The Massachusetts child-protection agency announced Friday that it is actively pursuing plans to return an ailing teenager at the center of a yearlong custody battle to her home state of Connecticut, in an apparent move to extricate itself from a drama in which the parents allege they have been unfairly stripped of their rights to make medical choices for their daughter.
The Department of Children and Families said it is also endorsing a plan to have Justina Pelletier’s medical care transferred back to Tufts Medical Center, which has long been a demand of her parents. Their attempt to move their daughter’s care a year ago from Boston Children’s Hospital to Tufts, where she had been treated previously, is what set in motion the events that led them to lose custody of the teenager.
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As recently as Monday, state officials sought to have Pelletier, 15, moved to foster care in Merrimac and her medical care moved to UMass Memorial Medical Center in Worcester. “Our primary goal has always been the health and well-being of Justina,” said spokesman Alec Loftus, in the children’s agency’s first public comments on a case drawing national attention. “We want the parents to be able to work with the providers and courts to ultimately move Justina back to her home state of Connecticut.”
The agency has also backed off its push to have the girl’s father held in contempt for speaking publicly about the case in violation of a juvenile judge’s gag order, Loftus said — in remarks that themselves may have defied the gag order. Loftus said it was dropping the gag-order complaint against Lou Pelletier.
But the potentially promising overture may yet lead nowhere — as has happened repeatedly. Justina’s father, reached by phone Friday morning on his way to a weekly visit with Justina at a Department of Children and Families office in Roxbury, initially reacted positively, though guardedly, when a Globe reporter told him about the agency’s announcement. Lou Pelletier said it was “a step in the right direction” but he needed to see concrete results.
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Within a few hours, though, he was part of an angry public outburst against the agency, after he and his wife were initially denied their visit with their daughter. State officials, apparently motivated in part by spotting Fox News television cameras outside, put off the meeting.
Just when the teenager might move back to her home state has not been decided, nor is it known where she will live — whether at home in West Hartford, in a foster care placement, or at a residential facility. Gary Kleeblatt, spokesman for the child-protection agency in Connecticut, acknowledged that it had received a request from Massachusetts to “assess a resource in Connecticut for possible placement of Justina.” He said the state “is working with the Pelletier family to identify services they may need going forward.”
Several sources who have been involved in the case say many factors likely affected the Department of Children and Families’ decision to shift course. They include pressure from the national attention the case has generated and a petition circulating in the state Legislature, an acknowledgment that Justina’s condition has not improved to the degree that doctors and state officials had expected, and a determination by Massachusetts child protection officials and the juvenile court judge to force their counterparts in Connecticut to step up their involvement.
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These sources said Judge Joseph Johnston has said he wants to see Justina’s case transferred to Connecticut.
“The judge has provided a path out of this conundrum, and DCF, having hit a wall, is taking advantage of the opportunity,” said one of the sources briefed on the case.
Gail Garinger, who heads the Office of the Child Advocate, which is a watchdog over DCF, said she was heartened by Friday’s announcement. “This is the best shot at getting everyone to work together and focus on Justina’s treatment and reunification,” Garinger said.
If Massachusetts officials had hoped to attract some good will from Justina’s parents based on Friday’s news, it did not seem to last long.
After the parents’ meeting with Justina was abruptly postponed, the Rev. Patrick Mahoney, head of the Washington-based Christian Defense Coalition, who says he represents the family, scheduled a news conference to air the Pelletiers’ grievances over the nearly-canceled visit. He insisted that the child-protection agency’s actions were grossly unfair, and that the parents had nothing to do with drawing the news cameras to the meeting, which was ultimately held later in the day.
“The Pelletiers didn’t invite them,” said Mahoney, whose group is one of several conservative Christian groups backing the Pelletiers.
Mahoney said that despite the agency’s announcement, his group is going ahead with a “Free Justina” vigil on Saturday outside the Framingham residential facility where the girl has lived for the past month, after spending nearly a year at Children’s Hospital.
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The Pelletiers’ frequent sparring with clinicians over the years in Massachusetts and Connecticut — and their willingness to go public so often about their daughter’s situation — has been an ongoing concern for the courts and the Department of Children and Families. Such parental behavior can be at the heart of complaints of medical child abuse — a controversial, new term that was applied to the Pelletiers. These allegations refer to parents or caregivers seeking unnecessary and potentially harmful medical interventions for children.
A two-part series in the Globe in December about the Pelletier case, one of a handful of complex medical child abuse cases at Children’s in the past two years, showed that Justina’s parents had been questioned over the quality of their care for her, including pushing for invasive procedures and ignoring mental health issues.
After hearing extensive testimony, the juvenile court judge found earlier this year that the parents were unfit to handle many of Justina’s complex problems, say two sources briefed on the closed-door hearings. Also in the past two months, these sources say, the child-welfare agency in Connecticut, responding to a medical child abuse complaint filed last year, opened a case after finding sufficient reason for concern.
Justina’s parents have long rejected the suggestion they are unfit parents drawn to seek attention, saying they go to the media only as a last resort to seek help for the grave injustice their family has endured.
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The parents insist their daughter’s chronic gastrointestinal problems and immobility in her legs relate to a rare metabolic illness, called mitochondrial disorder, for which she had been treated by Tufts physicians for a year. However, staff at Children’s, where Justina was brought last February after she almost stopped eating and walking, concluded after a few days that the girl’s symptoms were largely psychiatric in origin and announced plans to change her treatment plan.
When the parents rejected the psychiatric diagnosis and threatened to remove Justina from Children’s, staff filed medical child abuse allegations with the state. The parents asked for the girl’s Tufts metabolic specialist, Dr. Mark Korson, to be included in discussions about Justina’s care. However, Children’s and child-protection officials did little to involve Korson. As the months passed, the parents’ relationship with the state agency and Children’s grew only more contentious.
In addition to just when and where Justina will be moved, another looming issue is who will pay, Massachusetts or Connecticut, once she is moved. MassHealth, the state’s Medicaid insurance for the poor, typically pays for medical expenses for children in the custody of the state. But two sources briefed on the case say it remains unclear whether Connecticut’s Medicaid program will pay for Justina’s care if she returns to her home state.
The next juvenile court hearing on Pelletier’s case is March 17.
Patricia Wen can be reached at patricia.wen@globe.com.