Six years sober, she was still reported for child abuse for taking addiction medication. Is it time to change the rules?

Kayla Ford hugged her 2-year-old son, Memphis, while playing in their front yard. Ford was in recovery and taking Suboxone when she was reported to DCF following the birth of each of her children.Erin Clark/Globe Staff

When Kayla Ford learned she was pregnant, her addiction to pills had morphed into heroin use, and she knew she needed help. She connected with a psychiatrist, and began receiving Suboxone as part of her treatment. By the time her first son was born, she had been in recovery for months.

And still, under the state’s mandated reporter law, she was reported to the Department of Children and Families for suspected abuse or neglect because she was taking the addiction medication. When her second child was born 14 months later, the hospital reported her again. And again after her third.

At that point, she had been sober for six years.

“The social worker . . . even said to me, ‘I don’t even want to report you. But they make us. I have to,’ ” said Ford, 33, who lives in Worcester with her three kids, now 7, 6, and 2. “I remember toward the end of my third pregnancy being terrified that they’re going to bring DCF back into my life. I was thinking about that more than the delivery.”

Kayla Ford sat on her front stoop with her three sons, Remington, 7, (left), Memphis, 2, and River, 6.Erin Clark/Globe Staff

A pair of legislative proposals that has the backing of doctors, the state-appointed child advocate, and others would end the mandate that medical professionals automatically report a mother to DCF for suspected child neglect because a baby is born exposed to an “addictive drug,” a list that includes medication to help treat addiction.

One bill would add nuance to such decisions, requiring doctors to report the family to DCF only if there are other concerns, such as if a parent’s continued drug use would leave them “unable to fulfill the [child’s] basic needs.” The goal is to eliminate a dragnet that, while well-intended amid a still-raging opioid crisis, can stoke fear and sow distrust toward the medical professionals on whom pregnant women should be relying for care.

The proposals’ emergence is also emblematic of a broader question circulating around mandated reporting: Is less, not more, actually better?

“Mandated reporting has kind of been a blunt instrument. ‘If A, then B,’ ” said Dr. Miriam Komaromy, medical director for the Grayken Center for Addiction at Boston Medical Center and a supporter of ending the requirement. “The law is casting a very wide net, saying, ‘This could indicate a problem, this could be a flag for something we need to pay attention to, so, in fact, you must report it.’ But then, the downstream consequences can be devastating.”

For years, the policy debate in Massachusetts and beyond has largely focused on who else should be required to flag the state about suspected abuse or neglect, a list that’s long included teachers, doctors, child care providers, and others. Clergy were added to the Massachusetts law in 2002 following the Catholic Church sexual abuse scandal. More recently, animal control officers joined the list in 2018.

Another proposal under consideration this year would make athletic coaches and other volunteers mandated reporters. At least a half-dozen other states have taken similar steps in recent years, adding trainers and occupational therapists in the wake of the USA Gymnastics sex abuse scandal. In as many as 18 states, any person who suspects child abuse or neglect, regardless of their job, is required to report it.

That long-running push is now clashing with arguments that such mandates may actually cause harm, when they’re supposed to uncover it.

Mandated reporting in Massachusetts disproportionately targets families of color, who, state data show, are more than twice as likely to have reports of suspected abuse and neglect filed against them than white ones.

A wide expansion of mandated reporting laws elsewhere has, in some cases, failed to uncover a rise in abuse. In Pennsylvania, lawmakers expanded the pool of who qualifies as a mandated reporter in the wake of the Penn State University child sex abuse scandal. The result, according to an NBC News and ProPublica investigation: Investigations soared, but the number of actual substantiated allegations remained flat.

“It’s an extremely biased way of alerting the government to the risk of child maltreatment,” said Dorothy Roberts, a professor in the University of Pennsylvania’s law school and departments of sociology and Africana studies. “To say, ‘Let’s improve mandated reporting’ obscures what the problem is.”

The debate has pitted some attorneys and advocates for children against the state officials charged with helping them. All recognize there’s an imbalance in reporting, with parents of color more likely to face scrutiny, but they diverge on how to reshape the actual mandated reporting law, which drives the vast majority of abuse and neglect allegations DCF receives. Roughly 80 percent of so-called 51A reports come from mandated reporters.

Maria Mossaides, director of the state's Office of the Child Advocate, said she believes the state's mandated reporter law should be “cleaned up” but not thrown out, as some child welfare advocates have argued.Craig F. Walker/Globe Staff

“Since the pandemic, there has been a movement, both on the national and state level, to eliminate all mandatory reporting,” said Maria Mossaides, the state-appointed child advocate who believes the state mandated reporter law should be “cleaned up” but not thrown out. The movement has put a new focus on racial biases in reporting, which need to be addressed, she said, “but that doesn’t eliminate that there are certain children that need protection.”

”Even when a reporter might be more suspicious of a Black family than the equivalent white family, that doesn’t mean that that child is not at risk,” she said. “There’s a discussion about what we do about racial bias that’s different from the obligation to protect children.”

The state in 2019 created a first-of-its-kind commission, led by Mossaides, to examine the mandated reporter law. Its initial proposals were to greatly expand the number of people considered mandated reporters, as well as stiffen penalties for failing to report suspicions. Those recommendations drew heated criticism that the changes would only worsen a system that already disproportionately enters the lives of Black and Latino families.

The commission ultimately folded after two years without agreeing on any recommendations it could make to lawmakers. DCF data released since show the disparities haven’t abated: Last fiscal year, Black and Latino children were not only 2.3 times more likely than white children to be reported to DCF as suspected victims of abuse or neglect, they were also roughly 2.5 times more likely to be in foster homes and other out-of-home placements.

DCF commissioner Linda Spears declined an interview request. But Andrea Grossman, a DCF spokesperson, said that addressing the disproportionate number of children of color in the child welfare system is a complex task that can’t “readily be solved through a single practice or policy strategy.”

“The concerns that bring families to the attention of child welfare and other service entities are multifaceted, rooted in inequities and social concerns and have a differential impact on families of color,” Grossman said.

The agency, she said, “continues to strive for improvement,” not just in who is reported but ultimately what allegations are considered legitimate. For example, Latino children make up just 19 percent of kids in Massachusetts but account for 33 percent of those referred through a 51A report and 34 percent of cases where DCF finds reasonable cause to believe the child was abused or neglected.

“While DCF may be striving to improve, their job is to investigate child abuse and neglect. They need to be held responsible to have the competence and the tools to distinguish between child abuse and neglect and racial bias,” said Susan Elsen, an attorney and child welfare policy advocate at the Massachusetts Law Reform Institute. “We really need to expect them to do better.”

William Sheehan, at far right, with Eagle Scouts and an official from Troop 70 in 1974. Sheehan allegedly abused dozens of children over two decades starting in the early 1960s.Handout

Supporters of expanded mandated reporting say they, too, are cognizant of the disparities, but argue there’s great risk in not broadening the existing law. The view is held deeply in communities like Foxborough, which was rocked more than a decade ago by allegations that William Sheehan, a former teacher, Boy Scout leader, and swim coach, had abused dozens of children over two decades starting in the early 1960s.

Sheehan was not prosecuted and has since died. But the revelations still sparked change: The town formed a so-called Child Sex Abuse Awareness Committee, and has now trained thousands of residents — including public works officials, town hall employees, and others who fall outside the mandated reporter law — in recognizing abuse or neglect.

“Our philosophy in Foxborough is, the more eyes aware and watching, the better. Why would we restrict that?” said Bill Dudley, a pastor at the Union Church of Foxboro and a member of the committee.

The town’s state senator, Democrat Paul Feeney, has again filed legislation to add athletic coaches, higher education personnel, and volunteers for scouting groups, among others, to those required to report suspicions of abuse and neglect. The Legislature’s Committee on Children and Families approved a version of the bill last year, though it never surfaced for a vote in either chamber.

“I don’t want perfect to be the enemy of the good. But I think we need to take action,” Feeney said. “There’s a moral obligation [to report]. In my mind, this should be a statutory obligation.”

Mandated reporters are currently required to undergo training. But the state has lacked a standardized program, something Feeney’s bill also seeks to create.

Mossaides’ office, using a $200,000 legislative allocation, is preparing to launch a pilot course in all of the state’s public school systems in the fall that she said will both train teachers on how to spot signs of abuse and how to decide to actually file a report. Her office then plans to track data over several years on the number and type of 51A reports teachers file.

Still, critics argue, training alone cannot address the unintended consequences that mandated reporting and its rigid requirements can sometimes produce. Ford, the Worcester mother of three, said that having to navigate multiple open cases with DCF after becoming — and for years, staying — sober was overwhelming.

“You did all these things to change and here you are having to start over again to have someone trust and believe in you,” she said. “They’re drowning women who are trying to do the right thing.”