A Snapshot of Ohio’s Broken CPS System UPDATED

This snapshot is about a 200-pound boy (now 8 years old) from Cleveland Heights, Ohio. Removal of a child from a home is a drastic step that should be due to imminent risk to the child.

The story begins when as The Cleveland Plain Dealer explains ” County workers were alerted to the child’s weight in early 2010 after his mother took him to a hospital for breathing problems. He was diagnosed with sleep apnea, which can be weight-related, and was given the breathing machine. Social workers began to monitor him under what the county calls protective supervision.

Last year, the boy lost weight but in recent months began to gain it back rapidly. That’s when the county moved to take the child, records show. [Many subsequent stories fail to mention that he did initially lose weight.]

The mother said that when she found out that other kids and a sibling might be giving her son extra food, she tried to put a stop to it and explain to him that he could eat only certain foods.

She tried to follow the recommendations of the doctors, such as getting him a bike and encouraging him to get exercise.

The mother wonders what role genetics plays in the boy’s condition — both she and his father and some other family members are overweight, she said. However, she also has a 16-year-old son who is tall and thin.

The mother agreed to enroll the child in a special Rainbow Babies & Children’s Hospital program called Healthy Kids, Healthy Weight.

That program has evaluated more than 900 overweight and obese children from the ages of 4 to 8 since 2005. A team of specialty doctors, nutritionists, psychologists and others treat the children and work to educate families about creating healthy eating habits.”

WKYC says “In June 2010, he was put under Protective Supervision of Juvenile Court, but was still living at home while professionals worked with the boy and his mother to try to get his weight under control.

In December 2010, the boy turned eight, and weighed 196.

A few months later he was up to 215. This past March, the court’s supervision was continued, while they kept working with the boy and his mother.

But on October 19, the county decided the child’s health was in danger and he was removed from his home and placed in foster care.

Then four weeks ago, his mother asked the court to return her son to her. The boys turns nine in a couple weeks and that’s the date his mother finds out if she’ll get him back.”

“Cuyahoga County Children and Family services thinks they have made their case for having to remove him” as they have a written record of all the interventions.

Pediatric Endocrinologist of the Rainbow Program Discusses the Issue

The Cleveland Plain Dealer says “Dr. Naveen Uli, a pediatric endocrinologist and co-director of the program, said he is seeing more children who are quickly developing diseases that in the past were seen only in adults, like Type 2 diabetes and hypertension. These can affect a person’s health, life span and health care costs, he said.

But he said interventions need to be targeted, if possible, for the whole family.

Uli said many families in the program have found it difficult to relearn how to eat, to read and translate confusing food labels and to make the healthy choices. Not all families complete the intense 12-week program, or they are unwilling or unable to grasp the seriousness of the threat, he said.

There is no policy on whether to report obese children to the county if they do not complete the program, but doctors can call if they think the child is at risk.

Uli said most of the children don’t require immediate medical intervention but instead need help to prevent them from getting diseases like diabetes.

Uli said that in most cases, he thinks that keeping the family unit intact is better. But if that doesn’t work, other interventions have to be derived, he said.”

Taking the Side of Removal of the Child

“Earlier this year, Dr. David Ludwig, Harvard University professor and pediatric obesity expert, urged children’s services agencies to intervene in severe cases when parents have failed to address a weight problem that leads to imminent health risks.

Ludwig, the co-author of an article that appeared in the Journal of American Medical Association this summer, said other interventions should be tried first and that children should be removed only as a last resort.

The article cited the example of a 12-year-old patient of Ludwig’s who weighed 400 pounds and had developed diabetes, cholesterol problems, high blood pressure and sleep apnea — conditions that could kill her before the age of 30. ”

“Removal Was Wrong” Side-Bioethicist Stance

MSNBC interviewed Dr. Arthur Caplan, professor of bioethics at the University of Pennsylvania in Philadelphia.

“I think it’s a bad policy,” Caplan told Tamron Hall, host of MSNBC’s NewsNation. “Moving kids out of the home is wrenching for them, they’re going to live with strangers. You’re creating emotional turmoil.”

Caplan, an msnbc.com contributor, says the solution is working with the entire family to change behavior. “The problem with an overweight child doesn’t end with the child and moving him out of the house because he’s going to come back to the house. You’re going to have to figure out ways to change bad habits with the whole family.”

Caplan noted that the child may also be indulging outside of his mother’s watch. “This parent, unless you’re going to monitor the kid 365-days a year, 24 hours a day, who knows where [he] may be getting the food. [The parent] may be making the effort to get the kid to be less obese.”

Not only is it bad for the child to be taken from his home, it’s bad for the foster care system as well, he said.

“It can’t be the right answer to turn to foster care. There are too many overweight kids. You’d overwhelm the foster care system if this became the policy.”

Caplan also fears that children from low-income parent homes with limited access to healthy foods will be targeted.

“Does anyone really think a 200-pound kid in a rich family household out in the burbs is going to be put into foster care? Because I don’t. I think it’s going to fall mainly on the single moms, on the poor since they don’t have the resources to resist this. Plus, we have no reason to think this will work.

There’s no study that shows taking kids out of the home and putting them somewhere else is going to make him skinnier.”

American Society of Bariatric Physicians Stance on Government Intervention for Obese Children

The ASBP does not support removal of children from the home. Their statement (see pdf in Sources section) points out some practicalities as well.

“”Approximately two million children are severely obese, clearly more than an overburdened foster care system can handle.

Research has shown that the quality of life of an obese child is analogous to that of a child with cancer. Obese children are discriminated against by peers and teachers, and are bullied relentlessly.

The additional insult of removing a child from her home will in most cases do more harm than good.

In addition, given the fact that 2/3 of our society is overweight and 1/3 obese, the chances that a child will be placed in a home of family who itself struggles with a weight problem is more likely than not.”

Rally says: Social Workers should not be doing the job of Health Professionals! And to prove the point in this case…

Current Situation of this Child in Foster Care

The Cleveland Plain Dealer says “In the Cleveland Heights case, county workers believed that disconnecting the boy from his family, at least temporarily, might help. And he has lost a few pounds in the last month.

But now lawyers for the mother say they’ve been told that the foster mother who has the child in a neighboring suburb is having trouble keeping up with all of his appointments.

There was even a discussion about getting the foster mother additional help or moving the child again, this time to a foster home with a personal trainer, Amata said.

“I wonder why they didn’t offer the mother that kind of extra help,” Amata said. [Yes, why did the biological mother not get offered a personal trainer, which would be a MEDICAL intervention in this case, not a luxury?]

WKYC reports “But Tuesday night Channel 3 learned from court records that, while away from his mother in foster care for his own health, the child is having dreams of dying, is wetting the bed, and is anxious that the world is going to end in 2012.”

Sources:
County places obese Cleveland Heights child in foster care
[The Cleveland Plain Dealer 11/26/11 by Rachel Dissell]

Obese third-grader taken from family: Did state go too far?
[CBS News 11/28/11 by Ryan Jaslow]

Officials wrong to take 200-pound boy from mom, bioethicist says
[MSNBC 11/28/11]

Mother wants overweight son returned to her
[WKYC 11/29/11 by Dick Russ]

American Society of Bariatric Physicians Statement-No Support for State Intervention of Childhood Obesity

Update: The boy’s “mother is now represented by the American Civil Liberties Union. Attorney James Hardiman says the ACLU got involved because this case could set a dangerous precedent if children are removed from their parents solely because of weight issues.

County prosecutors represented CFS and both sides agreed that the best temporary solution is to place the boy in the custody of his uncle who lives in Columbus.

The boy will spend the holidays with his mother and after this school semester is over he’ll move to Columbus until the next hearing on February 27th.”

Obese Child Will Now Live With Uncle
[WKYC 12/14/11 by Monica Robbins]

“A boy removed from his mother’s custody over health concerns when his weight ballooned to more than 200 pounds will be taken from foster care and placed in the custody of an uncle, a judge ruled Wednesday.

Judge John Hoffman also said the boy, who celebrated his 9th birthday Wednesday but didn’t appear in court, would be allowed a weeklong visit with his mother for Christmas. His name was withheld by Cuyahoga County Juvenile Court.

The mother left court without commenting, but the placement with her brother living in the Columbus area had been accepted by all sides before it was announced during a brief court hearing.

The court-appointed attorney representing the boy’s interests, John Lawson, said he was sure the youngster would be happy with the agreement.

“This is only an interim plan because the real goal of everybody here is to get him back in his home with his mother and his sibling,” a brother, Lawson said.

“He’s a very smart boy and I think he’s got goals about himself,” Lawson said, including losing weight.

While in foster care, the boy’s weight dropped from about 200 pounds to 192.

Mary Louise Madigan, speaking for the Cuyahoga County Children and Family Services agency that sought foster care for the boy over weight-related health issues, said having the uncle caring for the boy was part of the county’s goal of getting him to a healthy weight and back with his mother.

“He’s in a least restrictive placement with a family member and I think that’s what the court was looking at,” she said.

The American Civil Liberties Union of Ohio joined the case on the boy’s behalf and said he should be with his family.

“We think it’s a fundamental liberty for a child to be brought up in his home among family and friends,” said the ACLU’s James Hardiman.

Taking a child from the home over weight issues could set a bad precedent, he said.

“We’re concerned that if this were to establish a precedent that it would be a pretty dangerous precedent. So we take it as a basic fundamental civil liberties issue,” Hardiman said.”

In the comments: Leonard Henderson, co-founder of  American Family Rights explains the two laws that were not followed in this case as “”It is worth pointing out that the agencies do not make even the pretext of complying with the Reasonable Efforts requirement mandated by 42 U.S.C. § 671 (a) (15) http://bit.ly/sCv9Sa

-nor with the Relative Placement law 42 U.S.C. § 671 (a) (19) http://bit.ly/sc4hwm   ”

Judge says 9-year-old Ohio boy who weighed 200 pounds will leave foster care, live with uncle
[Washington Post 12/14/11 by Associated Press]

“Lawyers for the boy, his mother and the county hammered out the deal behind closed doors Wednesday.

As a part of the agreement reached in Cuyahoga County Juvenile Court, the boy will stay with his uncle, a Columbus-area Realtor, and his family until at least February when the judge will review the case.

The child’s mother will have unrestricted visitation with him and he will also get to spend a week with her at her Cleveland Heights home for Christmas.

Visiting Judge John Hoffman Jr., who approved the move, said the group — and especially the mother — had the child’s best interests at heart. ”

“The child has been an honor roll student and there were no allegations of neglect or abuse other than his obesity.

His case came to the county’s attention in April 2010 and the county said they worked with the mother for more than a year, during which the child’s weight fluctuated.

Challenging county’s methods

The county moved in September to take custody of him saying the mother wasn’t doing enough to get his weight down and had missed a few doctor’s appointments. They said his weight was a danger to his health.

Lawyers for the mother, joined by American Civil Liberties Union of Ohio, filed a motion late Tuesday to terminate the emergency custody that was granted to the Department of Children and Family Services and asked that the child be returned to his mother.

In the motion, they skewered the county agency’s decision-making and disputed many of its allegations, arguing that the child was never in “immediate” danger and that other alternatives, such as placing him with his uncle or godmother were never properly considered.

They also had an independent doctor review the child’s medical records to bolster their argument that he was not in grave danger.

The attorneys also said the county failed to provide the mother with food vouchers it promised so she could afford the specialized diet prescribed for the child.

Additionally, they accused the agency of not properly monitoring the child’s only diagnosed medical condition of sleep apnea. They said while in county custody, his breathing machine was not being used or monitored by his doctors.

The county did not have time to reply to those allegations and said it likely could refute them, a spokeswoman said.

Getting the boy back home

James Hardiman, the legal director for the Ohio ACLU said that the group’s intent was to get the boy out of the county’s custody.

“Obviously, we would have preferred he go home with his mother,” Hardiman said of the compromise. “However, recognizing that the judge was going to be somewhat cautious, the backup plan was to have [the boy] in the care of relatives.”

Juvenile Public Defender Sam Amata, who was also representing the boy’s mother, said he still believes that the county had no grounds for removing the child, but says the compromise was reasonable.

“We were hoping to get him home quickly,” Amata said. “But this is the best alternative, I guess.”

Amata said he hopes they can move up the February hearing so the child can return home sooner.

Mary Louise Madigan, a spokeswoman for Children and Family Services said the county will coordinate services for the boy with the county where he will live, but the agency is working with its lawyers to understand the ruling and what its role will be.

“The social worker and her supervisor have been working with this child for almost two years,” she said. “They care a great deal about him.”

Attorney John Lawson, appointed as a guardian for the child’s interests, said that family members should have been looked at first before the child was placed in foster care.

In the end, he said he’s hoping local services, such as a “big brother” or a fitness professional might step in and volunteer to work with the child and his family. ”

Compromise sends obese boy removed from his home to live with uncle
[Cleveland Plain-Dealer 12/14/11 by Rachel Dissell]

Update 2: According to this story, the boy WAS allowed to move in with his uncle sometime in January 2012. He has lost 50 pounds and will be returned to his mother on Saturday March 3, 2012. He still weighs 167 pounds at 9 years of age.

“The decision to allow him to return home was made at a hearing Monday at the Cuyahoga County Juvenile Court.

“There was a mutual agreement among everyone that the boy should return home as soon as possible,” said Lawson, who noted that The Cuyahoga County Department of Children and Family Services wanted to delay the boy’s return until the end of March. “Judge David Stucki, a visiting judge from Stark County, agreed. He’ll return to his mother on Saturday.”

When the boy returns to school, he’ll look like a different child.

“He has made remarkable progress with his weight issues while living with an uncle in Fairfield County near Columbus since January,” Lawson said. “He has learned a lot about nutrition, portion sizes, exercise and reading labels. He now knows the value of eating vegetables, grains and proteins as part of a weight-loss regimen. He has been exercising and will continue.”

The Cuyahoga County Department of Children and Family Services on Sept. 13 asked Juvenile Court to remove the boy from his mother’s home after unsuccessfully working with the boy’s family for almost a year to reduce his weight.

Lawyers for the mother, a substitute elementary school teacher who is also taking vocational school classes, earlier said that the county overreached in this case. The county argued that medical conditions the boy is at risk for — but doesn’t yet have — posed an imminent danger to his health.

The mother’s lawyers questioned whether the emotional impact of being removed from his family, school and friends was also considered.

He was initially placed in a foster home in Shaker Heights and was transferred to his uncle’s home in early January. ”
Obese boy to return home Saturday after dropping 50 pounds
[Cleveland Plain-Dealer 2/28/12 by Michael Sangiacomo]

Update 3: ““An 8-year-old Cleveland Heights boy who had been removed from the custody of his mother due to his weight and overall health will remain in her care following a hearing on Tuesday afternoon.

Fox 8 News crews were in the Juvenile Justice Center as the boy, his mother, a juvenile public defender and the child’s previous temporary guardian met to discuss the child’s health.

At the time of the child being placed under the custody of Child and Family Services in late November 2011, he weighed more than 200 pounds.

An administrator for Child and Family Services, Pat Riteout, told Fox 8 News in November that the agency had been involved with the family for roughly 20 months before the step of removing the boy from the home was taken.

On March 3, 2012, the boy was returned to his mother’s care after dropping over 20lbs.

Today in court it was said that the boy now weights 175 lbs.

It was also disclosed that he has put on eight pounds since returning to his mother’s care 10 days ago.

Fox 8 News reports that a follow-up meeting has been scheduled for April to track the boy progress.”

Obese Boy to Remain in Mother’s Care Despite Weight Gain
[Fox 8 3/13/12 by Don Jovic]

Update 4: A juvenile court judge in Cleveland released the boy from protected supervision on Thursday, May 10, 2012.

“Social service workers still plan on checking in with the boy and his mother in Cleveland Heights and have offered them nutritional and health counseling. The YMCA also gave the boy and his mother a free membership.”

“He weighed as much as 218 pounds, but dropped to 166 pounds when he was with his uncle, Lawson said Friday.

He was placed in the custody of his uncle last December on the day he celebrated his ninth birthday. The goal all along was to get him back with his family.

The uncle took him to the gym three nights a week, Lawson said. He also began swimming and playing basketball and is doing well despite changing schools and homes several times in recent months, Lawson said.

The boy is continuing to exercise, and his mother recently found a job, which should help with the family’s financial stability, Lawson said.”

 

Obese 9-year-old boy removed from Ohio home sheds 50 lbs

[Toledo Blade 5/11/12 by Associated Press]

 

REFORM Puzzle Piece

Update 4:”The mother of a grossly overweight 9-year-old boy had the right to move from Ohio to Georgia with her son, who was temporarily removed from his home last fall to lose weight, a juvenile court judge said on Thursday.

The case of the boy, who at one point weighed 219 lbs (99 kg), sparked a national debate over childhood obesity after Ohio social workers temporarily removed him from his Cleveland-area home last year. He was returned to his mother in April and she agreed to voluntary monitoring for 90 days.

An attorney appointed to represent the boy’s interest requested the court hearing because he was concerned for the health and welfare of the boy after losing contact with his mother.

Ohio Juvenile Court Judge John Hoffman Jr said the court’s jurisdiction ended in May.

Over a two-year period social workers monitored the boy’s weight until a court order removed him from his home last fall. He was returned to his mother’s home in April after losing about 50 lbs.

After living with a foster family and then an uncle in Columbus, the boy weighed 166 lbs. He returned to live with his mother and two weeks later when a judge terminated the order that had removed him, he weighed 173 lbs.

In May, the boy’s mother agreed to work voluntarily with the county agency to help with the boy’s weight loss.

But the boy’s mother told a doctor and social workers involved in the case that she and her son have moved to Georgia even though her older son still lives in Cleveland, according to documents filed by John Lawson, the attorney appointed to represent the boy.

“I just want someone to monitor his health,” Lawson told reporters after the hearing Thursday. “It is my job to worry about what is best for him and it is my obligation to report it to the court.”

An ACLU attorney representing the boy’s mother, James Hardiman, argued that the court did not jurisdiction in the case and that re-opening the case would mean the family would be forced to come back to Ohio.

“This is an issue of liberty,” he said. “We continue to take issue with the county removing a well adjusted child from his home solely on the basis of his weight.”

Mother of obese Ohio boy has right to move to another state: judge

[WHTC 6/28/12 by Kim Palmer]