REPORT SAYS ABANDONED-BABY PROBLEM GROWING

WASHINGTON - In the late 1980s, as the crack epidemic reached a peak in
America's largest cities, thousands of newborns were stranded in urban
hospitals, abandoned by mothers too sick, too addicted to care for them.

Since then hospitals, child protective agencies and social workers have been
working together to attack the problem with intervention programs funded in
part by Congress under the Abandoned Infant Assistance Act.

But after a decade of such effort, the numbers of "abandoned" and "boarder
babies" in hospitals have increased substantially, according to a troubling
new study produced for the U.S. Department of Health and Human Services.

The number of boarder babies - infants medically ready to leave hospitals
but stranded for lack of suitable homes - has jumped a startling 38 percent,
from 9,700 in 1991 to 13,400 in 1998.

And the number of abandoned infants - those being treated but who are
unlikely to go home with their biological parents - has shot up 46 percent,
from 11,900 in 1991 to 17,400 in 1998.

Those numbers, in a draft copy of the study obtained by Knight Ridder,
appear likely to stir concern among children's advocates and health-care
professionals.

"This is incredible human waste," said Gretchen Buchenholz, executive
director of the Association to Benefit Children, a New York-based advocacy
group that has sued to fight what she calls "the warehousing of babies."The
hospital babies had been difficult to place because of their reputation for
having special medical needs. But in fact only 28 percent of boarder babies
had serious medical problems in 1998. Some 45 percent of abandoned babies
had medical conditions in 1998. Around two-thirds of all the babies were
exposed to drugs, but only a small fraction tested positive for HIV.

The study indicates that while a few big cities have apparently made
progress, the problem of babies left in hospitals has persisted in most and
has spread to smaller cities.

Places that in 1991 had no identifiable problem are trying to cope with
burgeoning caseloads of abandoned and boarder babies, the as-yet unpublished
study found.

"I think there had been a sense that the boarder baby problem was
disappearing. We're under an illusion," said researcher Elyse Kaye, who
headed the study.

A persistent national drug problem and spreading drug use in smaller cities
and rural areas are believed to be contributing to the problem. And there
are growing reports of family violence. But childcare experts say the
reasons more babies are left in hospitals are difficult to untangle.

"Even though there has been some increase, we can't account for all the
reasons," HHS spokesman Michael Kharfen said this week.

Whatever the causes, the phenomenon that has strained foster-care and
family-care networks and stretched social-services budgets continues to unfold.

Children's hospital stays are shorter, but more of them are being served and
costs have risen from an estimated $476 a day in 1991 to $548 in 1998. "Most
of those rates are more than a foster family would receive for an entire
month," says Kaye.

But the real costs are to the children themselves.

Kaye said she finds an "alarming aspect" to the problem's "spread to smaller
counties where we hadn't seen it before."Kaye is vice president of James
Bell Associates, an Arlington, Va.-based research and evaluation consulting
firm commissioned by HHS to update estimates of abandoned and boarder babies
and to assess how the nature of the problem had changed. Her company
conducted a similar survey in 1991.

The statistics were gathered from 865 hospitals in counties identified by
their state child-welfare agencies as having a boarder-baby problem in 1991
and 926 hospitals in counties that were similarly identified in 1998.

The key factor in the persistent hospital baby problem appears to be a
continuing, insidious spread of drug addiction. Crack cocaine, a cheap,
powerful stimulant, can cause users to lose interest in any goal but
obtaining the next high, and has led to many abandoned babies.

"Crack is still king in this," Kaye said.

Methamphetamine, another highly addictive stimulant, which can be made in
any kitchen, also appears to be stirring trouble. Methamphetamine use seems
to be growing in places off the major drug supply lines found in cities,
including rural and urban sections of the South and Midwest.

Says Kaye: "That's a drug locally made in trailers, garages. "Kharfen of the
HHS agrees that drugs are to blame in many cases. He noted that 520,000
children of all ages were in foster care in 1998, up from 422,000 in 1991.
"We're seeing different trends coincide," said Kharfen. "Substance abuse is
the leading factor (in why) these children are coming into foster
care."Still, a few large cities -Detroit, New York and Washington - have
seen a reduction in hospital baby cases because child protection agencies
and medical institutions have progressed in investigating abandonments and
working swiftly and cooperatively to find proper placements for the babies,
according to the report.

Detroit has seen boarder-baby cases drop 62 percent, from 707 in 1991 to 266
in 1998, according to the study. The number of reported abandoned infants
fell 31 percent, from 380 in 1991 to 261 in 1998.

"Before, we were lone rangers," said Guadalupe Lara, a child and family
support program manager at Children's Hospital of Michigan in Detroit. "We
didn't have a process in place," she recalled.

Over the years, professionals from all disciplines have developed a team
approach. They have become much faster at identifying children at risk and
have set up procedures to speedily find suitable placements, inside or
outside the children's families. "We're always looking for foster families,"
said Lara.

"This is not a hotel. It's not healthy for a well child to be in a
hospital," she concluded.

Just outside Washington, the change is also visible at St. Ann's Infant and
Maternity Home, a refuge for some hospital babies.

In a nursery there on a recent afternoon, a caregiver patiently juggled five
babies all anxious for dinner at the same time. But the number of abandoned
infants and boarder babies who come to this place of pastel tiled hallways,
and of statues of motherly saints, has dwindled.

"Five years ago we actually opened a new nursery, there were so many babies.
Six beds - we'd say they never got cold," said Lisa Boyle, the
social-service director. "We're getting fewer and fewer."Cooperative efforts
led by a new coalition of Washington's private child-welfare agencies have
been credited with helping to make the difference by working to place
abandoned babies, and by targeting social services toward their families.

But other cities, including as Seattle, Cleveland and Newark, N.J., have
apparently seen steep increases in their numbers of boarder babies,
according to the HHS report.

In Cleveland, local officials acknowledge the problem.

Cuyahoga County, where the city is located, reported 252 "boarder babies" in
1998, up from 153 in 1991, according to the HHS report; and the number of
abandoned infants was up to 343 in 1998 from 108 in 1991.

Laurel Conrad, a spokeswoman for Cuyahoga County's Department of Children
and Family Services, says she has seen a huge increase in allegations of
abuse and neglect involving children of all ages.

"Drugs have played a big part in it in the past 10 years," she said.

Conrad says the county is attempting to identify and work with families at
risk and to find new families for children who cannot rejoin their parents.
"We call them great kids with bad parents."Others elsewhere question the
report's findings.

At Project BABIES, a community-based organization in Newark that works with
substance-abusing women to preserve and reunify their families, officials
challenged the report.

"It raises a lot of questions; how the numbers have been counted; whether
the numbers are accurate. Now it would look like New York has decreased and
Newark has tripled," said Karen Towns, deputy executive director. "Are they
indicative of reality?"Beyond the troubled urban centers the growth has been
extraordinary. When the eight counties with the largest numbers of hospital
babies are excluded, the boarder baby problem grew by 111 percent from 1991
to 1998 - from 3,779 to 7,979 hospitalized babies. The number of abandoned
babies rose 68 percent in these communities - from 6,840 to 11,492.

The names of individual communities other than the eight largest are not in
the report, because its purpose was to provide a national picture, Kaye
said. Locations in at least 39 states are included.

Dealing with this intractable problem will never be easy, experts believe.

At the HHS, Kharfen believes the future lies in learning from the
innovations of the past 10 years. "In many ways, the problem of children
staying in hospitals for a very long time - the system being ill-equipped to
deal with these infants - has improved substantially."Buchenholz, of the
Association to Benefit Children,
said she too is heartened by signs of progress in some of the cities where
her organization has fought battles. But she is troubled by the problem's
apparent spread.

"I think there's some national work to be done on this issue," she says.
"Drug treatment and prevention; and once the baby is born, we need a
national system to be sure the babies aren't housed in hospitals."