A CASE FOR REFORM OF THE CHILD WELFARE SYSTEM

There are more than half a million children in our nation's foster care system. While foster care is intended to provide a temporary safe harbor for abused and neglected children, too many of these youth spend years in foster care limbo—experiencing a turbulent life in motion as they move from placement to placement, community to community, and school to school. Youth in foster care commonly fail to receive basic health and psychological care, and nearly 20,000 youth age out of foster care every year to an adult path of homelessness, unemployment, and despair. Our entire community must work together to more responsibly parent these youth. This article will address how lawyers and child advocates can advocate for new approaches and enhanced support on behalf of the voiceless and most vulnerable members of our community. It will address existing hurdles and systemic challenges that have helped to create the current disheartening status quo. The article will then discuss strategies that advocates can employ to turn the corner on behalf of these youth at risk.     

A NOT SO HAPPY BIRTHDAY: THE FOSTER YOUTH TRANSITION FROM ADOLESCENCE INTO ADULTHOOD

Every year close to 25,000 youth age out of our foster care system; without the anchor of a family, former foster youth disproportionately join the ranks of the homeless, incarcerated, and unemployed. While the average age of financial independence in America is twenty‐six years of age, we presume that foster youth can somehow attain financial and emotional independence by age eighteen. Instead, these adolescents are woefully unprepared for independent adult life, and when they falter, too often no one is there to provide support or guidance. As a result, former foster youth are ten times more likely to be arrested than youth of the same age, race, and sex and one in four youth who age out of foster care will end up in jail within the first two years after leaving care. This article will discuss strategies for changing these disheartening outcomes for transitioning foster youth, including breaking down our silos and collectively taking charge of the lives of children in our care; keeping a watchful eye on data and outcomes and using that information to guide our actions; ensuring that the voices of youth are an ever‐present part of decisions and processes that will chart their future; and educating ourselves about best practices and new approaches. This article also discusses new opportunities that now exist to support foster youth as they move into adulthood, including new federal legislation that—for the first time—will allow states to support foster youth beyond age eighteen. Finally, this article provides a backdrop for this Special Issue and summarizes the insightful articles and innovative thinking contained herein.     

An Examination of the Postmortem Redistribution of Fentanyl and Interlaboratory Variability,

Fentanyl is a synthetic opioid agonist used for pain control. Often administered as a transdermal patch, it is an interesting drug for study of postmortem redistribution. We hypothesized that fentanyl concentrations would increase over time after death, as measured in blood drawn on the day prior to autopsy and in blood drawn at the time of autopsy in ten cases where fentanyl patches were identified at the scene. Concentrations were compared, and heart blood to femoral blood ratios were calculated as markers of postmortem redistribution. Fentanyl concentrations measured in peripheral blood drawn the day of autopsy (peripheral blood 2 [PB2]) were higher than those drawn the day prior to autopsy (peripheral blood 1 [PB1]) with a mean ratio (PB2/PB1) of 1.80. The ratio of heart blood concentrations (HB) to femoral blood concentrations drawn at autopsy (PB2) had a mean ratio (HB/PB2) of 1.08. Some cases had blood from the same source analyzed at two different laboratories, and concentrations of fentanyl in those samples showed inter‐ and intralaboratory differences up to 25 ng/mL. Postmortem fentanyl concentrations may be affected by antemortem factors, postmortem redistribution, and laboratory variability. Forensic pathologists must use caution in interpreting fentanyl levels as part of death investigation.     

The Public/Private Cleavage in a Welfare State: Attitudes Toward Public Management Reform

This study contributes to the growing literature on differences in attitudes between public and private sector employees, particularly with respect to their receptivity or resistance to public management reforms. We begin by asking the question: to what degree does perceived self-interest play a role in accounting for attitudes toward public management reforms such as downsizing, privatization, and public spending? Using attitudinal data from Sweden, a social welfare state with a large public bureaucracy, a tension is observed both among public employees in different levels of government and between public and private sector employees. In the context of public management reforms, national government employees emerge as more right-leaning politically and more supportive of public management reforms than those working in local government. The analysis finds, particularly among national government employees, that while interest as measured here is strongly related to attitudes toward reform, status as a public employee and status as a public bureaucrat are not as significant as other components of interest in accounting for attitudes toward public management reform.     

A Policy for the Retention and Extended Examination of Organs at Autopsy*

Abstract: Recent organ retention scandals and law suits have created a focus on the practice of saving postmortem tissues for extended examination or research purposes. The New Mexico Office of the Medical Investigator (OMI) established a policy to notify families about organ retention and the subsequent disposition of the tissue. The OMI examined the success of this policy in regards to the retention of brains for extended examination by analyzing data abstracted from verbal consent forms from 2003 to 2006. During this time, 715 cases were identified as needing an extended examination of the brain. The percentages of brains saved in any given year, as a percent of the total number of autopsies performed that year, were: 2003 6.5%, 2004 10.4%, and 2005 11.8%. The disposition was cremation in 79% of cases, release with the body after a determined period of time in 14%, and cut fresh in 4%. In conclusion, the instigation of a policy on the verbal notification of the next of kin when organs are retained can be successfully implemented.     

DISRUPTING THE PATHWAY FROM FOSTER CARE TO THE JUSTICE SYSTEM—A FORMER PROSECUTOR'S PERSPECTIVES ON REFORM

Nearly half a million children are victims of abuse and neglect and part of our foster care system. Over time, many of these youth cross into our juvenile and then adult justice systems; some will end up as federal offenders, immersed in a process where mandated penalties provide little room for flexibility or consideration of the characteristics and needs of the individual. This article will offer the perspectives of a former prosecutor and child welfare advocate on: (i) the current conditions and challenges within our foster care system—the feeder for many youth into gangs and criminal activity; (ii) the misaligned priorities and disheartening patterns we currently see in our justice system; and (iii) the ill‐advised practices, that set our nation apart from the rest of the world, allowing juvenile offenders to receive life without parole sentences. The article will then discuss a series of recommendations in all of these areas that would enable us to turn the corner and chart an improved and more hopeful path for our nation's vulnerable and at‐risk children and youth.