Medical Reporting
“The chasm between medical journalists and physicians appears mostly to be one of ignorance rather than conflicting interests or malice,” writes Terry L. Schraeder, who for 10 years worked as a medical journalist before entering medical school. Now doing her residency in internal medicine, she uses these experiences to highlight the problems between journalists and doctors and ways to close the widening gap of distrust. She is convinced that only when they “understand the other’s professional training, education, deadlines, responsibilities, codes of ethics, and internal stresses” will the chasm narrow. – Melissa Ludtke, Editor
Like other children’s beat reporters, I closely followed the case of Florida’s missing five-year-old foster child, Rilya Wilson, whose disappearance last year added to the already abysmal reputation of Florida’s Department of Children and Families. I wondered how many foster kids were missing in my state of Michigan.
After 15 years on the juvenile justice beat, I already knew that runaway foster children were a chronic problem in the child welfare system, but it was a problem that no one seemed too concerned about. The typical response from juvenile court judges and child welfare officials has been to file a missing person report with the police and hope for the best.
Whatever the number of missing Michigan foster kids was, however, I knew I’d need a compelling human element for my reporting to capture the attention of readers and to have any impact on how state agencies handle these cases. In August 2002, the right story appeared. A juvenile court referee in Detroit was livid that the state agency responsible for placing foster children into protective care had decided to send a 12-year-old boy named Prentiss to live with his mother—even though the referee had terminated the mother’s parental rights to Prentiss because of drug abuse and homelessness. The mother had moved to Atlanta, gotten a decent job with MCI and, reportedly, kicked her drug habit. She was caring for two younger kids who were doing just fine, at least that’s what child protective services officials in Georgia told their counterparts at the Michigan Family Independence Agency (FIA).
Two months after the FIA sent Prentiss to be with his mother in Atlanta she, Prentiss and one other child disappeared. Three weeks later, Prentiss and his sister were found in Dallas panhandling to feed his mother’s crack cocaine addiction.
Tracking Missing Foster Children
My article in the Detroit Free Press about Prentiss (August 30, 2002) said that the state had lost track of 302 foster children. FIA spokesperson Karen Smith had provided the number that, she said, is sent quarterly to the U.S. Department of Health and Human Services. I quoted Smith as saying the vast majority of the kids were teenaged runaways; many of them were girls neglected or abused at home who latched onto a boyfriend.
When the story appeared, the FIA’s initial response was anger at me for “blowing out of proportion” a routine problem with teenaged children under state supervision running away from foster homes and shelters. All state child welfare systems experience a certain number of children who are kidnapped out of foster care by their parents or relatives, the officials in Michigan said. FIA Director Doug Howard strenuously denied that the state had lost kids; they were merely “absent without legal permission” (AWOLP) from their foster care placement, he told me. “This is Michigan and in Michigan we don’t lose kids,” Howard said. “They walk away or are taken by others without the court’s permission, but we don’t just lose them…. I take great offense that the article made it look like in Michigan we don’t care.”
By happenstance, the Wayne County Sheriff’s Department’s child rescue task force—which works with the FIA and juvenile court to locate at-risk children—found a missing six-year-old foster boy the day the first story broke. He had been kidnapped by his mother, a former FIA employee who had sworn to a judge that the child was with his father in California. My admittedly snarky lead in the next morning’s Free Press was, “There are now only 301 missing foster children in Michigan.”
Based on the e-mail and voice mail I got during that Labor Day weekend, those two stories prompted strong reactions of outrage at the overseeing agencies from Free Press readers. The day after Labor Day, Governor John Engler called the FIA director in for a meeting. Suddenly, the agency’s attitude of denial about missing foster kids changed, and the state began to take some practical and innovative steps toward finding solutions. Three weeks later, Michigan became the first state to publish the names and photographs of missing foster children on its Web site, www.michigan.gov/fia. (I’d broken the story about the Web site a week before it was announced.)
Realizing that the FIA did not have photographs of dozens of missing foster kids, the agency ordered its social service workers and private foster care agencies under state contract to conduct face-to-face visits of all 18,000 foster children immediately and to take pictures of them. Foster care workers also scrambled to make sure that the court orders to take into custody missing children were current. Within a month, Maura Corrigan, the state Supreme Court’s chief justice, stepped in and ordered all of the state’s family courts to establish a special docket for abused or neglected children missing from foster care placements. In special “investigative hearings,” judges began to question the social workers responsible for locating missing kids, and they scheduled weekly or monthly updates to hold the agency’s feet to the fire. People who might have information—such as school guidance counselors, relatives, even peers—were subpoenaed to court to be questioned by the judge about what they knew. Leads on the whereabouts of the children were turned over to the child rescue task force, and the police unit found dozens of them, many in dangerous places such as drug houses or abandoned buildings. Several of the runaway foster girls, aged 13-16, were working as prostitutes and/or strippers in Detroit’s many illegal after-hours clubs.
Gaining Access to Confidential Files
At our request, the chief judge of Wayne County Family Court authorized the Free Press to examine the confidential court files of the foster children known to be missing from Wayne County. It was not an easy task, because the FIA refused to identify which counties missing foster kids had come from. We had to cross-reference all 199 missing foster kids on the state Web site (the FIA did not list all missing foster kids) with the dockets at local juvenile courts. We finally found that 107 of the 199 were from Wayne County.
Chief Judge Mary Beth Kelly said she gave us access to these sensitive records because she respected my record of covering juvenile justice in a fair and accurate manner, and because she wanted the newspaper’s help to keep the pressure on everyone in the child welfare system to find those kids. Since each file takes about an hour to review, editors assigned a colleague, Nancy Youssef, to read them, sketch out each case, and find common themes. Meanwhile, I continued to report daily developments on the search for missing foster kids, including 15-year-old runaway Heather Kish, who was found murdered on October 5th. Including the three-part series Nancy and I wrote in December, I wrote another 27 stories on efforts to find missing foster kids.
The children of Michigan are fortunate that the editors of the Free Press are committed to covering children’s issues. Since 1993, in more than 4,000 articles, the paper’s “Children First” campaign has focused attention on the health and safety of all kids. In January, publisher Heath Meriweather marked the campaign’s 10th anniversary by recommitting the Free Press to “Children First.” My role is to cover the juvenile justice system in a way that exposes problems and celebrates successes.
To date, more than 200 of the missing foster children have been located, sometimes in dangerous homes with drugs and guns within easy reach. In several cases, the kids had managed to find someone responsible to move in with. I remember, in particular, one missing foster girl, 15 years old, who was found by the police at Mackenzie High School in Detroit. She was in her ROTC uniform, and she was getting mostly A’s in school while living with an unrelated adult female. The judge in charge of the AWOLP docket, Mike Hathaway, allowed her to remain in that home.
Although foster kids still run away from placement, there are now established protocols and procedures that the police, juvenile court judges, the FIA and others in the system use to find and house them. Each foster child over age 12 is given a copy of the court order placing him or her in foster care, and they are told that if they run away again they will be violating the order. That could get them locked into juvenile detention. Although the juvenile detention facility in Detroit is rated among the best in the country, kids still don’t like being there, and many of them are obeying the judge’s order to stay in a shelter or foster home because they don’t want to get locked up again. One 16-year-old girl who had been missing for two years called Judge Hathaway, who promised not to lock her up if she came to court. The girl drove herself and said she’d been working cleaning houses and living with a 44-year-old woman. But she hadn’t been going to school because she didn’t have a legal address to register. Hathaway allowed her to stay with the woman in an arrangement that will now allow that child to return to school.
The Impact of Press Coverage
As this situation has developed, observers have commented that without the Free Press coverage of these AWOLP children, none of these changes would have happened. Two people even joked that court officials should call the special docket “the Kresnak docket.”
Juvenile justice is a complex system running on two tracks: In dependency court, also called child protective proceedings, judges deal with cases involving children who are the victims of maltreatment; on the delinquency track, the court handles kids who commit crimes or status offenses, including acts like smoking cigarettes or skipping school, which are against the law only because of the juvenile’s status as a minor.
Journalists covering this beat for a long time realize that there is really no one inside the system—either at the court, or the agencies and programs dealing with kids—who sees the entire spectrum of a case. Fortunately, a journalist with reasonable access to juvenile court matters—and the amount of access reporters have varies among states and cities—can find the context or back-story of a particular child or family situation. Overcoming confidentiality restrictions is a challenge, yes, but because of the openness of Michigan’s juvenile courts, I can get information from many sources, including foster parents, group home workers, court files, lawyers, social workers, agency documents, trial transcripts, and police reports.
Because we take this broader perspective, judges, agency officials, legislators and line social service workers often say that they learn more about what’s going on in the child protection and juvenile justice systems from the stories we publish than from any of the official memos or training sessions or court hearings they attend.
The Juvenile Justice Beat
Shortly before Michigan’s juvenile courts first were opened to the public and the press in 1988, I asked my editors to create a new beat, juvenile justice. I figured I would try it for two or three years until something else came along. Fifteen years later, after covering too many stories of child maltreatment, my reporting has become something child welfare systems in every state desperately need—it’s a watchdog approach that works to hold public official accountable to those they are supposed to serve. I investigate the deaths of abused or neglected children and uncover weaknesses in the systems designed to protect kids.
Public officials in Michigan have responded amazingly well to the problems described in my stories. In September 2000, a story I did on the smothering death of a seven-month-old girl named Miracle Jackson prompted better and more systematic cooperation between two state agencies, the FIA and the Department of Community Health. I recognized the name of Miracle’s mother from previous stories on her children being abused by a boyfriend. One of her sons was beaten so badly he remains in a persistent vegetative state; his care costs thousands of taxpayer dollars every month. When Miracle’s body was found inside a plastic grocery bag left in a field, I was able to write an authoritative story with historical context. Another of the mother’s bad boyfriends had killed her child.
Within a week, the two state agencies announced that they would begin crosschecking computerized records of live births with the FIA’s central registry of known abusers. When a child is born to a parent with a history of abuse or neglect, the FIA now knows about it and is required to investigate and assess the risk to that child. The story of Miracle Jackson is used during the training sessions for FIA and private agency social service workers. Workers are told that they must be cautious and thorough, otherwise they might end up on the front page of the Free Press. At the same time, I was wrapping up a six-part series on the system’s failure to protect a two-year-old girl named Ariana Swinson that ran in December 2000. The series is now cited as a cautionary tale for judges, referees, lawyers and social service workers.
Stories Make a Difference
Other stories and their impact include:
I have never really considered myself a child advocate—although that is what people who work in the child welfare system call me. I cover the children’s beat in the same way a Pentagon reporter covers the Department of Defense or a health reporter covers the health care system—by being diligent, open to new ideas, and honest with sources and readers. What the child welfare system needs are more journalists who are committed to covering it as a beat and doing the kind of watchdog reporting that can make a difference.
Jack Kresnak is the juvenile justice reporter at the Detroit Free Press. His stories about various children’s cases can be found at www.freep.com. His reporting on two-year-old Ariana Swinson won the Casey Medal for Meritorious Journalism, presented by the Casey Journalism Center for Children and Families. He also is the only journalist among 30 fellows with the Urban Health Initiative, a project funded by the Robert Wood Johnson Foundation to improve the lives of children in five U.S. cities.
After 15 years on the juvenile justice beat, I already knew that runaway foster children were a chronic problem in the child welfare system, but it was a problem that no one seemed too concerned about. The typical response from juvenile court judges and child welfare officials has been to file a missing person report with the police and hope for the best.
Whatever the number of missing Michigan foster kids was, however, I knew I’d need a compelling human element for my reporting to capture the attention of readers and to have any impact on how state agencies handle these cases. In August 2002, the right story appeared. A juvenile court referee in Detroit was livid that the state agency responsible for placing foster children into protective care had decided to send a 12-year-old boy named Prentiss to live with his mother—even though the referee had terminated the mother’s parental rights to Prentiss because of drug abuse and homelessness. The mother had moved to Atlanta, gotten a decent job with MCI and, reportedly, kicked her drug habit. She was caring for two younger kids who were doing just fine, at least that’s what child protective services officials in Georgia told their counterparts at the Michigan Family Independence Agency (FIA).
Two months after the FIA sent Prentiss to be with his mother in Atlanta she, Prentiss and one other child disappeared. Three weeks later, Prentiss and his sister were found in Dallas panhandling to feed his mother’s crack cocaine addiction.
Tracking Missing Foster Children
My article in the Detroit Free Press about Prentiss (August 30, 2002) said that the state had lost track of 302 foster children. FIA spokesperson Karen Smith had provided the number that, she said, is sent quarterly to the U.S. Department of Health and Human Services. I quoted Smith as saying the vast majority of the kids were teenaged runaways; many of them were girls neglected or abused at home who latched onto a boyfriend.
When the story appeared, the FIA’s initial response was anger at me for “blowing out of proportion” a routine problem with teenaged children under state supervision running away from foster homes and shelters. All state child welfare systems experience a certain number of children who are kidnapped out of foster care by their parents or relatives, the officials in Michigan said. FIA Director Doug Howard strenuously denied that the state had lost kids; they were merely “absent without legal permission” (AWOLP) from their foster care placement, he told me. “This is Michigan and in Michigan we don’t lose kids,” Howard said. “They walk away or are taken by others without the court’s permission, but we don’t just lose them…. I take great offense that the article made it look like in Michigan we don’t care.”
By happenstance, the Wayne County Sheriff’s Department’s child rescue task force—which works with the FIA and juvenile court to locate at-risk children—found a missing six-year-old foster boy the day the first story broke. He had been kidnapped by his mother, a former FIA employee who had sworn to a judge that the child was with his father in California. My admittedly snarky lead in the next morning’s Free Press was, “There are now only 301 missing foster children in Michigan.”
Based on the e-mail and voice mail I got during that Labor Day weekend, those two stories prompted strong reactions of outrage at the overseeing agencies from Free Press readers. The day after Labor Day, Governor John Engler called the FIA director in for a meeting. Suddenly, the agency’s attitude of denial about missing foster kids changed, and the state began to take some practical and innovative steps toward finding solutions. Three weeks later, Michigan became the first state to publish the names and photographs of missing foster children on its Web site, www.michigan.gov/fia. (I’d broken the story about the Web site a week before it was announced.)
Realizing that the FIA did not have photographs of dozens of missing foster kids, the agency ordered its social service workers and private foster care agencies under state contract to conduct face-to-face visits of all 18,000 foster children immediately and to take pictures of them. Foster care workers also scrambled to make sure that the court orders to take into custody missing children were current. Within a month, Maura Corrigan, the state Supreme Court’s chief justice, stepped in and ordered all of the state’s family courts to establish a special docket for abused or neglected children missing from foster care placements. In special “investigative hearings,” judges began to question the social workers responsible for locating missing kids, and they scheduled weekly or monthly updates to hold the agency’s feet to the fire. People who might have information—such as school guidance counselors, relatives, even peers—were subpoenaed to court to be questioned by the judge about what they knew. Leads on the whereabouts of the children were turned over to the child rescue task force, and the police unit found dozens of them, many in dangerous places such as drug houses or abandoned buildings. Several of the runaway foster girls, aged 13-16, were working as prostitutes and/or strippers in Detroit’s many illegal after-hours clubs.
Gaining Access to Confidential Files
At our request, the chief judge of Wayne County Family Court authorized the Free Press to examine the confidential court files of the foster children known to be missing from Wayne County. It was not an easy task, because the FIA refused to identify which counties missing foster kids had come from. We had to cross-reference all 199 missing foster kids on the state Web site (the FIA did not list all missing foster kids) with the dockets at local juvenile courts. We finally found that 107 of the 199 were from Wayne County.
Chief Judge Mary Beth Kelly said she gave us access to these sensitive records because she respected my record of covering juvenile justice in a fair and accurate manner, and because she wanted the newspaper’s help to keep the pressure on everyone in the child welfare system to find those kids. Since each file takes about an hour to review, editors assigned a colleague, Nancy Youssef, to read them, sketch out each case, and find common themes. Meanwhile, I continued to report daily developments on the search for missing foster kids, including 15-year-old runaway Heather Kish, who was found murdered on October 5th. Including the three-part series Nancy and I wrote in December, I wrote another 27 stories on efforts to find missing foster kids.
The children of Michigan are fortunate that the editors of the Free Press are committed to covering children’s issues. Since 1993, in more than 4,000 articles, the paper’s “Children First” campaign has focused attention on the health and safety of all kids. In January, publisher Heath Meriweather marked the campaign’s 10th anniversary by recommitting the Free Press to “Children First.” My role is to cover the juvenile justice system in a way that exposes problems and celebrates successes.
To date, more than 200 of the missing foster children have been located, sometimes in dangerous homes with drugs and guns within easy reach. In several cases, the kids had managed to find someone responsible to move in with. I remember, in particular, one missing foster girl, 15 years old, who was found by the police at Mackenzie High School in Detroit. She was in her ROTC uniform, and she was getting mostly A’s in school while living with an unrelated adult female. The judge in charge of the AWOLP docket, Mike Hathaway, allowed her to remain in that home.
Although foster kids still run away from placement, there are now established protocols and procedures that the police, juvenile court judges, the FIA and others in the system use to find and house them. Each foster child over age 12 is given a copy of the court order placing him or her in foster care, and they are told that if they run away again they will be violating the order. That could get them locked into juvenile detention. Although the juvenile detention facility in Detroit is rated among the best in the country, kids still don’t like being there, and many of them are obeying the judge’s order to stay in a shelter or foster home because they don’t want to get locked up again. One 16-year-old girl who had been missing for two years called Judge Hathaway, who promised not to lock her up if she came to court. The girl drove herself and said she’d been working cleaning houses and living with a 44-year-old woman. But she hadn’t been going to school because she didn’t have a legal address to register. Hathaway allowed her to stay with the woman in an arrangement that will now allow that child to return to school.
The Impact of Press Coverage
As this situation has developed, observers have commented that without the Free Press coverage of these AWOLP children, none of these changes would have happened. Two people even joked that court officials should call the special docket “the Kresnak docket.”
Juvenile justice is a complex system running on two tracks: In dependency court, also called child protective proceedings, judges deal with cases involving children who are the victims of maltreatment; on the delinquency track, the court handles kids who commit crimes or status offenses, including acts like smoking cigarettes or skipping school, which are against the law only because of the juvenile’s status as a minor.
Journalists covering this beat for a long time realize that there is really no one inside the system—either at the court, or the agencies and programs dealing with kids—who sees the entire spectrum of a case. Fortunately, a journalist with reasonable access to juvenile court matters—and the amount of access reporters have varies among states and cities—can find the context or back-story of a particular child or family situation. Overcoming confidentiality restrictions is a challenge, yes, but because of the openness of Michigan’s juvenile courts, I can get information from many sources, including foster parents, group home workers, court files, lawyers, social workers, agency documents, trial transcripts, and police reports.
Because we take this broader perspective, judges, agency officials, legislators and line social service workers often say that they learn more about what’s going on in the child protection and juvenile justice systems from the stories we publish than from any of the official memos or training sessions or court hearings they attend.
The Juvenile Justice Beat
Shortly before Michigan’s juvenile courts first were opened to the public and the press in 1988, I asked my editors to create a new beat, juvenile justice. I figured I would try it for two or three years until something else came along. Fifteen years later, after covering too many stories of child maltreatment, my reporting has become something child welfare systems in every state desperately need—it’s a watchdog approach that works to hold public official accountable to those they are supposed to serve. I investigate the deaths of abused or neglected children and uncover weaknesses in the systems designed to protect kids.
Public officials in Michigan have responded amazingly well to the problems described in my stories. In September 2000, a story I did on the smothering death of a seven-month-old girl named Miracle Jackson prompted better and more systematic cooperation between two state agencies, the FIA and the Department of Community Health. I recognized the name of Miracle’s mother from previous stories on her children being abused by a boyfriend. One of her sons was beaten so badly he remains in a persistent vegetative state; his care costs thousands of taxpayer dollars every month. When Miracle’s body was found inside a plastic grocery bag left in a field, I was able to write an authoritative story with historical context. Another of the mother’s bad boyfriends had killed her child.
Within a week, the two state agencies announced that they would begin crosschecking computerized records of live births with the FIA’s central registry of known abusers. When a child is born to a parent with a history of abuse or neglect, the FIA now knows about it and is required to investigate and assess the risk to that child. The story of Miracle Jackson is used during the training sessions for FIA and private agency social service workers. Workers are told that they must be cautious and thorough, otherwise they might end up on the front page of the Free Press. At the same time, I was wrapping up a six-part series on the system’s failure to protect a two-year-old girl named Ariana Swinson that ran in December 2000. The series is now cited as a cautionary tale for judges, referees, lawyers and social service workers.
Stories Make a Difference
Other stories and their impact include:
- Documenting the sorry conditions at the local youth home in 1996. After this story appeared, Wayne County built a $48 million juvenile detention facility that opened two years later. It is considered among the best juvenile detention facilities in the world.
- A five-part series on a man’s efforts to have access to his two daughters while repeatedly being falsely accused of sexually molesting them might have led the judge to award custody to the father.
- In March 1999, I wrote a front-page story on a juvenile court referee ordering life support systems to be removed from a child born with severe birth defects. The parents were not present for the hearing, the baby’s court-assigned attorney was not present, and only hearsay testimony was taken on whether the parents had agreed to their baby being allowed to die. An initial appeal of the referee’s ruling was dismissed as moot. But the state Court of Appeals, which had seen my article, took the matter up, severely chastised the juvenile court actions, and established legal protocols to be used when a request to remove life support from a child is being made.
I have never really considered myself a child advocate—although that is what people who work in the child welfare system call me. I cover the children’s beat in the same way a Pentagon reporter covers the Department of Defense or a health reporter covers the health care system—by being diligent, open to new ideas, and honest with sources and readers. What the child welfare system needs are more journalists who are committed to covering it as a beat and doing the kind of watchdog reporting that can make a difference.
Jack Kresnak is the juvenile justice reporter at the Detroit Free Press. His stories about various children’s cases can be found at www.freep.com. His reporting on two-year-old Ariana Swinson won the Casey Medal for Meritorious Journalism, presented by the Casey Journalism Center for Children and Families. He also is the only journalist among 30 fellows with the Urban Health Initiative, a project funded by the Robert Wood Johnson Foundation to improve the lives of children in five U.S. cities.
