The Neglectful Parens Patriae: Using Child Protective Laws to Defend the Safety Net

Introduction

Two-month-old Tyler Walrond died of malnutrition on August 27, 1997 in the Bronx. His mother, Tabitha Walrond, had tried several times to obtain medical care for him, but was turned away each time by public assistance caseworkers and medical clinic staff who told her she needed Tyler’s Medicaid number before he could receive care. These denials of aid to Tyler were unlawful. He should have been automatically provided with Medicaid coverage because his mother was on Medicaid. Unfortunately, Tyler’s case became part of a pattern which was later uncovered in federal investigations and a federal lawsuit. The City had been wrongly turning away poor parents who sought assistance to which they were legally entitled. The forces at fault in Tyler’s death were clear: an unresponsive public benefits system that turned away Ms. Walrond and her son in their hour of need, and doctors and administrators in the newly privatized Medicaid managed-care system who should have recognized this need. The federal government had recently enacted the Welfare Reform Act, creating financial incentives for states to limit access to benefits and to place strict conditions on their receipt. The City’s response was to place barriers in the way of needy families seeking help. Families applying for assistance were met with a presumption that they were not truly needy, and were forced to overcome a slew of bureaucratic obstacles blocking access to the benefits they so desperately needed. Simply by making the application process difficult and discouraging, the City deterred participation and succeeded in decreasing the welfare rolls tremendously. At the same time, these barriers to access meant that families were also unlawfully excluded from federal programs such as Medicaid and food stamps, which were supposed to remain available even as cash assistance was being cut. Thus, the door to government assistance from all levels of government was shut in the faces of needy families like Tyler Walrond’s. One might imagine that Tyler’s death would have set off a wave of activist backlash against the new punitive welfare policies. Instead, Tyler’s mother, Tabitha Walrond, was prosecuted for and convicted of criminally negligent homicide in her son’s death. Even though Ms. Walrond had attended every prenatal appointment and Lamaze class, even though doctors had failed to warn her that her earlier breast-reduction surgery might make breastfeeding dangerous, and even though both her welfare center and her Medicaid HMO had unlawfully rebuffed her attempts to obtain the medical care that could have saved her son’s life, it was she who eventually took the legal blame for his death.

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