Seven years ago, after two tragedies, State House investigators identified a major flaw in the Massachusetts child-protection agency: It lacked medical expertise to help caseworkers sort out the complicated conditions affecting children under its watch. The findings led lawmakers to approve reforms, but today, very little has changed.
The position of physician medical director was funded by the Legislature but never filled by the agency. A plan to set up a standing panel of pediatric specialists to offer consultations on medically complex cases went unheeded by top state officials. To this day, if staffers within the agency need advice from medical experts, they are often left scrambling to find help on their own.
“They have not set up a system to bring in the strong expertise that is available in the Commonwealth,” said Dr. Robert Sege, a pediatrician and child-abuse specialist at Boston Medical Center. “It’s a shame.”
The Department of Children and Families’ lack of medical expertise emerged this year as an issue in an emotionally charged case involving a 15-year-old girl who has been at Boston Children’s Hospital for the past 10 months, most of it in the locked psychiatric ward. According to a two-part series in The Boston Globe earlier this week, hospital doctors filed charges of “medical child abuse” last February shortly after seeing Justina Pelletier in the emergency room. Within three days, they concluded that the girl’s parents had wrongfully subjected the child to treatment for a rare metabolic disorder and were blocking psychiatric treatment that she badly needed.
When the parents from West Hartford, Conn., threatened to discharge the girl and take her to see her doctor at Tufts Medical Center, Children’s filed a complaint and the state took emergency custody. The parents, Lou and Linda Pelletier, say they are victims of a Massachusetts child-welfare system that fails to objectively referee complex cases and is overly deferential to Children’s, given the Harvard-affiliated teaching institution’s high standing in pediatric medicine.
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