After the Hotline Call

It’s too easy for innocent parents to get caught up in the child-protection system, and too difficult to then get out unscathed.

A boy sits on a bench
Esthermm / Getty

Jacob Weidner spent the first 12 days of his life on a ventilator in the neonatal intensive-care unit at OSF HealthCare Children’s Hospital of Illinois in Peoria. He was diagnosed with meningitis. After his parents, Michelle and David, brought him home, his care included medication through a catheter and near-daily appointments for cardiac, respiratory, blood- clotting, and infection-related issues. Jacob would eventually be diagnosed with a rare genetic disorder.

When Jacob was about five weeks old, on October 8, 2010, he began vomiting intensely. Michelle rushed him back to OSF HealthCare Children’s Hospital’s emergency room, where for a few terrifying moments he stopped breathing. Doctors quickly ordered a CT head scan, which seemed to show an acute skull fracture. At that point, a resident called the state’s child-abuse hotline, reporting a suspicion that Jacob had been abused. According to Michelle, none of the specialists treating Jacob were consulted before the hotline got the call.

Michelle eventually reached out to the Family Defense Center, a group I founded and led, for information and advice. Her story didn’t surprise me. I have been working with parents suspected of abuse for many years, and I offer her experience here because it encapsulates many of the problems I’ve seen—and suggests some of the ways in which they might be remedied.

Michelle’s story wouldn’t come as a surprise to anyone who works in pediatric health care, either. In keeping with a federal law that first passed in 1974, doctors and many other health-care professionals are required to report reasonably suspected child abuse to a state-designated authority. But it is up to states to define abuse and the level of suspicion required for reporting; direct who must report abuse; establish procedures for the investigation of calls (which may involve law-enforcement as well as child-protection authorities); set the penalties for failure to report; and establish the consequences of findings of abuse or neglect.

Lawmakers set up the system with the best intentions: The goal is to protect abused children and save lives. But one result of pervasive pressure, reinforced with potential civil and criminal penalties for nonreporting, is a skyrocketing number of hotline calls. According to a 2016 report, 7.4 million children came to the attention of child-abuse hotlines in a single year. In Illinois last fiscal year, 77,422 families were investigated, but only 20,023 complaints were substantiated. And for the families subjected to unfounded complaints, the harms can be very real.

Hotline reporters generally do not fret over the potential impact of their calls on the accused. They reasonably expect Child Protective Services (CPS) authorities to competently investigate each case and accurately assign blame. To some, an occasional misplaced allegation is acceptable collateral damage in the fight against a terrible crime. But as the story of the Weidners reveals, it’s rather easy for innocent people to get caught up in the system and all too difficult to then get out of it unscathed.

The resident who called the CPS hotline presumably thought Jacob had a skull fracture. While the hospital would not comment on this case because of privacy issues, it did say that its staff members must, by law, report suspected abuse and do not need to consult other doctors if they have “reasonable cause.” Child abuse was one possible cause of Jacob’s reported skull fracture—but not a particularly likely one. Jacob had no bruises or other noticeable signs of maltreatment associated with abuse, and he was in near-daily contact with doctors and nurses, who would likely have noticed abuse or neglect. If the resident had asked the treating team about the Weidners—which, according to Michelle Weidner, she did not— she would have heard that they were attentive and caring parents, not ones who presented any red flags for child abuse.

Other staff at the hospital, as Michelle recalls, quickly reassured the Weidners that the hotline call, while mandated, did not reflect their views of the Weidners’ likely culpability. After receiving the hotline call, however, CPS treated the Weidners as the prime suspects in an opened abuse investigation.

Channing Petrak, through her employer’s contract with Illinois CPS, was put in charge of providing medical evidence to the state’s investigative team. Though she is a pediatrician, she was not tasked with providing medical care to Jacob.

Petrak reviewed Jacob’s CT scan and interviewed the Weidners, who cooperated fully, believing—wrongly—that Petrak was part of Jacob’s specialized diagnostic team at OSF. Their urgent concern was for their son’s health, including his reported skull fracture.

According to a CPS report, Petrak told CPS investigators that Jacob had a “big fracture” that had to have been caused by his “hitting or being hit by a wide flat structure or object.” According to the Weidners, a CPS caseworker then informed them that they must accept a “safety plan” calling for round-the-clock supervision of all contact with Jacob and their two other children until further notice. Otherwise, all three of their children would be put into foster care. The Weidners started to live with the terrible fear that their children might be taken from them.

Threats of family separation, coupled with restrictions on families’ living arrangements during CPS investigations, are commonplace in a number of states, including Illinois. Several years ago, I co-led a class-action suit that challenged forced safety plans as unconstitutional. But in 2006, the Court of Appeals for the Seventh Circuit labeled safety plans “voluntary” agreements, thus disregarding a lower court’s finding that CPS routinely used express threats of child removal to coerce parents to agree to safety plans. The appellate court declared that an “inarticulable hunch” sufficed for the state to demand that parents agree to safety-plan restrictions during investigations. (Some corrective policies were adopted in Illinois in 2016 following further litigation, but these new policies have yet to be fully implemented statewide.)

The Weidners’ safety plan added to their stress over Jacob’s condition. Still, they faced a less extreme burden on their family life than many others have experienced. When Jacob came home from the hospital after seven days, local and out-of-state relatives and friends stepped forward to supervise family time. By comparison, in a 2011 case, grandparents tag-teamed flying from California to Illinois each week, for three months, to supervise their daughter with her baby before the investigation was dropped for lack of probable cause.

The Weidners had many advantages over most other families on the receiving end of a child-abuse allegation. For one thing, as white, middle-class professionals with graduate degrees, they fell on the privileged side of the color line that disproportionately brings minority families into contact with CPS. Indeed, an analysis of 2015 data showed that Peoria County took children into foster care from African American families at rates nearly eight times as high as those of the non–African American population. The Weidners also had better luck than many other families—they received quick, definitive proof that they were innocent. Ten days after the hotline call, on October 18, a neuroradiologist reported that he did not see a skull fracture. On the strength of that opinion, the next day, the police closed their case. The day after that, the Weidners were released from the safety plan.

Michelle asked her caseworker whether the investigation was now over, but as she recalls, the caseworker told her that Petrak wanted the investigation to remain open. (Petrak refused to comment for this story.) Exasperated, the Weidners took Jacob to a well-respected out-of-state children’s hospital, which confirmed the nonexistence of any skull fracture.

Even then, CPS refused to budge. Operating under guidelines stating that investigations should take no more than 60 days, the CPS caseworker requested an extension on the 55th day, claiming that more time was necessary to complete file notes. Only after 97 days under the CPS microscope did the Weidners receive a mailed notice deeming the abuse allegation “unfounded.”

Michelle Weidner’s 97-day-long experience with CPS bothered her deeply. She realized that she was not the sole parent to experience an erroneous abuse accusation, and she pressed for answers and accountability.

In an email to The Atlantic, the Illinois CPS said, “The first responsibility of a child-welfare agency is to protect children. We evaluate calls that come in to determine whether the caller has credible information regarding possible abuse or neglect of a child by a caregiver. If so, we assign an investigator. We take the investigations seriously, and base the conclusions on the weight of the evidence.”

CPS elaborated:

It is understandable that some parents feel our intervention was unfair and maybe even unjustified. Any questioning about what is happening in the privacy of a home is intrusive and disturbing, especially when it’s about harm to a child. If this case happened as you described it, with a doctor’s mistaken reading of an x-ray, and [CPS] took longer than seems reasonable to complete the paperwork, I understand the parents’ frustration. Nothing I can say is likely to change their view, including consideration of other factors that may have been involved in the completion of the investigation. But the parents clearly were listened to in the investigation and produced additional fact-finding. Our investigation came to the right conclusion exonerating the parents.

As I mentioned, Michelle reached out to me for information, eager to better understand the operation of the child-welfare system. In 2005, I founded and, until 2017, directed legal advocacy at the Family Defense Center in Chicago. By 2011, when I first met Michelle, I had represented dozens of families who had faced similar problems, often the result of a system remarkably lacking in checks and balances.

I had seen doctors work hand in glove with CPS to decide the merits of the hotline calls that their own hospitals had placed—a recipe for confirmation bias. They rarely used independent forensic specialists—a common practice in settings where controversies may arise over contested facts. A select group of child-abuse pediatricians served as the liaisons between accused parents and the state authorities. Later, if cases were filed in court, state prosecutors relied heavily on these same pediatricians to provide medical-expert testimony against the accused parent. None of the families I represented were informed about their assigned pediatrician’s entanglement with CPS. Some parents had freely shared personal histories with these state-paid medical consultants, only to find the same information mistranscribed in notes by the police, CPS investigators, and the state’s attorneys.

The treatment of families such as the Weidners raises serious questions about whether the system runs contrary to the American Medical Association’s codified ethics standards. Doctors have a duty to disclose third-party contracts and are expected to obtain informed consent from parents before accessing family medical records or divulging them to the state. Doctors are expected to collaborate with other specialists in reaching diagnoses. Over and over again, parents told me they felt blindsided. And they never received an apology.

Jacob Weidner was eventually diagnosed with a rare genetic disorder, pseudohypoaldosteronism, and his unusual condition was successfully treated by the age of 2. The Weidners view the child-abuse allegation against them as a stress that nearly broke them at their most vulnerable time, as they sought medical answers for their fragile son.

In March 2011, Michelle Weidner went to a local newspaper with her story, and then the phone calls started coming in. Other families in central Illinois sought her help in defending themselves from the sort of allegation that her family had fended off. In January 2018, she helped found the Family Justice Resource Center. (I’m its board president.) Five of the eight board members are also Illinois CPS exonerees. To date this year, Michelle Weidner has helped more than 25 families respond to medically based CPS hotline calls.

She’s not the only parent who’s been spurred to action by contact with CPS. In 2013, a group of mothers from several states, each of whose families had been wrongly accused of causing bone fractures in their children, created an international advocacy organization called Fractured Families. Members of the group recently mounted a successful legislative campaign for fairer independent medical assessments in Texas, culminating in the 2017 enactment of a medical-review law. It created a new state system for second or third expert opinions in cases where a medical condition might provide an alternative to a conclusion of child abuse.

Despite the passage of this new law, however, one Texas couple who had a premature infant in March got no help from the state in securing the available neutral medical review. During an April visit to a hospital in Austin to treat the infant’s viral bronchiolitis, staff reportedly saw an unexplained rib fracture and called the Texas CPS hotline.

After detecting a second possible rib fracture, Texas CPS authorities demanded that the family abide by a restrictive safety plan. The parents, in turn, pointed out that the fractures were quite possibly the result of birth trauma or a potential genetic condition, and asked the state for an independent evaluation, but their request was denied.  The family was compelled to use its own resources to gather five medical opinions from a geneticist, an endocrinologist, an obstetrician, a maternal- and fetal-medicine specialist, and a neonatologist. All took the family’s side, but the CPS-affiliated pediatrician still pressed to keep the investigation open, until the family’s lawyer intervened. The CPS investigation against the family stayed open for 71 days, with round-the-clock supervision imposed on the family for 55 days.

The CPS system needs some sensible checks to protect the innocent. “When in doubt, call the hotline” inevitably leads to unnecessary stress for wrongly accused families. Unless there’s reason to fear imminent harm to a child, a medical review for “reasonable suspicion” should precede rather than follow the decision to place a call. States need to use neutral decision makers. Relatedly, doctors who work directly with the state need to disclose their roles so that parents have a genuine and fair choice about how to respond to allegations against them; parents shouldn’t mistake physicians tasked with evaluating the merits of a hotline call for members of their child’s medical-care team. Finally, long delays in concluding investigations, especially where evidence of wrongdoing by parents has not been uncovered, should no longer be tolerated.

The goals of child-protection hotlines and investigations are to catch abusers and stop them from hurting children. Genuinely abused children would benefit most from improvements in the system; if states do a better, faster job of sorting loving families from abusive ones, then caseworkers will have more time to help children in real danger. Children whose parents deliberately hurt them and children whose parents are innocent of wrongdoing all deserve a system that gets child protection right.