by Beam, Cris
I had scooped up Dominique’s cell phone, which had also been thrown to the far side of the street. After Dominique had been rushed through the back of Jamaica Hospital, I flipped through her contact list to call her foster mom.
I reached her on the third ring and told her, as evenly as I could and with a preface that Dominique was basically fine, that there had been an accident. Dominique had been hit by a car.
“Call the agency! Call the agency!” shouted the woman at the other end. This was not the answer I expected, so I explained the incident more thoroughly. I said the car had been going slowly, Dominique was conscious, and so on.
“Call the agency!”
“OK,” I answered. “But she’ll need someone here with her. They cut her clothes and—”
“I can’t come there!” the foster mom interrupted. “I’m in Manhattan. Call the agency.”
My stomach knotted and dropped as the subtext of her words hit me full on. She didn’t care to know what had happened to Dominique. She just wanted to pass on the responsibility.
I spoke slowly, realizing I was going to have to start issuing commands. “We’re at the emergency room of Jamaica Hospital in Queens. Dominique is going to need some clothes to leave here, so—”
Again, the woman interrupted. “I’m all the way in Manhattan. Call the agency. They should have some clothes.”
I said I would give her my number so she could call to find out how Dominique was.
“I don’t have anything to write it down with. Call the agency.” And she hung up.
Sadness folded through my body and I slumped in my chair alongside all the other tired people in the waiting room. After Dominique’s fifteen-year tenure in foster care, this is what it could offer her: a final stop with a “grandmotherly type” who wouldn’t come to the hospital.
I called her caseworker. I’d called her before, several times actually, whenever Dominique had fallen off my radar or changed her phone number or lost her phone (which was fairly often), to find out where Dominique was living and how she was faring. I had gotten only the caseworker’s voice mail, and she had never once returned my calls. This time, though, perhaps because there had been an accident, she called back in ten minutes.
But the caseworker couldn’t come to the hospital either; she was working in Harlem and she didn’t have time. She’d send a colleague who was in the neighborhood and who could bring Dominique some clothes. I knew Dominique wouldn’t be happy in a gown that flapped open in the back, and the caseworker agreed; her colleague could arrive in ten minutes.
I waited four hours. I couldn’t in good conscience leave Dominique alone, sad and scared in the ambulance drop-off area, where she lay sequestered in a bed next to eight other patients, one of whom was visibly pregnant with bandages wrapped around both wrists. It was crowded and chaotic in that room, with patients groaning in pain or yelling for water; every time I tried to get information about Dominique’s case, someone in scrubs would tell me he wasn’t her doctor and no, he didn’t know who was. All Dominique and I could gather was the obvious physical evidence: she had been x-rayed and catheterized, and she had an IV dripping fluids into her arm. We figured nothing was broken or she would have been set up with a cast by now, but we couldn’t tell for sure.
“Oh, her?” said a doctor, when I had finally commandeered some attention from an exhausted-looking man at a computer terminal. “She’s been admitted. We’re just waiting for a room to open up.”
Dominique wasn’t having it; she tried to yank the IV from her arm as soon as I brokered the news. “I’m signing myself out!” she shouted. “They can’t make me stay!”
A nurse shuffled up to her bed and explained that Dominique couldn’t leave. She’d had a head trauma and needed to be monitored for the night. Then he walked away.
“I hate hospitals,” Dominique moaned. “The last time I was in one, they said I attacked the doctor! I didn’t attack the doctor! I just can’t be having people examining me.”
I asked her if it would be possible to sleep over if she had someone stay with her, to make her feel safer. Even as I said it, though, I felt the falseness of my words: Dominique didn’t have anybody like that in her life.
“I don’t like people to pity me,” she said, her voice now small and miserable. She agreed at least to wait until she could talk to her doctor, whoever he was, to determine the risks in leaving. I wondered where the agency social worker was, and why I was doing her job. And despite Dominique’s wishes to avoid “pity,” I went outside to make a phone call. To Fatimah.
“Oh my God, oh my God, is she OK?” Fatimah gasped when I told her where we were. Even though they didn’t see each other so much anymore, Fatimah still considered Dominique her sister. They had lived together at the Greens’ for seven months, but more than that, they shared a kind of unspoken understanding about growing yourself up in the free fall of foster care.
“She’s fine,” I said. “But can you come to Jamaica Hospital? I’m with her now, but I don’t know if anyone from the agency is going to show up. And she needs clothes, and she doesn’t want to stay the night; maybe you could talk to her?”
And there was the irony: with all of the people paid to care for Dominique, hired expressly to provide her clothing and family and tools to navigate bureaucracies like hospitals, I was reduced to calling another foster kid for help.
“Of course!” Fatimah gushed. She said she’d be right there. But Dominique was a lot bigger than she was; maybe she could buy something for her on the way. Fatimah had a job at a high school cafeteria; she wasn’t enrolled in classes, but she had a paycheck, and she could buy Dominique some clothes.
And then, finally, the social worker showed. Without any clothes.
“Did you call her foster mom? Can’t she bring them?” the social worker asked me, patting down her hair. She couldn’t explain why it had taken her four hours to arrive at the hospital, but she wanted to know if I could drive Dominique home.
“I don’t have a car,” I said. “I came in the ambulance.” I explained that Dominique wanted to sign herself out, and that the social worker would need to locate the doctor, as I hadn’t yet found him.
But the social worker, who was probably just a few years older than Dominique, was entirely focused on transportation. “Where’s your car then?” she asked.
I ignored her. I tried to get her to follow me past all the rushing nurses and people on cell phones and into the room where Dominique was waiting.
“I prefer to do things professional,” she said, glancing around at the patients on gurneys lined against the walls. “I’ll wait in the waiting room until a doctor calls me.”
I stared at her. We were in Jamaica Hospital, famous for its overcrowding; the emergency room was built to hold sixty thousand patients a year, but it had admitted more than double that the year before. No doctor was going to call her.
“Couldn’t you stay and sign the release papers?” the social worker asked when I explained again that Dominique would need help getting someone to pay attention to her in the chaos of the emergency patient room. “I can’t sign anything for her.”
I spoke as if the social worker were a very young child: “Dominique is an adult,” I said. “She can sign her own name. She needs someone to advocate for her, because she is hooked up to an IV, in bed. Advocacy is your job.”
The social worker looked bewildered, but when I said I had to leave, she followed me when I went to say goodbye to Dominique. I found her sitting up in bed, texting messages into her phone.
“I’m leaving,” Dominique said happily, as I leaned down to give her a hug, gingerly avoiding the IV drip. “I already posted it to Facebook. And they’re gonna give me some scrubs to leave in.”
The social worker waved to Dominique from a few yards away and then trotted off to wait in the waiting room, presumably for someone to call her name. I felt bad going, but I had to teach a class, and anyway, an hour later, when I logged on to my computer, Dominique
was back on Facebook, saying she was home and mad as hell. Did anyone know a lawyer? She was going to sue that lady in the Toyota.
Epilogue
OVER THE SEVERAL YEARS I spent writing this book, a few lines from a few people kept rising above all the noise of research and interviews to guide my thinking and final theories. One was Kecia’s “You gotta rock with a kid, all the way,” as that simple dictum consistently proved key to a foster child’s ultimate internal survival. Kids who had someone who would “just stay,” whether they be biological parents who had support shored up beneath them or foster or adoptive parents who would go the distance, fared the best. If Kecia’s prescription were the central goal in child welfare policy—rather than, say, child safety or parental reunification—I think we’d start shifting toward a healthier system in general.
The other line came from Doreen. She was discussing her daughter, but it could be (and has been) applied to extended families, the child welfare system, civil rights, and civil wars—anything where human beings trot out their personal traumas and try to make change. Doreen said, “History keeps playing itself.” Over the five years of this book, kids replayed their parents’ patterns; agencies repeated their mistakes of the past. We do what we know, usually, not what we think, and we’re all, as Arelis once put it, “the self-destruct buttons of ourselves.”
Lei, the foster kid who aged out of care into college and then went to teach in Taiwan, also repeated a part of her history, by returning to New York to work in child welfare. I met with her this past summer, my very last interview, behind the 42nd Street library. It was the day of the National Puerto Rican parade, and all around us families waved flags, slurped up flavored ices, or leaned against one another on the library steps.
“In my own foster care experience, I had so many different workers, because the turnover rate is so high, but now that I’m in the field I know why: the low pay, the high stress. Over time, you get burned out, and you feel really disappointed,” Lei said about her new perspective as a giver rather than receiver. She looked different from four years prior: her hair was cut in a shaggy bob, and her face had softened. Gone was the “mmm-hmmm” tic that punctuated the end of most of her sentences, and she seemed tired—probably because she was working full-time in preventive services for an agency that contracted with ACS and going to graduate school on the weekends. She earned $41,000 to case-manage thirteen high-risk families, and she was “disappointed” because she had to spend more time writing reports than meeting with her clients, and, she said, she had to “conform” to the bureaucracy around her. “There’s a timeline for every case we have, and a number of contacts we have to make per week. The statistics are all about money—so you know a family needs more help but you have to close the case because you’ve met the expectations.”
Still, preventive services, I think, are the hopeful future of child welfare, especially as states shift toward the Florida-esque waiver options. In 2011, President Obama signed an act that allowed all states to apply for flat-sum waivers from the government. With flat sums, kids don’t have to be in foster homes to garner income for the agencies, so money is generally spent on preventive services to avoid the more costly removals. And agencies can spend waiver money as they choose (as opposed to the per diem pay structure where they have to justify each move with time-consuming paperwork), so ideally, people like Lei will be able to spend the time they should on the needier cases.
By the end of 2012, nine states had been approved for waivers, though more could still sign up. In New York City, ACS is currently piloting a foster care program with five of its agencies, wherein they’re allocating more money to hire more workers to provide deeper, more meaningful foster parent support and to make sure their kids are out of care within the ASFA timeline. They’re “front-loading the system,” as Francine Cournos would say. And if it works, Commissioner Richter told me, it would be like operating under a waiver system—wherein the pilot program has the freedom to allocate funding up front where the kids need it, and before they’ve tumbled down a roster of more restrictive and expensive placements. In fact, he told me he’d like to use the experience with the five agencies and expand it to the entire foster care system in New York—by applying for a waiver for the whole city. Later, the state did apply for the waiver and is now awaiting federal review; this is undoubtedly a positive trajectory.
Lei said she didn’t know that ACS had merged with juvenile justice, even though the merger happened long before we spoke. Mostly, she spent her days battling bureaucrats who did the same old things in the same old ways: “history playing itself.” So Lei worked extra hours for the families she cared about. In one of her recent cases, a teenage boy hadn’t attended school for three years; he was physically too large for the frustrated mom to force anywhere. Lei called the police, hospitals, the courts, the Board of Education, even her congresspeople, and everybody told her the boy didn’t fall under their jurisdiction; he hadn’t committed a crime. Eventually, after nearly a hundred phone calls, Lei forced a residential school to accept him, the Board of Education to foot the bill, and ACS to pick him up and deliver him to the locked campus.
I don’t know if that boy will feel abandoned, as Kecia did, to a residential school, or if he’ll feel that someone rocked with him all the way to an education; perhaps, right now, this is the best we can do. I do know that mother needed outside help, and she got it from an agency that contracted with ACS. Persuading families to trust child welfare will take tremendous effort, and perhaps several more generations. Lei lamented the grim reputation ACS still held with most of her clients.
“When an ACS worker investigates a case, they knock on the door like they’re the real police, and that’s still a big problem for a lot of my clients. The agency is always talking about cultural competence, but how dare you go into a home, check this, check that, when all sorts of families—Indian, Chinese—are not very open, not very American in that way,” Lei said. She waved her hands up toward the fancier apartments surrounding the library. “I say this because ACS rarely investigates the upper class. They know those people have lawyers.”
Still, I think there’s some hope on this front too, as in the past few years, groups like the Child Welfare Organizing Project in New York have changed the very business of child removals, making sure biological parents are involved in deciding where their kids go, and that they have more peer support as they work with the system rather than against it. There’s more room for allegiance and trust, but any partnership is promising.
And everywhere, the foster care numbers are down, which means everywhere, more kids are staying home to begin with. When I started this book five years ago, there were 488,285 children in care nationwide; when I was done, there were 400,540. All the problems—the racial disparity, the institutionalizations, the aging out into nothingness—are ongoing and likely will be for decades, if history keeps playing. And the poverty aspect of foster care is particularly troubling, as the one shining truth in my research was this: the poorer you are, the more likely you are to get entangled with child welfare. Between 2000 and 2008, the number of children living in poverty in America increased by 2.5 million, or 21 percent. And that was before the recession. In New York City, more than a quarter of all kids lived at or below the poverty line in 2008.
So that’s the bad news. Poverty is everywhere. And we have a broken system, made by fallible people with fallible families (stare at my tree; stare at yours). As Arelis said, we may have better and more creative ways to shove the puzzle pieces together, but the game was shattered so long ago, it’s never going to integrate perfectly. There are fault lines; tap them and they’ll break again.
And still. Poverty is a wide, wide road with many on-ramps for improvement. That’s where I feel some courage and optimism for child welfare—because we don’t have to fix the system directly to make things better for our kids. Work on one small aspect and we’ll be working on the whole. Better school lunches, better libraries, after-school
care, neighborhood resources—anything that touches social reform touches foster care too.
I wrote this book to be more descriptive than prescriptive, placing the why above the what next. There are countless academics and organizers and families with countless good ideas. Even politicians are getting in on it; in 2012, Congress launched its first-ever “listening tour” for its Congressional Caucus on Foster Youth, and listening is a good place to start. As for Lei, though, she’s getting out. She’ll stay in her job as long as it takes to get her master’s degree in social work, and then she’ll move on to higher ground—maybe, she thinks, doing policy for the UN. “This is my steppingstone; I need some ‘staybility,’” she told me, and she pronounced it that way—stay-bility. She watched her case-managing peers, and she saw a depressing trajectory. “People who have been in social work for a long time, they lose their passion. I mean, where’s their empathy? I don’t want to lose my faith in humanity.”
Still, if I believe that everything around us touches child welfare—and I do—then Lei’s future work, whatever it is, will ripple out. Looking around at all the families clutching their Puerto Rican flags and heading home, Lei said, “I want to get old and say to myself, ‘You have treated people well. That’s all.’”
Notes
Preface
1. [>] daughter, Alicia: Name has been changed.
[>]. [>] more than 400,000 kids: When I began reporting for this book (September 2007), there were 488,285 children in care nationwide; by September 2011, there were 400,540. The AFCARS Report, No. 19 (Washington, DC: U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau, estimates as of July 2012). http://www.acf.hhs.gov/pro grams/cb/resource/afcars-report-19. When I began reporting for this book (September 2007), there were 488,285 children in care nationwide; by September 2011, there were 400,540. The AFCARS Report, No. 19 (Washington, DC: U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau, estimates as of July 2012). http://www.acf.hhs.gov/pro grams/cb/resource/afcars-report-19.
