and 16, that were met with resistance. When she first took in the boys as a “kinship” foster parent, they received counseling through DCF. But it was not tailored to the boys’ trauma-related attachment problems, she said.

“We had every service they offered, and none worked,” she said. “It’s like giving seizure medication to a kid with diabetes.”

Once she and her husband adopted the boys, “We were dropped. You’re on your own,” she said.

In the last few years, the younger boy threatened one of Bronko’s older children, who was home visiting: “I’m going to slit your throat ear- to-ear while you’re sleeping and watch you bleed to death,” Bronko recounted. Another time, he slammed her husband into a wall.

Bronko, an evaluation coordinator at a regional mental health agency, has scrambled to find therapists and keep both boys at home. She describes her home as an “inpatient jail”; there are cameras and a lock on her bedroom door.

“I do believe children should be at home with their parents,” she said. “But this has consumed my life. It eats you up . . .

“I thought it would be easier for me, because of my background and ability to work with mental health services. It isn’t.”

With DCF laying off workers this year and touting reductions in out-of-state placements – including programs that specialize in reactive attachment disorder – O’Neill-Davis and the other parents are not optimistic that new funding will be coming for higher-level care.

The group is talking to lawmakers about legislation modeled after Illinois’ “custody relinquishment prevention act, ” which requires state agencies to “intercept” a child at risk of custody transfer and provide the family with appropriate services to stabilize the child’s mental illness. The group also wants the state to pursue new funding mechanisms for specialized trauma treatment.

Maureen O’Neill-Davis on the difficulty in getting proper treatment for her daughter.

O’Neill-Davis and others also are lobbying for passage of the federal Family First Prevention Services Act, which would allow states to use federal foster-care dollars to pay for mental health services for adopted and biological children.

Advocates say the custody-for-care issue has rarely come before lawmakers, in part because many parents are afraid to speak out. But at a July 2015 hearing convened by the Children’s Behavioral Health Advisory Committee, Katz spoke about services available to parents who voluntary seek mental health care through DCF. She expressed concerns that too many of the parents accessing Voluntary Services were white and too few were African American, and she acknowledged that fear of losing custody could be a factor in some parents staying away.

“I said this at another meeting and am not ashamed to say it here: Frankly, when I was raising my children and I thought I needed DCF’s help, I wasn’t worried that DCF was going to take them away from me,” she said. “And I recognize that that is still a real fear and concern for families in the communities… and we need to do better about that.”

To see a TV version of this story, tune in to WTNH, News8 Monday night at 6 p.m.