Private versus Public Agencies

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The New York State website for Children and Youth with Special Health Care Needs includes many links that provide information about state services for those needs, as well as publications on the various topics. Of the many listed I was lead to a document describing city resources for special needs children. The city’s Children with Special Health Care Needs Program (CSHCN) mainly provides a diagnosis, payment of medical bills, and a treatment program. Since the brochure does not go into detail about the treatment program, one would assume that it is nothing to boast about. If parents seek further assistance for children with special needs, they must take it upon themselves to find continued treatment, therapies, and normalizing activities. It is New Alternatives for Children, Inc. (herein NAC) that many low income New Yorkers turn to for guidance, support, and treatment. NAC’s services seek to ensure the physical, social, educational, health, and mental health requirements of special needs children are met.

NAC’s brochure states that their foster care and adoption services find a home for a child with either the natural parent, if safe, or adoptive parents with “virtually no recidivism rate.” This is quite contrary to what has been stressed in the past. From the onset of our course, beginning with Love and Diane, most class speakers emphasized a major concern in the system being the high recidivism rate that occurs in most foster parent and incapable parent situation. Many parents who were incapable of parenting tried getting their child returned to them, but the cycle of incapable parenting seemed inevitable.

In the film Love and Diane, Diane’s children were in and out of foster homes throughout their entire childhood, they ran away from homes on numerous occasions, and they were constantly seeing city social workers. Yet, the struggle in the foster system continued with Diane’s daughter Love; she too was incapable of caring for her own son, Love’s grandson.

The dichotomy in recidivism rates may exist for a number of reasons. First, in prior examples it is the parent that is not mentally or emotionally capable of taking care of a child without disabilities, whereas in NAC’s case the parents may be more capable or fit but the children have severe disabilities or chronic illness that require substantial medical attention. Second, the two may differ because in the prior examples the parents fight for their child or children’s return. The parents try bettering themselves mentally, whereas in NAC’s case the parents unfortunately may not care about the return of a mentally or physically disabled child. Parents may feel it is best that their child be left in a home where there is proper medical attention available and where the child fits in. Third, NAC’s provides extra services that government agencies do not allot for. The additional services, which include the Homefinding Agency and Post Legal Adoption Network (PLAN) probably increase the success rate in foster or adoptive homes. They focus on the entire families needs, rather than just one child or parent. As mentioned in the brochure, NAC negotiated for a client, Juliana, for a refrigerator replacement. They also purchased new beds for her children, and provided her with an education specialist as well as a bilingual social worker to help solve the family problems. NAC’s eight-point method of care makes for a more stable placement for special needs children.

Yet, what happens to NAC children as they grow older? The brochure discusses a case of a college student who plans to receive a masters in art therapy. But what are the statistics on continued care through high school, and college? How many children are mainstreamed? How many remain in the therapies, and until what age? Does NAC provide services for the children who mature and eventually become parents? Do they provide services to those who have their own children?

From the transcript of trial testimonies provided by NAC it is clear that most mentally or developmentally disabled parents can never properly care for their children. It is also unlikely that parents who have severe disabilities ever get their children back from Child Protective Services once they are under examination. One mother with severe disabilities could not give her daughter eardrops for an ear infection, thus Child Protective Services had to take the child away. It is hard to determine whether this is within the child’s best interests. Once taken away who knows where that child will end up. Is a better alternative teaching parenting to mentally or developmentally disabled parents and checking up on them weekly, twice weekly, or daily? Should NAC be providing this overshadowing for its clientele? What would be most resourceful? What would be in the families best interests? What should advocates for these clients tell the courts?

The NAC brochure implies that the organization advocates for their clients educational needs within the NYC Department of Education. It is a lawyer’s duty to advocate for the client’s expressed position no matter if its in the clients best interests or not; It is a guardian’s task of determining and advocating for the best interest of the child.

Thus, if the advocacy is not within the child’s best interest is it counter to NAC’s mission of “opening doors” for children? The American Bar Association has noted,

“Even when children are represented, the representation they receive is sometimes inadequate. Children’s cases are often ‘processed,’ not advocated, and too frequently children’s interests are poorly represented.”

Attorneys face the conflict of “rolelessness”. Although legal advocacy plays an extremely important role in helping the client, is this the role NAC should play? NAC strives to help represent children with special needs, perhaps they should work to make advocacy better.