Editorial | Fixing the DHS
A matter of life or death
It's a good sign that broken policies and practices are beginning to be fixed at the Philadelphia Department of Human Services, even before all of the reviews have been completed.
Unfortunately, a good beginning does not guarantee follow-through. The 38,000 abused and neglected children DHS is serving need city and state officials to back up their words with sustained action.
A number of investigations were launched after a 2006 Inquirer series found that as many as 25 youngsters had died in the previous three years after they or their families had come into contact with DHS. A DHS review panel appointed by Mayor Street is set to make recommendations this month.
Soon after his October appointment as acting DHS commissioner, Arthur C. Evans Jr. ordered an internal review of 52 child deaths over the last six years. The Pennsylvania Department of Public Welfare studied 80 cases in which the city paid contractors to do home visitations. The state and DHS reports echo flaws The Inquirer detailed.
Did DHS physically harm any children? Of course not. Most DHS workers deserve credit for engaging in difficult, thankless work to help the city's at-risk youngsters.
But lousy follow-through, too much secrecy, and too little accountability have undercut attempts to improve the child-protection agency. That trio remains the chief nemesis of progress.
The report Evans ordered showed little action on 36 recommendations made in the 52 cases. The suggestions weren't frivolous: They responded to fundamental gaps, such as DHS's incoherent policy for determining the risk of harm that children faced in their homes.
Other recommendations included revisiting families in DHS files after the birth of another child, and checking to make sure that children with physical or behavioral ailments were receiving medical care.
A failure to monitor ill children was among the flaws found in DHS's oversight of 14-year-old Danieal Kelly, bedridden with cerebral palsy, who died last summer.
Danieal weighed only 46 pounds when she died, and suffered from bedsores infested with maggots. Though DHS had opened numerous investigations on her situation, it never noticed that she was missing doctors' appointments and was not attending school.
Evans has shown a good sense of priorities by writing a clear guide for workers to determine what level of risk children face so they are kept in their own homes if possible, yet not left in situations too dangerous to overcome with added services.
A strong risk-assessment guide is the oxygen of child protection.
Evans has directed staff to respond immediately to cases involving children younger than 2. They are the most vulnerable to serious harm. The performance of contracted service providers will be better tracked. The state has been pushing DHS to make these changes as well.
"We are trying to create a sense of urgency in Philadelphia," said state Secretary of Public Welfare Estelle Richman. "They [DHS officials] need to see this as a matter of life and death, not just a matter of process."
That's true. But the toughest reform tasks will likely be buried once again if the public is barred from seeing reports such as child death reviews and data on the gaps found in DHS services.
Yet City Hall insists it won't release important information, including evaluations contained in routine DHS child-fatality reports.
The Street administration says doing so would violate state regulations. That interpretation shields adults who have done their jobs poorly and ill serves children in dangerous situations.
Richman, whose department licenses county child-protection agencies, says secrecy has doomed earlier DHS reform efforts. But the Rendell administration has done little to open up child-protection records to public inspection.
City and state officials can't have it both ways. They are not truly champions of abused and neglected children if they don't do everything possible to improve public services for them. If they don't release reports showing how DHS has messed up, then officials simply are not doing everything possible.