Page 91 - Impact: Collected Essays on the Threat of Economic Inequality

Relative Care Within a Public Health Paradigm
89
Kele M. Stewart1
The beleaguered child welfare system is the primary means by which poor families obtain legal custodial rights and state support to allow a relative to care for a child . Kinship care, in which children are raised by relatives or someone else with an emotional connection, is an important resource when parents struggle with poverty-related stressors such as substance abuse, incarceration, mental illness, and homelessness .2 Legal custody, which allows the relative to fulfill parenting functions such as participating in school or authorizing medical care, may be difficult to access through private family law proceedings . The relative may not be able to care for a niece or grandchild without financial assistance and services that, with the diminution of the welfare state, are less available outside of the child welfare system . This assistance comes at an onerous cost as families must subject themselves to the punitive child welfare system . A public health approach has been proposed as an alternative paradigm to provide a continuum of community- based services to children and families, and relegate the current crisis-oriented child welfare system to fewer situations with severe maltreatment .3 Legal scholars have only recently begun to explore how the law can shape and support a public health paradigm for child well-being . This essay contributes to that project by examining the legal structure needed to help relatives care for children in a public health paradigm . The law should make it feasible for families to get custody orders that meet their specific needs, and provide need-based support and services to relatives without having to enter the child welfare system .
I. Public Health Paradigm as an Alternative to Child Welfare
a. The Failings of the Child Welfare System
The child welfare system uses an adversarial model in which the state has the power to investigate reports of abuse and, for substantiated reports, remove children from their home and assume custody . Mandatory reporting laws encourage high-volume reports, and much of the system’s resources are devoted to investigating and proving parental fault . Services are provided to parents, who must quickly get their lives together, or risk permanently losing custody of their children .
1 Professor of Clinical Legal Education, University of Miami School of Law.
2 Marc Winokur et al., Kinship Care in the United States: A Systematic Review of Evidence-Based Research, soc. work. res. cTr.1, 2 (2005), available at http://www.ssw.chhs.colostate.edu/research/swrc/files/KinshipCareSystematicReview. pdf.
3 Public health describes a complex system that draws on knowledge from multiple sciences, and includes services, programs, and policies that focus on health and safety on a broad scale. It is rooted in the social-ecological view that “a complex interplay of biological, behavioral, psychological, social and environmental factors contribute to health outcomes.” Theresa Covington, The Public Health Approach for Understanding and Preventing Child Maltreatment: A Brief Review of the Literature and a Call to Action, 92 child welfare, n. 2, 22 (2013). As applied to child maltreatment, public health strategies: address the range of conditions that place children at risk for abuse or neglect; provide prevention efforts at different levels—individual, family, community, and societal; operate in a range of community settings that serve children; and are implemented through a continuum of services that are targeted to the level of risk involved. Id. at 22; Francine Zimmerman & James A. Mercy, A Better Start: Child Maltreatment Prevention as a Public Health Priority, 30 zero To Three (j), n. 5, 4-6 (2010), available at http:// vetoviolence.cdc.gov/apps/phl/docs/A_Better_Start.pdf.
Protecting Families