Sunday, March 30, 2014

Sunday Globe Special: DCF Do Over

They screwed up the first injection?

"Social workers also have started gathering more information about what happens to substance-exposed newborns after they get home in an attempt to provide better services, which Gail Garinger, head of the state’s Office of the Child Advocate, called a good start."

The most innocent that must be sacrificed upon the altar of black budget profits for money-laundering banks.

"Cases of newborns with addictions soaring" by Jenifer McKim and Michael Bottari | New England Center for Investigative Reporting   March 30, 2014

MARSHFIELD —  It was not the heroin passed to her in utero by her drug-addicted mother that killed the infant, prosecutors say.

Instead, it was the heroin-tainted milk bottle her parents allegedly handed her five months later in their overcrowded and squalid apartment in this South Shore town. Now the parents, Ryan Barry and Ashley Cyr, are charged with manslaughter for the 2011 death. They pleaded not guilty last year, and the criminal case is pending in Plymouth Superior court.

See: Cyred By Heroin Addiction 

No matter the outcome of the case, Mya Barry’s brief life and untimely death point to weaknesses in a social services system that is struggling to deal with the region’s booming addiction to prescription and illegal drugsa plague that has besieged hospitals with drug-exposed newborns and overwhelmed state social workers for the past five years.

Still working miracles.

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There is no statewide data from earlier years for comparison, but anecdotal evidence suggests the number of cases is exploding....

They are the tiniest victims of the region’s growing opiate epidemic. On Thursday, Governor Deval Patrick declared a public health emergency to combat the increasing abuse of opiates, directing that all the state’s police, firefighters, and other emergency personnel be equipped with a drug that can quickly reverse heroin overdoses.

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The increase in drug dependent babies has hospitals scrambling to care for them, but a potentially bigger danger awaits the children when they leave the hospital.

Most of these high-risk infants go back to the mothers — and sometimes fathers — who caused their drug problems in the first place, according to local doctors who treat opiate-exposed infants. Mya’s story prompts serious questions about whether the state’s social services agency is doing enough to protect children from drug-afflicted parents.

The state Department of Children and Families, which learned about Mya from hospital workers, declined to discuss the infant’s case. But state records, released to the New England Center for Investigative Reporting, show DCF sent Mya home to her father and grandmother, even though they knew her heroin-addicted mother would visit. Although social workers checked on the baby regularly, they apparently failed to see what witnesses described as a rapidly deteriorating situation at the home.

Well.... I can understand it might be an impossible job to be perfect, but they need to stop with public relations imagery and miracle worker stuff. 

Assistant Plymouth County District Attorney Frank Middleton said in the parents’ arraignment in October last year conditions in Mya’s home made it “almost inevitable” that her life would be cut short. Witnesses, he said, told investigators the parents appeared to be doing drugs daily and had trouble caring for Mya and her two older sisters, ages 3 and 4, though Ryan Barry’s attorney denied in court that his client used drugs while Mya was in the home.

Two other kids were caught up in this?

Mya did not even have a crib to sleep in.

Mya’s great uncle Jeffrey Pinkham still wonders why state social workers assigned to protect her left the newborn in what was described by prosecutors as a dirty, cluttered apartment with parents who struggled with addiction.

“They knew how addictive the drug is. They should have been at the house every other day,’’ said Pinkham, 60. “If somebody was there checking on them, why would she have died?”

Dangers at home

Even before Mya drew her first breath, she was in danger.

Her mother, Ashley Cyr, 26, did not know she was pregnant until six months into her term — yet that knowledge did not cause her to alter her daily heroin habit, according to Middleton’s court statements.

????

After her birth, Mya spent six weeks in the hospital being weaned from the opiate. Doctors gave her morphine, a drug used to help infants gradually detox, court records show.

Hospital workers — as required by law — notified DCF that Mya was born with drugs in her system, one among thousands of reports of abuse or neglect against newborns filed in Massachusetts each year.

(Blog editor fins it hard to comprehend the horrible introduction into this world)

Nonetheless, most drug-exposed children like Mya return to their families, said Robert Sege, medical director of the Child Protection Team at Boston Medical Center.

At Boston Medical Center, which treated 106 children last year who suffered drug withdrawal, about 85 percent return to their parents, he said. Most of them were exposed in utero to methadone or buprenorphine, drugs commonly prescribed for those in treatment for addiction.

At this point I'm thinking Pelletiers

So they keep the kids that should be returned to their parents and give the kids back to those they should not. WOW!

Many parents work hard to fight their addictions and get better, he said. Unfortunately, Sege’s own hospital data shows that a large portion — more than a third of parents — end up relapsing. Within a year, their children are often sent to foster care.

Sege said state social workers need to continuously monitor these troubled families because when parents relapse, children are more likely to be neglected, found wandering alone, unclean, or hurt. Boston Medical Center also has seen children die of abuse or neglect after returning home, he said, although he could not provide numbers. Sege said families need more support when they leave the hospital.

This whole economy geared toward the privileged and wealthy has destroyed that.

Social workers investigate the home life of each child identified as born drug-exposed, but Sege said too often they close cases for these fragile children and families quickly....

DCF officials said they are trying to do a better job managing the “explosion” of drug-addicted babies statewide. In January, the agency launched a new training program to teach managers how to identify addiction in adults and recognize when the children of substance abusers are at risk, according to Kim Bishop-Stevens, DCF’s substance abuse manager.

“The problem is growing across the country,” Bishop-Stevens said. “It is becoming more and more of a challenge.”

Before letting a drug-exposed child go home with drug-using parents, state officials say they review the home situation, including housing, family supports, and whether a parent is getting help.

Piss tests doesn't catch them, and where are they getting the money? Theft?

“We would have to have a very solid plan if the mom was actively in treatment,” said Christina Joyce, acting deputy commissioner of clinical and program services at DCF. “Basically, it is a safety decision.”

Social workers also have started gathering more information about what happens to substance-exposed newborns after they get home in an attempt to provide better services, which Gail Garinger, head of the state’s Office of the Child Advocate, called a good start.

Time for me to make a fresh start and get off the Globe.

DCF has been under intense scrutiny since December following the disappearance of 5-year-old Jeremiah Oliver, who is still missing and feared dead after social workers allegedly failed to check on him for months. In response, the governor commissioned a Washington-based advocacy group, the Child Welfare League of America, to review the agency.

See: Can't Find DCF Draft

An initial report, released this month, said the state needs to reduce social workers’ caseloads and upgrade technology, among other improvements, to adequately supervise the 36,000 children under its supervision.

But child advocates such as Laurie Myers, founder of Community Voices, a Chelmsford-based advocacy group for child abuse victims, said problems go beyond caseloads. The state child welfare law states that its first priority is “strengthening and encouragement of family life,” and Myers said social workers often try to keep dysfunctional families together even when it puts the children at greater risk.

In cases involving drug-exposed babies, she said DCF should have distinct and more detailed guidelines to address the children’s specific long-term needs and determine when to pull them out of a precarious situation.

“There was nobody looking out for Mya,’’ she said. “We have to start protecting kids first.”

Representative Sheila C. Harrington, a Republican from Groton, recently filed legislation to make the child’s best interest — not family reunification — the top priority of the child welfare law. She believes that change would make tragedies like Mya’s less likely to occur.

Leaving Mya with her drug-addicted parents “was the most negligent thing they could have done,” Harrington said.

Mya’s mother admitted to state officials that she had been using heroin while she was pregnant, according to a DCF report released to the New England Center for Investigative Reporting. But DCF officials decided to let Mya go home with her father and grandmother on condition that Cyr, the mother, would have no “unsupervised” time with her children, the report said. Essentially, that meant that she would not be left alone with her children, family members say.

But child welfare experts say there is an inherent weakness in placing at-risk children with relatives, who may be unable or unwilling to shield children from drug-addicted parents. Currently, more than 50 percent of children in DCF foster care are placed with relatives, according to DCF.

Social services are so overstretched. How do you ever monitor, pay close enough scrutiny to these families so something like this doesn’t happen?” asked Barry Lester, professor and director of the Brown Center for the Study of Children at Risk at Brown University and Women & Infants Hospital in Providence.

But the government has enough resources to track our movements and collect all our communications so they can spy on us all. Plenty for corporate welfare and war-profiteers that are well-connected. Plenty for lavish political functions and all the rest.

Prosecutor Middleton said in court that Mya’s parents repeatedly lied to a social worker about the fact that Cyr was living at the home.

Mya’s grandmother Debra Pinkham said in an interview that Cyr ended up essentially staying with the family, but other adults were always in the house. She said the social worker was well aware of how many people — nine — lived in the small two-bedroom home. Pinkham also said the house was not filthy, as prosecutors claimed, merely packed.

“They knew that Ashley would come to visit, as far as how long she stayed, I don’t know how much they cared,’’ she said. “We were doing exactly what they told us to do.”

Pinkham, a 56-year-old Dunkin Donuts waitress, said her son Ryan had showed up at her door after Mya’s birth, his two older girls in tow. She could not turn them away. She gave them one of the two bedrooms, the other was used by her adult daughter, her daughter’s husband, and their small child.

Related: Sip of Asian Coffee 

Isn't that dangerous?

Pinkham said she knew that Ashley was using heroin. She also suspected her son was using, even though he denied it. Still, she felt the family was functioning — Ryan still cared for the kids; Pinkham helped out.

She now wishes she had taken her son’s three children, including the baby, and escaped before everything fell apart.

“I know I made the biggest mistake of my life by trying too hard to help everybody,” Pinkham said. “We are not bad people. We are just people who have been struggling with this.”

Peter MacKinnon, a long-time social worker and president of the DCF chapter of the Service Employees International Union, said protecting children from opiate-abusing parents is challenging. Adults can hide their drug use, he said, and social workers can only pull children from their home if they can prove that parents are being abusive or neglectful to such an extent that a child is in immediate danger.

How?

It’s a difficult judgment that social workers and judges alike sometimes get wrong — with fatal consequences for children.

Lives cut short include Chase Gideika, a Lynn baby born with drugs in his system who was allowed to go home with his mother last year even though his older brother, a toddler, was placed in foster care after being found unattended near a busy street.

Three months later, Chase was fatally assaulted, allegedly by his mother’s boyfriend, Anthony Gideika. Chase’s death prompted the Patrick administration to call for a review of DCF’s decision to leave Chase and his twin with their mother and her boyfriend, both in drug treatment. The review by the Office of the Child Advocate is still pending. 

Related: Maury Povich Murder in Massachusetts

In February of this year, 23-month-old Lucas Braman, also born with drugs in his system, was found unresponsive in his Yarmouth crib in the home of his mother’s cousin, who was caring for him.

This post might shed some light on it.

Lucas had lived in a foster home, but was sent to live with relatives by a judge last year despite opposition from social workers, according to DCF spokesman Alex Loftus.

Prosecutors said there is no indication of foul play in the child’s death, but the toddler suffered from physical and emotional problems related to his neonatal drug exposure. Cape and Islands District Attorney Michael O’Keefe declined to speculate on how Braman died.

However, Elizabeth Cavallini, who was caring for Lucas when he passed away, believes his prenatal drug exposure contributed to his death. Lucas had many health problems, she said, such as banging his head against the wall so much he had to wear a protective helmet.

Cavallini, whose partner is a cousin of Lucas’s mother, said social workers should never have let Lucas go home with his mother in the first place and they should have provided more help caring for his fragile health.

“I’m extremely frustrated with the lack of concern with Lucas when he was born addicted to drugs,’’ Cavallini said. “It is not fair that these women can do drugs their entire pregnancy and walk out of the hospital with their babies. That is abuse in my eyes.”

A tragic end

Mya’s life came to an abrupt end on Sept. 23, 2011, when Marshfield police found the infant, cold and blue, lying on the living room floor, prosecutors said....

I couldn't read anymore.

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Also see: The End of Riley

Related: Woes in child welfare agency run deeper than Jeremiah Oliver case

Yeah. If it were one case or two maybe not, but the Globe listed a bunch of them above. they problem is systemic. 

Time for a hit:

"Governor declares an emergency on opiate abuse" by Brian MacQuarrie | Globe Staff   March 27, 2014

Governor Deval Patrick declared a public health emergency Thursday to combat the growing abuse of opiates, directing that all the state’s police, firefighters, and other emergency personnel be equipped with a drug that can quickly reverse heroin overdoses.

“Heroin today is cheap and highly potent,” Patrick said. “We have right now an opiate epidemic.”

Another part of his legacy.

In addition, the governor said, the state will prohibit the sale of Zohydro, which he called “a potentially lethal narcotic painkiller.” The drug was approved last year in a controversial decision by the Food and Drug Administration.

Patrick said the powerful drug, which is not yet made in tamper-proof form, will be banned until safeguards are implemented. Addiction-treatment providers have warned of Zohydro’s high potential for abuse.

The governor also pledged to spend $20 million more to increase treatment and recovery services for the public, state prisons, and county jails.

He took it from heating aid to give to late-night T service, and then the legislature had to replace it due to the cold winter.

The moves, approved Thursday by the Public Health Council, were applauded by state officials and first responders, who have been startled by an alarming increase in heroin overdoses across Massachusetts. The Globe reported last month that at least 185 people died of heroin overdoses between November and February....

Another component of the state’s action will be a mandate that physicians and pharmacies monitor prescriptions of narcotic painkillers and other drugs linked to abuse. Such checks had been voluntary, the governor’s office said.

“We must have more rigor over the overprescription of pain medication,” Patrick said. Opiate overdoses in Massachusetts rose 90 percent from 2000 to 2012, the governor said.

A keystone of the plan is making Narcan more available to police, firefighters, and people close to drug addicts....

Who make$ Narcan?

Under the emergency directives, every first responder will be permitted to carry and use Narcan immediately. The state also will work with medical directors of large pharmacies to write standing orders that will allow Narcan to be purchased by individuals, Bartlett said.

That answers that que$tion, and explains even more why where the poison is coming from is never addressed. Another monied intere$t profiting from the problem, and the state so compassionate in its reactivity.

Judge Rosemarie Minehan, the presiding justice at Plymouth District Court, attended Patrick’s announcement at DPH headquarters in downtown Boston. The fallout from opiate abuse has become an increasing part of the workload in many courtrooms, she said.

On March 18, a man in the jury pool at Plymouth District Court crumpled from an overdose, the judge said in an interview. He turned blue as police, firefighters, and medical personnel, all potential jurors, frantically tried to revive the man’s heart.

As they worked, a woman rushed forward and pulled Narcan from her purse. Within minutes, two doses of the drug had halted the overdose.

“Intervention was very important,” Minehan said.

The cost of expanded Narcan use is expected to be covered by a combination of state and local funding....

State Senator John F. Keenan, a Quincy Democrat who co-chairs the joint Public Health Committee, welcomed the governor’s actions but cautioned that the opiate epidemic will not be curbed easily.

“These are critical steps,” he said. “We also have to recognize that these are just first steps, second steps, and third steps.”

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Related: From Where is the Killer Heroin Coming? 

Globe never asks.

Been over a week since I smoked, and the Globe has only offered one hit since:

"Marijuana licensees to face new scrutiny" by Kay Lazar and Shelley Murphy | Globe Staff   March 28, 2014

The Department of Public Health has notified companies approved for provisional licenses to run the state’s first medical marijuana dispensaries that they will be required to undergo extensive additional background checks, an action that caps weeks of controversy about the selection process.

They are scrutinizing medical marijuana even more than the criminal casinos!

The department’s letter, obtained by the Globe, states that background checks will now be required on anyone “who will have any involvement” with the proposed dispensaries, including volunteers, consultants, advisory board members, staff members, and all corporate and individual investors....

It is unclear whether this new round of scrutiny will delay the opening of the dispensaries, most of which were expected to be running by August, according to earlier projections by the department.

The expanded background checks come as the state defended its selection process in Suffolk Superior Court Thursday....

Since the state announced its choices, several problems have surfaced about misrepresentations and conflicts of interest involving several of the companies selected, and state officials have acknowledged they did not check the veracity of the companies’ statements in their applications.

Has any industry been cleaned of $eeds and $tems so completely? 

“All the vetting should have been done before they awarded any of the licenses,” said Stephen Werther, president of Alternative Compassion Services Inc., which unsuccessfully applied for a dispensary license in Bridgewater but is not a party to the suits.

A spokesman for the Department of Public Health declined to comment Thursday.

Letters about the intensive background checks were sent on March 14 to companies selected for the 20 provisional licenses.

“These follow-up background checks are only one part of the ongoing verification process,” these letters said.

DELAY, DELAY, DELAY! 

How many people must needlessly suffer for how much longer?

On Thursday, the agency sent similar letters to six companies that were not chosen for provisional licenses but were invited by the state to reapply in one of the counties that has not yet been earmarked for a dispensary.

Companies are being charged $550 per individual checked, according to the letters. That’s in addition to the $30,000 charged for the application fee in November.

I'm not opening up a shop anytime soon, and I thought I could be an entrepreneur rather than an unemployed nobody. Wish I had a do over.

Amid the brouhaha, Back Bay business groups had raised an uproar, saying the fashionable, upscale shopping district was not an appropriate site for a drug dispensary.... 

I agree, what with the fire and all.

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Yeah, forget the meth labs and cocaine and go after the marijuana

Maybe they could locate the dispensary in Utah:

"Utah to allow marijuana extract for limited medical use; Substance believed to fight seizures comes from Colo." by Michelle L. Price | Associated Press   March 26, 2014

SALT LAKE CITY — Parents of Utah children with severe epilepsy are cheering a new state law that allows them to obtain a marijuana extract they say helps with seizures, but getting it involves navigating a thorny set of state and federal laws.

Does it make the kid feel normal?

Governor Gary Herbert, a Republican, has approved the law and held a signing ceremony for about 50 parents and children at the Capitol Tuesday.

I must be high!

The new law does not allow medical marijuana production in Utah but allows families meeting certain restrictions to obtain the extract from other states. Similar legislation is pending in at least one other state, and advocates hope more will follow.

The marijuana extract, which some believe helps with a severe form of epilepsy, is produced in Colorado and is designed to not produce a high.

I burned my lips last time I was there.

Specialists say restrictions passed in Colorado to appease the federal government make it a murky process for Utah families to get marijuana-derived products, particularly as all state medical marijuana laws are illegal under federal law.

Then I don't even want to smoke.

Utah Representative Gage Froerer, a Republican from Huntsville who sponsored the new state law, said families are willing to take that risk to treat their children with the oil.

‘‘They know very well that this may not protect them from the DEA if the federal prosecutors stepped in,’’ Froerer told his colleagues this month.

To gain support in conservative Utah, the push for the legislation focused on helping children suffering from a severe form of epilepsy and the law is tempered with restrictions.

The law takes effect on July 1 and expires in 2016. It is restricted to those with severe epilepsy for whom regular treatments are not effective, and requires a neurologist’s consent to obtain and use the extract.

The extract comes from a strain of marijuana called Charlotte’s Web, named after the first child treated with it. The plant is low in THC, the hallucinogenic chemical in marijuana, and high in CBD, a chemical that might fight seizures.

Doctors and others have warned that there is no proof that the extract is effective at treating epilepsy or even safe, but for parents like Jennifer May of Pleasant Grove, the hope that the oil will give their kids a better quality of life is worth pursuing....

No proof because they have done no studies.

A similar medical cannabis oil bill was passed recently by the Alabama Legislature and awaits the governor’s signature.

Alabama, too?

Some legal specialists say states authorizing certain strains of marijuana medicine may be unlikely to produce any relief for patients....

Now take this sick-making pre$cription pharmaceutical they are paying me to promote.

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Well, you know, it's Utah:

"Ski area says snowboarders’ suit demeans the Constitution" by Brady McCombs | Associated Press, March 26, 2014

SALT LAKE CITY — A Utah ski area that is one of the last US ski resorts to prohibit snowboarding says a lawsuit challenging the ban demeans the Constitution and should be thrown out.

In a lawsuit filed in federal court in January, four snowboarders asserted discrimination on national forest lands....

The snowboarders contend in the lawsuit that Alta dislikes them for their allegedly reckless activity on the slopes, inconsiderate attitude, baggy clothes, and their overuse of such words as “gnarly” and “radical” when describing difficult terrain....

The lawsuit has reignited a long-festering culture clash on the slopes between skiers and snowboarders....

The lawsuit concedes that snowboarders were “perhaps rightfully” stereotyped as riffraff decades ago by more sophisticated and affluent skiers, but times have changed.

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