Child-protection answers within grasp; training and changes reforming S.C.
This story was orignally published in The State on January 22, 1996.
The Gail Cutro child-murder case carried a message for parents:
This state is unprepared to monitor violence against children in day care, especially in the fastest-growing type, in-home day care.
In its examination of the case, The State interviewed day-care owners, day-care regulators, child advocates, police, prosecutors, coroners, child-care experts, doctors and emergency medical technicians.
A year after her trial, here are some of the problems the Cutro investigation exposed and what, if anything, has been done about them.
Problem: No investigator went to Cutro's Irmo day care when Parker Colson died Jan. 4, 1993. Ambulance medics rushed the boy to the hospital, but no one called the police or the coroner to her home.
When Ashlan Daniel died eight months later, the police showed up, but a coroner allowed her body to be taken away without inspecting the scene.
Scene investigations are especially critical in child deaths because clues often are much more subtle, say experts in child-death investigations.
Solution: South Carolina now has uniform guidelines for gathering evidence at child-death scenes, but they are not always followed.
The guidelines were issued by the Child Fatalities Department of the State Law Enforcement Division on the day Ashlan died.
Before the Child Fatalities Department was established July 1, 1993, police and coroners dealt with child deaths in whatever ways they determined to be proper.
The Lexington and Richland coroner's offices acknowledge they made mistakes by not going to the scenes. Both say they've redoubled their efforts to follow SLED guidelines, including going to the scene whenever a child dies outside of a hospital.
Training for emergency medical technicians was upgraded last summer to teach them more about child anatomy and injuries.
Problem: South Carolina's child-protection agency, the Department of Social Services, does not have a fail-safe system to ensure that child abuse in day care is not overlooked.
The Department of Social Services did not look into Parker's death because it initially was judged to be sudden infant death syndrome, or SIDS.
The department did neither an abuse nor a regulatory investigation. Furthermore, daycare regulators didn't know that Cutro's facility was operating illegally. She had been keeping more than the limit of six children almost since she opened in June 1989.
Even the department's record-keeping policies hamstrung them. In fact, Cutro had a clean day-care file even though her home had been investigated for possible abuse nearly two years before the first death.
Solution: The child-protection agency has made many improvements since the Cutro case. Authorities now investigate most day-care deaths with a team that unites regulators who know day-care rules and caseworkers who deal with child abuse. A watchdog position also has been created to help the new system work.
However, SIDS deaths still trigger only regulatory, not abuse, reviews.
The agency has gotten more aggressive about investigating day-care complaints, including using surveillance. It also has begun cross-training caseworkers and regulators so they know more about one another's jobs.
Most day-care owners now are required to report serious injuries or deaths to the department. But 300 church-run facilities are exempt.
Problem: South Carolina does not have a uniform way of doing child autopsies, leaving procedures to individual pathologists, many of whom are not trained in criminal death investigation.
The state also does not have a pediatric pathologist who specializes in child and infant anatomy, diseases and deaths.
Initial autopsies found that Parker and Ashlan died of SIDS. The prosecution brought in out-of-state experts who testified that the children died of abuse. The experts also took issue with medical procedures used by local pathologists.
Solution: The medical-evidence debate still rages in professional circles, including in Cutro's legal appeal. But SLED's Child Fatalities Department is about to issue an autopsy protocol for all cases that come to its agents. Pathologists will have a year to try it and suggest changes.
Pediatric pathologists are highly paid specialists who usually work at teaching facilities such as Richland Memorial Hospital in Columbia or the hospital at the Medical University of South Carolina in Charleston. The pathologists can then combine incomes as instructors with laboratory work assisting forensic pathologists and coroners on selected cases.
Problem: Confusion over which agencies had jurisdiction in the Cutro case caused investigators not to realize that something was amiss, delaying an effective investigation for eight months.
While infants were dying or being hurt at the day care, the wrong law-enforcement agencies, the wrong coroner's offices and the wrong child-protection offices were investigating aspects of the case.
For about half the time she was in business, Cutro herself was registered in the wrong county. The error was discovered by an abuse caseworker who missed that her business was overcrowded, therefore operating illegally.
Solution: Jurisdictional confusion has largely been fixed by the Child Fatalities Department that has authority to investigate any suspicious child death.
Problem: Child-abuse investigators are not trained in day-care regulations, and regulators are not familiar with child-abuse investigations.
Solution: Cross-training began late last year, and abuse caseworkers now have a simplified step-by-step investigations manual to keep cases on track.
Problem: Child-protection records were kept separate in different divisions of the social-services agency, making it difficult to cross-check.
Solution: Regulators now have more extensive information about abuse complaints and have a wider computer database that backs up written files on regulatory infractions.
Before 1994, regulatory infractions were handwritten and kept in county offices until enforcement was transferred to state headquarters.
Until 1993, the agency's central database did not show whether child abusers worked at day cares.
Records of regulatory complaints and infractions are now updated daily.
Furthermore, the state office is designing systems for tracking deaths in day care and for keeping up with chronic rule-breaking and violation of abuse laws.
Problem: In-home day cares are underregulated, and children are dying or being hurt there more often than at other types of day care.
Solution: Upgrade the training of operators or tighten regulations.
Some critics say the answer lies in tougher government regulation that sets higher standards for operators and allows unannounced inspections.
Gov. David Beasley and child-protection chief Jim Clark say that self-help is the best solution. They advocate networks of trainers who hold training sessions near the day cares.
Both say more government regulation would drive up the cost to parents and even force some legitimate operators to stop registering with the state at all.
Some in-home operators say they're already overregulated, especially because of a newly approved requirement that all child-care workers submit to national criminal background checks.
Pauline LaPlant, a 35-year veteran of the day care business, says that rule may force as many as half the state's providers to bypass any government monitoring. Many say they will keep children no more than four hours per day, which exempts them from any regulation, LaPlant said.
On the other hand, a committee that oversees child-death investigations supports uniform health and safety standards for all day cares, inspections before they can accept children and giving police the power to close facilities even before a criminal charge is filed if evidence indicates danger for children.
This story was originally published July 27, 2016 at 10:51 AM with the headline "Child-protection answers within grasp; training and changes reforming S.C.."