Danieal Kelly’s Death Could Have Been Prevented

Today the jury goes back to work in the Danieal Kelly case. Given the facts of the case, I would not want to be on that jury. Like many similar cases that make headlines way too late, this case caused people to wonder, “How could a child die when being monitored by DHS?” What we learn is that DHS—or an equivalent entity in other cities and states—is not monitoring. This causes a great hue and cry, reforms are made, and then it happens again with another child who comes to our attention only after abuse, neglect or death.

I recognize that the system is underfunded, understaffed, that social workers have brutal jobs and are severely underpaid. But in my experience working in the mental health system, I have seen social workers go above and beyond for the people they serve in the most heroic way possible. The social workers on the front lines who make a difference in people’s lives are, in my opinion, as worthy of praise as firefighters and police officers. And they prove that it’s far from impossible to do the job well.

Because their jobs are so stressful, it’s key to have good managers who facilitate good performance but also hold them accountable when they don’t excel, or worse, when they are neglectful. In my experience, I was shocked to see how many employees were retained even when everyone at an agency knew they were doing a terrible job. In the private sector these employees would have been terminated, albeit after the requisite HR mandates. So why, in the nonprofit and public sector, are poor employees kept on?

Let me give you an example. At one agency, there was an employee who slept on the job every day. He worked at a place where people with mental illnesses came for help, comfort and company. They generally weren’t in crisis, but they were entitled to be treated with respect. To have the staffer on duty sleeping all the time—what message does this convey to the visitors, who are already treated poorly by society? This staffer failed to do other work that was unrelated to interacting with people, i.e., paperwork and the like. He slept and slept and slept.

He was thought of as a joke. His manager wanted him fired. But the administration was reluctant to make a move. In this case, it was a question of being understaffed. Would a replacement be any better? The pay was so incredibly low, and applicants were often unqualified. If he was fired without a suitable replacement, the agency would be violating laws by not having sufficient staff at the location. But initiating a hiring process would be tough too, given that the job would be posted publicly and Sleepytime would find out. There was also a feeling that this guy—who was working additional jobs to make ends meet—was entitled to his sleep. As is so often the case, the needs of the clients, as they are sometimes called, was absolutely secondary.

Another example: A woman employee at a different facility was having increasing trouble coming to work regularly. Her behavior was erratic when she was there. In fact, several times she compromised the safety of her clients with her bizarre behaviors. Everyone felt keenly for her because she wasn’t well. She needed help. In the meantime, though, she simply wasn’t fit to be responsible for people. But I heard she wasn’t being fired because the administration feared a lawsuit for wrongful termination or discrimination. This fear was deeply entrenched. Employees often said, “I can’t get fired. They’re terrified of lawsuits.” This enabled some pretty bad behavior.

There was another employee who called out of work every Monday after payday. Each time he called out, he’d say a different family member had died and he had to go to the funeral out of state. Pretty soon his whole family was dead, including distant cousins. He missed as much work as he could get away with without violating rules. He was in direct service, meaning that clients depended on him particularly. His cavalier attitude about attendance was disrespectful and caused his co-workers to have to pick up his slack, thereby causing problems for their clients. Yet everyone laughed about his “antics.” And his supervisors said they couldn’t fire him because no one had proof that he was lying. Other aspects of his performance were subpar as well.  Then he was accused of sexual harassment—which he’d been fired for at his last job. The accuser in this case was credible. But, to be fair (and I agree with this), the agency launched an investigation—an investigation that took a very long time. Ultimately, the results of the investigation were termed inconclusive. He kept his job.

And in a similar instance, an employee who was accused of sexual harassment—and was found culpable—was not terminated but simply demoted and moved to a different department. I don’t think it’s a stretch to say that the transfers I saw were not unlike the Catholic Church shifting guilty priests around.

In the case of Danieal Kelly, social worker Dana Poindexter’s employment history was appalling. In the private sector—and I’m talking even at a Barnes & Noble or something—he would have been fired 20 times over. But instead of working at a bookstore, he was responsible for safeguarding the lives of vulnerable children. The Inquirer has done excellent reporting on this case and revealed a very problematic work history. From the paper:

As a DHS intake social worker, Poindexter was assigned to investigate hotline allegations of child abuse or neglect. Poindexter had 60 days to file a report recommending services or close the case.

In a June 25, 2003, evaluation, [supervisor Donna] Grubb wrote that Poindexter still had eight cases assigned to him in 2001—all awaiting determinations.

“This failure to move your cases deprives children and families of the services that they desperately need,” Grubb wrote.

Emphasis mine because this kind of evaluation—that acknowledges he is not working hard enough to protect children—was probably filed away in an HR drawer somewhere and essentially forgotten. I have seen that countless times. Rather than sound an alarm and say, “He is jeopardizing lives!” things just move along. Also from the Inky:

DHS social worker Catherine Mondi testified that she was sent to investigate the Kelly household on June 20, 2004, after an anonymous call to the DHS hotline….. Mondi, who said she believed Andrea Kelly and her children needed services immediately, told the jury she followed DHS protocol and reported to Poindexter.

More than a year later, on September 15, 2005, social worker Trina Jenkins testified that she was sent to the Kelly household, at a new address, responding to another anonymous hotline call. Jenkins said she also found Andrea Kelly overwhelmed and, two years after Danieal’s case was first opened, none of the children was in school and Danieal had not received medical or therapeutic care…. Like Mondi a year earlier, Jenkins said she went to Poindexter and his supervisor, Janice Walker, but got a hostile reception.

The blog Dreamin Demon (which I confess to being unfamiliar with) puts things more bluntly:

Poindexter received a report in October 2002 about Andrea Kelly’s children living in a house with no gas, no water, no working toilets, and a collapsed roof. All he had to do was determine, by December 8, 2002, that the Kelly family needed services or that the children were not at risk. However, he did nothing. And this was crucial for Danieal, because whenever a case is not properly closed by the intake unit, any subsequent reports will go to the worker with the unclosed case: in this case, Dana Poindexter. Danieal’s family was hotlined four more times between October 2002 and April 2005. All four reports landed on the desk of Dana Poindexter. And every single time, he did nothing. NOTHING. According to the grand jury’s report, he “failed to complete a single investigative report, progress note, risk assessment, or any other document required by DHS.” …

In April 2007, a detective with the Philadelphia District Attorney’s Office searched Poindexter’s work area. In his cubicle, she found a cardboard box large enough to hold a file cabinet. It was filled to the top with case files, food wrappers and unopened mail (some four years old). At the bottom of the box was the Kelly family file. …

And yes, of course, the story becomes even worse when you consider that Poindexter’s immediate supervisor Janice Walker referred to his paperwork as “horrendous” yet gave him satisfactory and even superior ratings on his evaluations. Not enough for you? Janice Walker’s immediate supervisor Martha Poller falsified DHS records to conceal Poindexter’s nonperformance. Poller subsequently was promoted … to oversee child fatality reviews.

So now that you’ve read all this, are you surprised Danieal Kelly died? I’m not. I wish I were.