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The abuses suffered by the children of this study were overwhelming. They often involved the drug addiction or mental illness of parents. Nearly one in three (29%) children had been a victim of sexual assault, primarily by parents and family members. The negative effects of sexual abuse permeate into adulthood as traumatic sexualization can lead to hypersexual or sexual avoid- ance behaviors. The feelings of intense guilt can mani- fest as substance abuse, self-mutilation and suicidal gestures.1

Cold case children have experienced numerous life traumas referred to as “adverse childhood events,” traumas proven to be significantly associated with lat- er life dysfunction. Such traumas include verbal abuse, physical abuse, sexual abuse, neglect, and living with a mentally ill family member. These traumas increase the chance of later problematic behavior, risky sexual practices, substance abuse, heart disease, and early death.2 While all children experienced some degree of trauma, 81% of the cold case children experienced ongoing or profound trauma. About one half of the children (51%) had multiple DSM-IV Axis I disorders or both Axis I and Axis II disorders. One in five (19%) had chronic, serious, treatment resistant mental ill- ness and/or cognitive issues. This latter level of pa- thology often requires fairly long-term inpatient care to stabilize and treat the child. Behavior issues were also prominent. One in three children (34%) exhibited behavior that was an issue in multiple settings with violence or serious criminality. An additional 16% of children exhibited behavior that was unmanageable in all but secure settings, with violence or serious crimi- nality. These children often spent long periods of time in therapeutic settings and institutions as a result.

Fellows examined for each case eight of the legal re- quirements placed on Georgia by the federal Child and Family Services Review. While the files would likely not fare well on a CFSR review, many of the cases reflect outdated agency practices because they have been in the system for so many years. A key component of this project was to use the post-review phone calls to edu- cate DFCS representatives on the importance of these CSFR areas. In that process, many county DFCS repre- sentatives volunteered to take corrective action with reviewed files in order to help meet federal standards. The legal review is summarized:

  • there was no evidence of a diligent search in 41%

of files

  • less than half (46%) of files had legal documentation

to indicate that a permanency hearing was held within one year of coming into care


  • the majority of files (71%) contained “reasonable

efforts” (to achieve permanency) language, but some would likely not survive a federal audit

  • one in four APPLA (another planned permanent

living arrangement) cases did not have “compelling reasons” documented in court orders for choosing APPLA as the permanency plan

  • 90% of children required to have a written transi-

tional living plan (WTLP) had one in their file; less than half were signed by the child

  • half (54%) of children that qualified for independent

living program (ILP) services showed evidence of a connection to services

  • half (54%) of children had a documented relation-

ship with an adult family member; another 24% had at least one connection to a non-familial adult

  • there was evidence of a plan for future education,

health, or housing needs for less than half (48%) of the children still in DFCS custody at the time of file review

  • roughly one quarter (27%) of cold case children had

an attorney

At the completion of file reviews, anonymous online surveys were conducted with two groups that work daily with foster children and have special insight into cold cases – Special Assistant Attorneys General (SAA- Gs), who serve as the Social Service Agency’s attorney, and DFCS case managers. The purpose of the surveys was to illicit qualitative detail on issues of concern, particularly areas where file review data was sparse or unclear. A total of 177 completed surveys were re- ceived (132 case managers and 45 SAAGs), evenly split across urban/suburban and rural locales.

When asked to consider system-wide challenges to achieving permanency for children, almost one-quar- ter of case managers mentioned practices at the state level of DFCS. Examples ranged from outdated poli- cies, pressure on local offices to “keep their numbers down” which can result in hasty placements, and a glut of mandated meetings and trainings which keep case managers out of the field where they could be working with children and families. Challenges also included large caseloads and high staff turnover, and a lack of permanency options for teens and special needs children.

SAAGs described the lack of funding to address the needs of parents and children, particularly funding

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