PARENTS: THE AMBIGUOUS THREAT

CLEVELAND - It fell to Pam Cameron a couple of years ago to explain the
unexplainable to a 4-year-old boy sitting alone in the back seat of her
car. I am driving you home, she said, but home is no longer with Mom
because Mom has a problem with drugs. Home, for now, is with a foster
family, where you will be safe.

Okay, the boy said, I understand. But there was just one question.

"Miss Pam," the tiny voice floated up from behind her as they drove across
a bridge. "Would you pull over? I think I want to jump."

Once more into the abyss, a terrain Cameron travels often as a caseworker
for the Cuyahoga County Department of Children and Family Services. It is
her job to protect children from a monstrously confounding menace: parents.
Parents on drugs, parents who drink, parents bent low by poverty, parents
with mental illnesses, parents who are simply incompetent - parents who
can't and parents who won't care for their children.

Every day Cameron goes to their homes, patrolling the murky boundary
between dysfunction and danger. She is supposed to know when a dirty house
becomes a health hazard, when a parent prone to rages is likely to turn
them on a child, when erratic behavior is benign and when it is
drug-induced. If disasters lurk unseen, she is supposed to see them and
pluck children from their path. And if she does all this, and a child says
he wants to jump, she is supposed to catch him.

For which Cameron earns the same pay as a barmaid at Cleveland's swank
Diamondback Brewery.

Multiplied thousands of times, spread across communities of every size,
Cameron, at 40, is the human face of a sprawling, overwhelmed apparatus
that is the nation's child-protection system. "The compelling thing about
the work is that it's no-win," Cameron said, "and you can't not do it."

>From her Formica-topped work station, where bulging case files literally
hang over her head, Pam Cameron has a zoom-lens view of the crisis in child
welfare. She has been a caseworker for almost seven years in Cuyahoga
County, which is dominated by Cleveland, twin symbol of urban renaissance
and urban poverty. In the last five years, reports of children being
neglected and abused here have increased 24 percent; the number of children
entering foster care or kinship care - foster care with a relative - has
risen 65 percent.

National attention on child welfare tends to focus on stories of children
abused or neglected by parents whom caseworkers mistakenly deemed fit to
care for them. But the unceremonious, often dangerous work of investigating
and monitoring risk to children - work that, for all its imprecision, can
prevent the next death - proceeds with little notice.

Child protection at every stage turns on judgment calls, from how much
local taxpayers will spend to how a particular judge balances a parent's
rights against the risk to a child. And the process begins in earnest the
moment a caseworker enters the world of an unstable family.

The Book of Tragedy

"Okay, sweetie, I need to ask you a couple questions," Cameron says,
walking in unannounced on one of 20 mothers she is monitoring this month -
fathers being a disappearing species in her cases. She checks baseline
indicators of neglect: Are the children in school? Are they immunized? Is
there enough food? She examines children for bruises. This much comes from
caseworker rule books, the rest from instincts.

"I spend a lot of time in kitchens," she says. "If there's a back door, are
there signs of heavy traffic of people in and out, coming here for
something I'm not seeing?" She looks extra-hard into children's eyes. "If
there's anger or confusion they're trying to hide, that's where you see it."

Her queries seem narrow, but underneath them is a question as big as
theycome: Is a woman a mother just because she has labored a child into the
world?

In Cameron's descriptions of her cases, the mothers are all Mom - as in,
"Mom is a drug addict," or "Mom is a schizophrenic." Children often are
"pumpkin," "Booka" or other diminutives. She keeps their pictures in a
floral-covered album too pretty for the stories inside. "My book full of
tragedy," she calls it.

The pictures startle because the children look so normal. Here are three
girls dressed neatly for school pictures. "Mom and Dad are schizophrenics,"
Cameron says. "The father molested the two older ones." Here are five
children laughing on a front porch. "Mom is an alcoholic. There are four
different fathers. This girl was raped by Mom's boyfriend. The twins were
beaten up by their father."

And here is a giggling toddler in a fire chief's hat. "Mom is a crack
addict. He was a crack baby," Cameron says. "He wasn't supposed to live,
but the foster parents literally willed him back to life." The foster
family wanted to adopt him, but the boy's mother completed drug treatment,
and a judge ordered them reunited. Certain Mom would relapse, Cameron
monitored her for six months but never caught her in random urine tests.

"Then came baby number six," Cameron continues, "positive for cocaine." The
baby was put in foster care, but a judge allowed the mother to keep the
other children when she agreed to enter outpatient rehab. Then came the
horror: An older son, who had a behavior disorder, sodomized the adorable
boy whose wide-open smile Cameron now scrutinizes with anguish.

Here is one lesson of the Book of Tragedy: There are families in America
that no one can save. Congress and President Clinton acknowledged this last
year in enacting a major adoption law, making it easier for courts to
terminate some parents' rights and free foster children for adoption.

But here is another lesson of the Book of Tragedy: It often is difficult to
distinguish hopeless families from those worth fighting for.

Here is a photo of three young children on a front porch - "one of my
success stories," Cameron says. Their alcoholic mother was developmentally
disabled; her own mother had cared for her and the children. When the old
woman died, relatives reported Mom for neglecting her little ones.

Cameron had a hunch that this mother could make it - educated hunches being
the unwritten rule of casework. She arranged, over the relatives' protests,
to supervise the woman's rehabilitation, with the children still in her
care. Within two years, she dried out, married her boyfriend, rented a
house. Recently, facing an end to her disability benefits, she found a
full-time job packing boxes.

As Cameron tells this story, a pack of television camera crews rushes by
her desk, smushing into an elevator. "What now?" she grumps. Word travels
across the work stations: An alcoholic mother has escaped from a hospital
with her newborn, who was about to be placed in foster care. The baby is
underweight, has fetal alcohol syndrome, and had been on a heart monitor. A
news conference has been convened.

"The beat goes on," Cameron sighs, her Book of Tragedy open in her lap.

The Vagueness of Risk

Seven years ago, when Cameron became a caseworker, such events rarely made
the news. But children at risk are now a public obsession. Starvations,
poisonings and physical tortures have occurred in recent years in
communities of every size, in families supposedly monitored by
child-welfare agencies.

Politicians have declared zero tolerance for child-protection breakdowns -
an impossible standard, in the view of most experts, but one that
nonetheless has caused authorities to remove more and more children from
parents.

Judith Goodhand, who has won national attention as a reformer as director
of Children and Family Services here, arrived in 1992 suspecting that many
children were being removed unnecessarily. She standardized criteria for
assessing risk to children, requiring outside "facilitators" to review any
to take children into custody.

"What happened was the opposite of what I expected," Goodhand said. "I
discovered that if anything, this child should've been removed four
referrals ago." The number of foster children here reached 5,215 last
month, up from 3,500 in 1992, an increase reflected nationally.

At one level, the pattern is familiar. The foster-care population last
surged in the mid-1970s - hitting an estimated 502,000 in 1977, a number
now considered overstated - amid spreading awareness of "battered child
syndrome," first diagnosed in the 1960s. States had enacted abuse and
neglect reporting laws; Congress put a superstructure on the system in 1974
by tying federal aid to state oversight of child protection, a function
ultimately vested in local agencies and courts. That system remains in
place today.

Following that 1970s surge, however, a consensus formed that many children
in jeopardy could be protected while remaining at home. The foster-care
population plunged to 300,000 as federal and state funds poured into
counseling for stressed-out parents, homemaking services for families
living in filth, housing grants for the homeless.

But by the late 1980s, the crack epidemic rendered these services pitifully
beside the point for many families. "With other drugs, Mom may have been
too spaced out to get kids up, or to cook, but at least she was there,"
Goodhand said. "With crack, they literally walk away."

Seeking to contain the crack wave, Goodhand changed her risk protocols to
compel many addicted new mothers to enter drug treatment or face losing
their children. Her counterparts in some cities have resisted this approach
as overstepping parental rights.

She also has expanded caseworker training. After a 4-year-old was starved
to death by an aunt, workers learned to spot early signs of malnutrition.
They also learned cues for sexual abuse, drug abuse and what she calls
"global risk," agglomerations of irregularities that sometimes can point to
trouble before a bruise or a gash surfaces.

And still there are horrors. Last May, Kenneth and Sean Logan, two brothers
aged 11 and 13, died in an arson at the home of a friend of their mother's.
Police said the fire was the work of drug dealers. Children and Family
Services reported that the boys had been in foster care in the 1980s but
had been returned to their mother, remaining with her despite subsequent
reports of alleged drug use, abuse and neglect.

A public furor built, led by a county commissioner and a local TV station.
Goodhand stunned Clevelanders by announcing that, even in retrospect, she
saw no grounds to remove children because the alleged drug use and abuse
had not been confirmed.

"Until the fire, we had unsubstantiated abuse, instability of housing and a
child expelled from school for truancy," Goodhand said in an interview. "If
that were the standard, we'd have to go out and put 5,000 more children in
foster care tomorrow. We have gone over and over that case with a
fine-toothed comb and all we can say is, 'My God, how do you know that's
going to be the one?' "

Page 2

Casework's 'Gray Areas'

Every caseworker knows there is no teacher like experience, but with seven
years on the job, Cameron is a rare breed. Most workers burn out long
before or leave in search of more pay, said Michael Petit, deputy director
of the Child Welfare League of America. Cameron's $27,000 salary is typical
of caseworkers nationally. In New York City, turnover exceeded 50 percent
last year. Nationally, few agencies require a related college degree, and
many provide no more than a week or so of training before sending workers
into homes to make life-or-death judgment calls. In Cleveland, workers
train for eight weeks before receiving cases.

For all the laws and court opinions that guide it, child welfare is one of
the most inequitable services in America. In rural Morgan County, Ind.,
caseworkers monitor 15 children at a time on average; in Sacramento County,
Calif., the average is 74, meaning troubled families are visited less
frequently. Cameron usually has about 60. The federal government heavily
subsidizes foster care, which received almost 80 percent of the $4.7
billion in federal expenditures on child welfare last year. But local and
state governments bear almost all of the cost of work like Cameron's,
including investigating and monitoring troubled homes.

Although abuse and neglect seem easily detectable in high-profile cases,
most families Cameron visited with a reporter - like most cases nationally
- - are what she calls "gray area cases." After stopping in on a mother who
was bedding down four of her 10 children among blankets and dust piles in
front of a television, Cameron asks, "How dirty can a house be? If there
are 10 dust bunnies, do I take the child? Is it 12? So many decisions are
value judgments."

One Tuesday afternoon, Cameron drives to the grayest area on her caseload -
the home of a crack-addicted mother named Yolanda, living with four
children in a notorious drug corridor. Yolanda has a rare asset that has
allowed her to keep her children: a husband who is sober and, because he is
disabled, always at home. She agreed to cooperate with The Washington Post
on condition her full name not be used.

Inside, the scene is oddly wholesome. The baby is chubby. There is food in
the freezer. One daughter lazes on the front porch, coloring beautiful
rainbows. Cameron smoothes the girl's hair, calling her "Booka," makes
small talk with the husband, calling him by his nickname. They know each
other - only too well.

Cameron helps herself to a dining room chair. "When was the last time you
used?" she asks Yolanda.

"It's been over two months. Two and a half," Yolanda answers.

A lie, Cameron tells herself. Never has she met a recovering addict who
couldn't give the exact date, down to the hour, of her last fix.

Asked how often she had "used" before this purported drug-free spell,
Yolanda says, "Five or six times a month." How many times a week? "Maybe
two or three," she says.

Cameron adjusts for mendacity. Okay, more like 12 times a month. She's
minimizing. Classic addict.

Some days, Cameron thinks she should remove these children. "It looks
stable," she says, "but with crack, tomorrow can always be different." But
she sees no legal grounds, maybe not even moral ones. Under the law, a
drug-using parent is not sufficient cause to break up a family,
particularly with a sober spouse at home.

And in caseworker parlance, Yolanda is a functioning addict. She trades
food stamps for crack, but keeps her children fed - stocking up at
community food pantries - and well-clothed and immunized. In sober periods,
she even volunteers in their schools. There also is obvious affection in
this family: Cameron notes a furtive, adoring look between Yolanda and her
5-year-old.

Cameron has had Yolanda's case for almost a year, pushing her without
result to enter drug treatment. Yolanda says she can't afford it; the
family has too much income from her husband's disability to qualify for
Medicaid. Cameron found a Narcotics Anonymous class in the neighborhood,
but Yolanda never went. By now, absent the threat of having her children
removed, Cameron is persuaded Yolanda will never comply. Yet how to prove
that these children are denied basic needs, the legal grounds for neglect?

Beyond the legalisms, what vexes Cameron most is that in every
dysfunctional family there are islands of normalcy. Almost every mother, no
matter how bombed out, is at some level still Mom.

This becomes comically clear when Cameron ambushes Yolanda with what she
believes will be a killer question: "How many scoops of formula do you put
in the baby's 8-ounce bottle?" Herself a new mother, Cameron feels certain
that no crack addict could manage the math of formula-mixing.

But now it is the crackhead's turn to play Supermom.

"Pam, you're not mixing bottles one at a time!" Yolanda declares. "Get
yourself a 24-ounce spaghetti bottle, sterilize it, put in 12 scoops. You
can use it all day."

Collaborating for Change

A few weeks later, Yolanda gets a new caseworker as part of another
Goodhand reform - assigning workers to particular neighborhoods so they can
become acquainted with possible support networks for troubled families.

The new worker, Jeanette Nameth, sees the same legal hurdles as Cameron but
wants to press the issue of custody on grounds that a crack addict raising
children presents an intolerable risk - with or without a sober husband.
Senior agency officials, learning of the high-risk case, offer to help pay
for the mother's drug treatment. Yolanda agrees to go.

Still, the agency has no legal leverage if she should back out. A
conference is called. Yolanda and her husband arrive more than half an hour
late, looking pained and resentful. "I'm the man y'all are trying to
deprive of his life," Yolanda's husband complains.

"When did you last use?" the facilitator, Meghan Hickey, asks Yolanda. "Two
weeks ago," Yolanda replies. With that burst of apparent candor, Yolanda
peers around the room, up the walls, out the windows. Cameron recognizes
the gesture well - a prelude to major lying.

She reaches across the table, almost lunging at Yolanda, grasping her hands
and gazing into her eyes. "Look at me," she says, then begins firing
questions: Where did you buy the crack? What did you pay for it? Where did
you store it?

Answers tumble out. Yes, Yolanda admits, she has routinely smoked crack in
her basement, storing her stash on shelves where children might have found
it. Her husband adds his own confession, admitting that he has done nothing
to stop her. The agency has its leverage.

At one point, the facilitator turns on Cameron, questioning her
forbearance. Why, she asks, wasn't Yolanda in drug treatment after "all
this time?" Cameron fumbles for an answer, says Yolanda couldn't afford it,
doesn't mention the conundrums that bogged her down.

"Most people think caseworkers control everything, but every case is
basically a dance," she says later, "and sometimes you're leading the
dance, and sometimes you're just in it."

If Cameron had been lulled by the bizarre normalcy of Yolanda's life, she
also had come to understand her on a level no training manual could teach.
Nameth's skills - and the agency's emergency fund - got Yolanda to the
table; Cameron's skills helped ensure that she wouldn't get away. With
Nameth personally escorting her, Yolanda entered a 30-day inpatient drug
treatment program, successfully completing it in December.

Cameron knows Yolanda remains at risk for a relapse, so common among crack
addicts that counselors consider it part of recovery. As goes risk for a
mother, so too for her children.

Cameron's Special Case

It is after 6 p.m., but Cameron has one more child to see, this one in a
neighborhood a world away from crack corridors and double-digit dust
bunnies. She parks in front of a Tudor-style house with a neat flower
garden and walks into a light-filled playroom outfitted with toys and a
glorious aquarium.

It is a family child-care center, and only one child, a baby girl in a
playsuit with red buttons, remains. Cameron bends over the little girl's
playpen and locks eyes with her, their faces bursting into smiles. "Hi,
Booka!" she coos.

This baby is different from all the others. Her name is Candace Cameron.
Mom is a caseworker for the Department of Children and Family Services. Dad
is a manager for a health maintenance organization. They love their
daughter, and they have the resources - emotional and financial - to care
for her and keep her safe.

Soon Candace is home, basking in her parents' attention, gurgling with
delight at the froth she is churning up from her saliva. It looks so
simple, so unexceptional - as if functional families just happen naturally
when two people have a baby. Try telling that to the children in the Book
of Tragedy.

"There are no stories here," she says. "No traumas. No dramas. We're just
going to sit here all night and watch Candace blow bubbles."

© Copyright 1998 The Washington Post Company