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    Lost fax a symbol of DCF’s need to revamp procedures

    A lost fax from Grafton police warning about possible harm to a 4-month-old baby who later died is the latest symbol of the breakdown of the state Department of Children and Families — an agency stumbling amid bureaucratic miscues that are now linked to a series of tragic outcomes.

    The most recent tragedy involves little Aliana Lavigne of Grafton. After visiting her home on April 3, Grafton police filed a report known as a 51A with the state child-welfare agency. But no one at DCF paid attention to it until six days later. The police officer who filed the report did not follow up with a phone call, which apparently contributed to a communications breakdown in this case.

    Initially, DCF said the fax machine was unattended because the person assigned to monitoring it was off that day. Agency officials now say the fax was received but accidentally misplaced. It was discovered on April 9. However, because the social worker assigned to the case was off on April 10, she did not begin her review until the following day. That’s when emergency workers found the baby was dead; her death is under investigation.


    DCF officials are calling the fax misplacement an “unacceptable error.” The agency is already under fire for cases involving the deaths of two other children whose cases also slipped through bureaucratic cracks.

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    The body of 5-year-old Jeremiah Oliver was found April 18 off the southbound side of Interstate 190 in Sterling. The little boy had not been seen by relatives since September, but he was not reported missing until December. His disappearance sparked an investigation that determined that a social worker had failed to conduct home visits as required.

    On April 26, 16-day-old Bailey Irish of Fitchburg died, the day after her family missed a scheduled home visit from DCF. The infant was unresponsive when her parents brought her to HealthAlliance Hospital in Leominster on Saturday morning and was pronounced dead. Her death is also under investigation.

    No one can say for sure if these deaths were preventable, but these cases show the high cost of human error when it comes to the business of child protection. A missed visit or fax can put an innocent life in the greatest of jeopardy.

    Governor Deval Patrick has stood behind DCF Commissioner Olga Roche, saying her agency needs more resources and better technology — and so it does, if it’s relying on a fax to trigger an investigation into a potentially life-threatening situation. But above all, DCF needs leadership that sets a tone for vigilance and backs it up with training and accountability.