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How computers call the shots for L.A. County children in peril

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There's no time to wash away the smell of sour milk from the baby's skin, so the mother wipes the dozing infant's face with the filthy bib hanging from his neck. "WIC cares about me," it reads, a reference to the free food program for poor women and children.

Social worker Ladore Winzer has just told the mother she will detain the 11-month-old boy and process him this night into foster care.

It's after dusk and the slim, efficient social worker, late returning home to her own family, is stuck for now in the middle of this ghetto vista. Cars swerve around a lampshade; a graffiti tribute to a dead man runs across a cinder-block wall; a hunched homeless man pushes his cart across the grass-tufted sidewalk.

"If I'm good, can I get my baby back in three months?" the mother asks, conjuring a weak smile in an attempt to seal the proposal.

Chances are Winzer will not be making the decision.

A computer will.

The process starts with a tip to Los Angeles County’s child abuse hotline. Over the course of a typical week, the Department of Children and Family Services receives 3,000 calls.

Those that meet the legal threshold -- as determined by the computer and verified by a worker -- are routed to investigators like Winzer. The process is usually inaccessible to outsiders because of child confidentiality rules, but over four days The Times had the rare opportunity to witness it.

Upstairs from the Hawthorne branch's stark waiting room, where a guard stands watch, the phone rings at Winzer's desk.

A caller to the hotline has reported seeing three young children wearing torn clothing on the broken sidewalk outside a Popeye's chicken. Nearby, a colleague fields a report of a 7-month-old baby hospitalized after being sodomized. Another worker responds to an allegation that a young mother has abandoned her infant with her ex-boyfriend's parents.

At their computer terminals, Winzer and her colleagues begin translating the allegations into answers that fit neatly into the multiple choice questions asked by the computer program called Structured Decision Making, or SDM.

If a parent has a drug or alcohol problem, the computer adds one point to the score; no prior referrals subtracts a point. An allegation of excessive discipline, defined as "torture," adds another point.

The system provides a series of questionnaires for different stages of an investigation.

Social workers' answers to certain questions prompt action. In a safety assessment, for example, a caregiver found not to be supervising or feeding a child must be directed to immediate assistance; otherwise the computer requires that the child be detained.

After about two dozen entries on the risk assessment questionnaire, the computer kicks back a level of risk: low, moderate, high or very high.

Critics say SDM mechanizes a decision-making process that only human beings can fully comprehend. The questionnaires, they argue, fail to take full advantage of social workers' experience and intuition. Others -- including many who use SDM on a daily basis -- say it provides objectivity in answering key questions where there once was subjectivity:

Should a parent be investigated for abuse or neglect? Should a child be removed from the home? Should a child ultimately be reunited with his or her parents?

As a case moves from one point to the next, the answers to SDM's questionnaires build a complete dossier. Because Los Angeles County's child protection system works like an assembly line, no single person follows a case from beginning to end; only the computer does.

Although humans can overrule the computer, SDM's call has stood in 91% of decisions in the county on whether to open an investigation, 92% of recommendations on removing a child from a home and 99% of decisions on whether to return a child.

There is evidence that favoring math over emotion works.

Studies show that actuarial statistics used by SDM predict the likelihood that a child will be abused or neglected with a precision never obtained when humans made decisions on their own.

But SDM is only as good as the information humans enter into it.

Since it went into widespread use in Los Angeles County seven years ago, there have still been high-profile cases of children left in abusive households.

"If the social workers don't do their investigation properly, if they don't analyze the case thoroughly, it will be garbage in and garbage out," said Trish Ploehn, director of the family services department.

Hope for a good outcome

In a conference room at the Hawthorne office, veteran social worker Wendy Luke seems full of hope.

"I think you really want to do whatever it takes," she tells a mother whose four children have been in foster care for weeks.

The children -- three boys and a girl ages 4 to 10 -- were removed from the mother's care after a police officer responded to a prank 911 call and found them home alone, wrestling in their underwear. One had burned another with a spatula while trying to fry an egg. None went to school.

According to SDM criteria, the home was unsafe and the children had to be removed. Now, Luke is working to resolve the safety issues identified on the computer questionnaires.

To get her children back, the mother needs to reduce her risk factors from high to moderate on SDM's scoring system.

The mother, estranged from the violent, alcoholic father, says she is overwhelmed working as a grocery cashier from 7 a.m. to 3 p.m. with no help. Luke asks her to name her strength as a parent.

"The only strength I see right now is me wanting to get my kids back," she says, adding that she made limited calls to her children's foster homes because it was too upsetting to be apart.

What was her plan to reunite her family?

"I have no idea how to answer that. The best plan is. . . . I have no idea," the mother says, releasing the words into the air slowly. "If I answered you as a mother, I would say I want them back right now. But it would be the same, with no one to watch my kids. I can say that everything will be fine, but I would be lying."

Luke and her teammates offer the woman assistance getting on waiting lists for child care and mental health counseling.

Although her SDM score was hurt by a previously substantiated case of neglect, she can reduce her points if she can show that she is sober. Luke tells her that if she complies with parenting classes and random drug and alcohol testing, she can be reunited with her children within 180 days of their removal.

The mother, with big hoop earrings, stark eye makeup and a hardened and weary disposition, writes it all down on a napkin.

An attempt to do better

Not long ago, the decision about whether to investigate a case and whether to remove or return a child was left almost entirely to social workers.

The result, the family services department determined, was standards that were applied scattershot. Choices could be improperly influenced by individual experience and unconscious bias. Even the best decisions were often backed up by sparsely written case reports, sometimes just a paragraph long.

"We would get cases of detained children and not be able to understand why the social worker made the decision they did," said Michael Nash, the presiding judge of the county's children's court system.

In the worst cases, social workers failed to remove children from homes where they were later killed.

Even as some children died, the department suspected that too many others were detained. A small city lived in foster care, population 52,135 in 1997.

But how would the county do better? The work would have to be done with the same corps of social workers whose low pay, low level of experience and high turnover rate were blamed for many of the department's shortcomings.

A social worker starts at $35,200 a year; among those out investigating in the field, two-thirds have fewer than five years' experience with the department; 7% of the department's 3,700 social workers quit each year.

In 1999, social workers at the Santa Fe Springs office began using SDM to score families' risk. The system was expanded department-wide in 2002. The number of children in foster care is now about 21,000.

A system supporter

Winzer embraces SDM under the belief that it provides her a solid basis to navigate unfamiliar circumstances, often colored by differences in race, class and sensibilities. But she knows the system, which is used in areas across the nation, is prone to manipulation.

An anonymous tip underscores this issue. The allegation? A young girl had been sexually assaulted by her mother's boyfriend. It's the third time the allegation has been received in as many months, and the girl must be examined by a doctor again. The accusation is related as if it were an eyewitness account, yet it provides an address for the mother and daughter that is long outdated.

As Winzer listens over the phone from her bare cubicle, the mother explains that she believes the anonymous tipster is her estranged husband who is angry about her new boyfriend.

"I know, ma'am. There is nothing I can do," Winzer says.

The girl is already classified because of additional factors as being at "high risk" for abuse and is in jeopardy of being placed in foster care. Now she must undergo an intrusive and time-consuming medical examination.

Winzer hangs up the phone. "She's tripping," Winzer tells the social worker in the next cubicle, "because this is a totally bogus referral. You know this is the husband trying to put this on the new boyfriend."

Another major question is why investigations involving black children result in detentions four times more often than investigations of white children. Although a racial disparity existed before the switch to SDM, Department of Children and Family Services officials had hoped it would be mitigated by the computer.

Instead, the disparity has worsened slightly over the course of SDM's use.

Now suspicion is centering on the system's use of factors that may disadvantage black families. For example, SDM counts prior referrals against a parent even if they are not substantiated, though substantiated referrals have greater weight. Studies show that black families are more likely to be the subject of referrals, perhaps because of bias and because they more often come into contact with mandated reporters such as social service workers and police.

Richard Wexler, executive director of the National Coalition for Child Protection Reform, said that SDM presents the "veneer of objectivity" but that the use of previous referrals is a "self-reinforcing" mechanism that unfairly raises risk scores.

Raelene Freitag, director of the Children's Research Council, the organization that developed Structured Decision Making, defends the inclusion of earlier referrals as appropriate. The continued racial disparity, she says, may have more to do with unequal access to the programs that help families stay together than bias in SDM.

Backed by computer

It's midafternoon when Winzer sets out to investigate a priority call. A tip has come in that the mother of an 11-month-old boy is using drugs again.

A Compton native, Winzer had wanted to be a police officer, but her mother vetoed the plan. Social work seemed similar in many ways.

The door is open to the mother's apartment, so Winzer knocks on the wall. "Hello," she calls out, "this is Children's Services. Ms. Winzer."

The 40-year-old mother, Darlene, emerges from the apartment in a T-shirt from her faith-based drug treatment program and greets Winzer with an open smile. The apartment is sparely furnished with a couch, a mattress on the floor, a playpen doubling as a crib and a bicycle with a flat tire. The floor is strewn with compact discs.

Winzer's posture has stiffened, as she steels herself for an investigation that may end badly. The computer program's analysis will count points against Darlene because the family services department has already removed 3- and 15-year-old children from her care. The points will rise further because she has been the subject of 13 referrals to the child abuse hotline since 1999.

This might not have mattered if the mother had not told a counselor at her drug treatment program that she had relapsed.

Revealing a certain lack of guile, she tells the story again to Winzer. Over the course of an all-night jag the previous weekend, she says, she smoked up to 15 rocks of crack cocaine and swallowed a handful of sleeping pills. The baby was with a friend, she says. "My whole life is designed around not using, and I used," she says.

Winzer asks for information to contact the baby's father, but Darlene is not even able to provide a full name. "His name is Kevin, as far as I know. He goes by so many names," she says.

Winzer consults with the office and agrees with supervisors that the mother's Structured Decision Making score is now through the roof. The social worker confides to a reporter that she's thankful to have the computer program's process backing up her assessment, making sure that all factors are considered.

Fifteen minutes later, she is strapping the baby into a child seat in the back seat of her truck. The mother sits on the couch, her head in her lap, her body heaving in sobs.

Because of the boy's young age, two processes begin simultaneously: one to reunite him with his mother; one to find a permanent adoptive family. The outcome will be heavily influenced by how well the mother is able to improve her SDM score.

Before the social worker leaves, Darlene says her Section 8 housing and welfare assistance is largely dependent on her ability to retain custody. "You don't know when I will get my child back?" she asks again.

"That all depends on you," Winzer tells her.

garrett.therolf@latimes.com

latimes.com/ childabuse Glimpsing the process An accompanying article and audio slide show are available online.

Copyright © 2014, Los Angeles Times
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