The Aftermath: Nebraska's Safe Haven Law

Leslie Byers never wanted to stop being a mother. She did, however, want to say goodbye to her daughter before giving up her rights as a parent to the state of Nebraska. After months of agonizing, Leslie had decided to voluntarily surrender custody of Megan, 10, who had been wracked for almost her entire childhood by severe mental illness—an affliction that called for care so intensive and expensive that the Byers family could no longer provide it. The state could, but only if it took over Megan's guardianship. That was how Leslie found herself at a Boys Town outpost in Omaha, watching a team of social workers lead her daughter down the fluorescent-lit hall and out of her care.

As Leslie stood in the hallway, something troubled her: Megan wasn't looking back. Leslie asked for permission to say goodbye, but a social worker told her no. Leslie left, alone. That night, in her new, institutional bedroom, Megan started crying for her mother. A staff member came in to see what was wrong, but with cold comfort to offer. "Your mother can't help you," Megan would later recall the staffer saying. "She's not your legal guardian anymore." The next day, Leslie was back to visit, and Megan had a question for her. Sitting across the table, Leslie's daughter looked at her and said, "They told me you gave me away, Mommy. Why did you give me away?"

It has been more than 12 years since Byers gave up her legal role in her daughter's life through a controversial yet surprisingly common practice called "custody relinquishment." But the story of how and why she did has taken on a freshly painful significance for her in the last two months. It is one that Byers, now the president of the board of the Nebraska Family Support Network, is hearing over and over again from other parents. In September, Nebraska enacted its now-infamous Safe Haven law, allowing parents to leave children up to age 18 at hospitals throughout the state without going through the more involved custody relinquishment process. Thirty-five kids, mostly preteens and teens—five of them from other states—were dropped off before the state legislature hastily convened to amend the law on Nov. 21. In some cases, these families' circumstances—their tragedies and unmet needs—were the same as those that had driven Byers to give up custody of her own daughter. Many of the teens were suffering from mental illness and behavioral problems; they had depleted their families' financial and emotional wells. Two of the families sought out Byerses' help. "The crisis that these children and families were in was one where the parents had gotten to the point of saying, 'Oh my God, my child is going to end up in jail or worse, dead'," she says. "They felt they had no choice but to do this."

Nebraska's amended Safe Haven law—which went into effect Nov. 22, a day after the state's Republican Gov. David Heineman signed off—now applies only to babies under 30 days old. Many child advocates applaud the fix; they say parents of older children should never use safe-haven laws, lest they scar their children with the stigma of abandonment. But the new formulation of the Safe Haven law does nothing to address the desperation that drove some of the original Safe Haven parents—from Nebraska and elsewhere—to drop off their children. As national attention to Nebraska begins to dim, some worry that momentum for helping those parents and others like them is in danger of fading, too.

On Tuesday, a 75-person task force of state senators, Safe Haven families and child-welfare advocates—including Leslie Byers—met at Boys Town's national headquarters in Omaha for the first of three daylong sessions to discuss changes to the state's system of family services. A second session is scheduled for today. It's a starting point. But nothing official will happen until at least January, when the state legislature reconvenes. At that point, the Safe Haven law will no longer be a pressing issue, and any follow-up legislation will need a fresh gust of political wind to pass—let alone be properly executed and funded. Nebraska's history of enacting such services at full capacity is spotty at best, and the current economic crisis won't make that challenge any easier. What will the state do for its most desperate parents, if anything? Will other states, whose own laws had families crossing state lines into Nebraska seeking relief, follow suit? And will that be enough—or will there be many more families like the Byers, so demoralized as to believe the best thing they can do for their children is to give them up?

Megan Byers's story begins much like those of some of the recent Safe Haven kids. Well before she was 10, Megan was "a danger to herself and others," says Leslie. She cut herself with razor blades, broke windows and threw plates and made threats on her mother's life. "This wasn't a child in a temper tantrum who wouldn't go to bed when you wanted her to," says Leslie. "This was a child who would fly into a rage, and you're praying to God the police get there in time. Meanwhile, you've got your two other kids huddled in the basement. You get to a point where you say, 'If I don't take the step of giving up this child, I'm afraid I'm going to be going to a funeral'."

Leslie and Steve Byers tried a range of parenting tactics to see if they could help Megan calm down. They talked to priests. They negotiated with Megan's school. They sought out psychiatrists and tried six months in a residential treatment center. Nothing seemed to help, and they began to wonder if there was anyone left to call. "If you have a burglar in your home, you call 911. If you have a medical emergency, you can go to the doctor," says Steve. "But with a child with mental illness, parents don't know who to contact. We didn't know what role this agency or this person or that person played or what kind of authority they had. We were groping in the dark."

By the time Leslie and Steve decided they could no longer care for their daughter, they were right—they had no financial way to do it. The Byers were not poor by any measure, but they did not have enough money to keep Megan in the regular, intensive, inpatient treatment that her psychiatrists had recommended; at $1,000 to $2,000 a day, very few families would. Steve and Leslie Byers had health insurance for themselves and their children, but that was no help. In less than a year, between April 1995 and March 1996, Megan was hospitalized seven times, swiftly exceeding her parents' insurance cap of $70,000 for such services over a lifetime. The Byers resorted to calling the police when Megan's illness, eventually diagnosed as bipolar disorder, got out of hand. "The officers came, and in their mind it was a domestic violence situation, so they manhandled her and handcuffed her," says Leslie. "She was taken to the ER, given a shot of Thorazine, and sent home. That was the only form of treatment we had left. They just knocked her out. They treat dogs better than this."

Unwilling to tolerate the ER "treatment" and unable to pay for anything better, the Byerses asked one of Megan's doctors what to do. He told the family he "didn't know how we were going to make it," says Leslie, "but that in the end, we would have go to through the courts." There was, it turned out, one program that could pay for the services Megan needed: Medicaid. But the Byerses' income far surpassed the threshold to qualify. The only way to get Megan on Medicaid was to make her a ward of the state through the controversial process called custody relinquishment—one that to some degree mirrors the first version of Nebraska's Safe Haven law. Fourteen states do not allow custody relinquishment, in which parents voluntarily turn over their children to the government. In at least 25 other states, according to the Judge David L. Bazelon Center for Mental Health Law, the practice is used or considered by "as many as 20 percent of families of children with serious emotional disturbance." Other reports suggest that many children across the U.S. have entered the child-welfare or justice systems solely for the purpose of getting mental-health care; a 2003 report by the General Accounting Office identified 12,700 such kids in 19 states alone.

The Byerses did not like the idea of giving up custody of their daughter, even if it seemed to be the only way to get her help. "We fought it and fought it and fought it. We tried not to have to go that route. It was like, how could you ask a parent to do that?" says Leslie. As they were agonizing over what to do, Megan was getting worse. One morning in the spring of 1996, after Megan had flown into another rage and been drugged up in the ER yet again, Leslie's youngest son said to her: "Mommy, I like it better when Megan's not here." Leslie met Steve at a local park, and they made their decision. On May 11, Megan entered state custody.

"I had realized," says Leslie, "that my family was already being torn apart."

Giving up custody did mean that Megan got help. It was not, however, easy on her or the rest of the family. Megan's school, her psychiatrists and state workers "put up roadblocks," says Leslie, ignoring what her parents had to say about Megan's care. Yes, Leslie thought, I did give up my legal rights, but I am still her mother. Why aren't people listening to me? "Once families get in the system, it's not pretty," says Leslie. "Once you give up custody, you finally get help for your child, but it comes at the cost of losing a say in your child's life. The family members are patently presumed to be part of the problem rather than imagined as part of the solution. Now the door is just shut in a different way. Instead of being a useful resource for your child, you are ostracized, shamed and blamed." The Byers family visited Megan weekly at Boys Town and other residential centers where she was treated until moving back home in 2002, just before her senior year in high school; they enrolled in family therapy. But Leslie constantly fought against state workers—one of whom, she says, tried to prevent her from visiting after Megan attempted suicide—who assumed she had simply turned her back on her child. "That's not it," she says. "Giving up custody didn't mean not wanting to be a parent. This was me doing my job as a parent."

While Megan slowly got better as a ward of the state, Leslie looked for ways to assuage her guilt—and to help other families. She found a calling at the Nebraska Family Support Network (NSFN), a nonprofit where she eventually became president of the board. When the Safe Haven families started streaming into Nebraska hospitals this September, she took on an additional responsibility: shepherding them through the court system, making sure they knew their rights and trying to ease their burdens.

Lavennia Coover was one mother who came to Byers. Coover had brought her 11-year-old son Skyler to a Nebraska hospital Sept. 24—the same night a father dropped off his nine kids at another hospital. A teacher, Coover occasionally led parenting classes; she had tried to keep her own son under control, to no avail. Since Skyler was 8, he had been ill. Like Megan Byers, he had kicked and bit and scratched and been thrown out of school repeatedly; psychiatrists had diagnosed him with multiple disorders. The single type of intensive behavioral therapy that seemed to help him was available only in Omaha, an hour and a half from where Coover, a divorced mother of three, lived. "He went for three weeks. At the end … I couldn't do it anymore," Coover says. "It was too much time off work and too much to pay for gas back and forth. It came down the point of [how] do I pay for medicine, how do I take care of my kid? I was in a money crunch every way you can think of." Medication—usually Depakote and Seroquel—cost $450 a month, and it didn't seem to help. "He would sleep all day and then wake up and rage," Coover says. "He was sleeping and raging his life away."

As months went by, Skyler became more and more aggressive, kicking his mother in the face, wrestling with his older brother "and making him cry, or else he wasn't satisfied." A stray kitten showed up at the house; when, a few days later, it appeared to be hurt, Coover strongly suspected her son had attacked it. Coover did not want to go through traditional channels to get help. She did not know about some of them—"I had no clue NFSN was even here," she says—and those she did know about, she didn't think would help. Her older daughter, who was also mentally ill, had been through Boys Town a few years after Megan Byers; ultimately, she was kicked out. Coover's parents told her about the new Safe Haven law. She started to see it as her best—perhaps her only, and certainly her fastest—option to get help for Skyler. She called a local hospital. "The one question I had for them was, will he get the help he needs? And they said, 'Yes, definitely'," she says. On the night of the 24th, Skyler left the house for the first time in weeks, coming into the yard. "I thought, 'This is my moment'," says Coover. "I said, 'Hey, let's get in the truck and go for a ride'."

At the hospital, Coover told Skyler he would have to go in; he did, but only after begging and pleading for another chance; he walked in with clenched fists. Coover went in, too. She wanted to stay, to find out what would happen to her son. Instead, she says, a caseworker pressured her to leave. "I gave everybody my information—my work phone, my home phone, my cell phone, my name. It was about 11:45, and I had to go," she says. "Skyler turned his back to me and I told him I loved him and gave him a kiss and a hug, and he didn't respond. Then I left and I cried all the way home. It was the longest drive of my life."

In Lavennia Coover's story, Leslie Byers heard something of her own. She understood the dilemma Coover had faced: give up custody of your child, or give up any hope of him getting serious and costly mental-health treatment. "Lavennia researched this [Safe Haven] law, and she's a very educated woman," says Byers. "She had gone through a great deal of thought with this. It wasn't an impulsive action."

Meanwhile, Byers had started pondering some action of her own. The Safe Haven law had begun to attract national attention—in her mind, the wrong kind. Families like Coover's were being hotly criticized for dropping off their kids, but no one, she thought, was paying attention to the forces that might have driven them to do so. She began to reach out to a far-flung group of people—child-welfare advocates, families such as Coover's, state senators—who might recognize the need to help parents who had reached wits' end, those who needed intensive services but for whatever reason could not seem to get them.

On Nov. 17, Byers and Coover traveled to the state capitol with a busload of other advocates. There, Coover testified about the Safe Haven law, telling her story—not just how she had felt compelled to turn Skyler over, but what had happened afterward. Coover wasn't told where her son was placed for four days; Todd Landry, the children and family services director for Nebraska Health and Human Services, told the media Coover had "misinterpreted" when she could expect to hear about placement. In the interim, Douglas County child-welfare officials charged her with neglect, an allegation she vigorously disputes. The state, Coover said, was "trying to prove that I was a bad parent"; people were persecuting her for a decision she never wanted to have to make. It was a feeling Leslie, sitting in the audience, knew well.

Today, Coover's case is in limbo. She has secured the right to regular visits with her son, who is being placed with a foster family, but she is still being charged with neglect. Scot Adams, director of Behavioral Health for Nebraska's Department of Health and Human Services, says he's unaware of any neglect cases among Safe Haven parents in which charges are unwarranted. A trial date is set for February. In the meantime, Coover continues to speak out about the lack of services for struggling families in Nebraska and the difficulty of supporting a mentally ill child on a low income.

Byers, too, is becoming one of the public faces of the Safe Haven controversy. Shortly before the state legislature amended the law to apply only to babies, she joined with other staffers at NFSN and similar groups to push for changes modeled on the child-welfare system in Florida, which is more comprehensive than Nebraska's. By the start of the new legislative session in January, the group will have met with seven state senators and a coalition of other advocates and families three times to try to come to a consensus on what the state should do. The hope is to gather support from enough senators to ensure that draft legislation—possibly calling for more funding for child welfare, new crisis centers for adolescents and a stronger emphasis on early intervention for families of troubled kids—will make it out of committee and onto the Senate floor. "There will be three eight-hour days where they'll lock the doors and we're going to hash it out," says Eve Bleyhl, the executive director of NFSN. "We can't put it off for much longer."

What consensus this group will actually reach is unclear. But it's a good guess that new legislation will call for more funding for the child-welfare system that is already in place. In some ways, this is a fix that applies across the board—one that is needed not just in Nebraska but in most states. "Child welfare is one of the least-funded programs in every state," says Father Steven Boes, the national executive director of Boys Town, which has campuses in 12 states. "Providers have to scrounge for money; it's like riding your horse into the ground without giving it food or water. Even the states that fund it well don't fund it enough." Many states try to "limit their costs, especially in these down economic times," says Boes, by giving inadequate care to kids with serious problems. "The kids with high-level needs are the slowest to get let into the system," he says, "because they're more expensive. The system is designed from the nationwide level on down to put kids in the lowest levels—the cheapest levels—of care first. That can be pennywise and dollar-foolish. The state doesn't always pick the right level of care at the right time, and kids end up cycling through the system again and again. They come to feel like failures, and in the process they cost the state a huge amount of money."

Nebraska is not one of the states that funds child welfare well. Jim Blue, president of Cedars Youth Services, a private family-support group in Lincoln, says state funding for the system currently runs at "about 60 percent of our actual cost of care." Last year the system received a measly 2 percent boost in funds, which failed even to account for inflation. According to a 2006 study by the National Alliance on Mental Illness, Nebraska ranked 39th among the 50 states in spending on mental health. A committee carefully examined the state's mental-health resources for children in 2007 and issued a 27-page report with damning conclusions: "The current Nebraska behavioral health care 'system' for children is multifaceted, fragmented, and complex … A lack of coordination and integration of the various systems has caused hardships for children and families." But so far, few of the report's recommendations have been implemented.

Nebraska did initiate child-welfare reform, effective July 1, to beef up services for families new to the system; it now is able to send caseworkers into homes within two hours of a hotline call. But that program applies only to families involved in cases of abuse and neglect. More funding might allow the system to open up to families that Blue characterizes as "on the periphery of the child-welfare system"—families like Byerses, where abuse and neglect have not occurred but where children are nonetheless in desperate need of help. "So many of these [Safe Haven] families seem to have lived in crisis or on the periphery when they made their decision to relinquish custody," says Blue. "If the current system can be expanded to provide help for those families, that would be very, very good." The Byers family agrees—if the system, and consequently, Medicaid, were opened to these families, far fewer of them might feel the need to give up custody. But Adams, the Nebraska Behavioral Health director, says that wouldn't have made much difference for the Safe Haven parents: "A very high percentage of those kids were already eligible for Medicaid. It wasn't 100 percent, but it was pretty darn close." He also notes that many family services are already offered on a sliding-fee scale.
Leslie Byers would also like to see an augmented crisis-response system, one with at least one center in each of the state's six "mental health regions." State Sen. Annette Dubas has suggested that these centers could constitute one-stop shops for parents; Byers approves. At best, the centers would provide parents with a place to leave their children for a night or two; at the very least they would serve as alternatives to shots of Thorazine in the ER.

Further legislation might address the problems families face before they get too serious—zeroing in on parents who report early symptoms of mental illness in their kids, for instance. "We need early intervention. These [mentally ill] kids are kicked out of preschool," says Bleyhl, the NFSN director. "They internalize this message of 'you are a problem, no one wants to deal with you,' and that becomes their vision of themselves." Early intervention was one of the hottest topics at the recent task force meeting. Byers says it might have helped Megan, who began seeing child psychologists at age 3 but was written off by many of them: "Nobody would listen to us." Only after Megan's symptoms became so serious as to endanger the rest of the family did the Byers get taken seriously.

There are, of course, problems that state legislation has no hope of fixing. Even though "a strong 20 percent" of the Safe Haven parents "had beaten their heads against the wall for a long time" trying to get services for their kids, not all of them were blame-free, says Boes: "We think parents need to hold themselves accountable for their kids, and there were some of them who did not do that. One mother tried to scare her daughter straight by dropping her off. Others really hadn't done that much [to help their kids]." The state cannot enforce good parenting. Nor can it do much about national insurance companies who set low bars for the amount of mental-health services they will provide. "No struggling parent is going to have enough private insurance to cover the services their child needs," says Olivia Golden, a fellow at the Urban Institute who studies family policies. The state, then, may be able to provide more services, but only after private insurance runs out—which it inevitably will. And in a time of economic decline, even with boosted funding, the state's services may eventually run out too. "There is no magic wand that can reliably fix difficult family situations," says Blue. "It requires a magnificent amount of patience for families, a variety of community resources to bring real help to the families and some luck that patience and those services will work."

There was no magic wand for the Byers, either. But time, at least, has helped. Megan Byers is now 23 and stable; she is piecing together a life in Denver, working at a dog kennel and building friendships. Given the events of her childhood, her relationship with her family is astonishingly close; she speaks with Leslie on the phone every day. She does not recall much about her time as a ward of the state. She remembers being stabilized on medications at Boys Town, having counseling sessions both individually and with her parents and eventually "getting out and feeling better." Mostly, what she carries with her from that time is a desire to defend her parents' decision. "I remember how hard that time was for my mom," Megan says. "We've talked about it, and my mom tells me not to blame myself. I can see that. But at the same time it's hard to let the guilt go."

Recently, a Fox News program referred to the Nebraska Safe Haven parents—and Leslie and Steve Byers—as having "abandoned" their children. Megan was incensed at the word. "I can't say enough about my mom. The things I did to her—there are millions of parents who would have just walked away, put me in a foster home and forgotten about me," she says. "That's not what my parents did. The only reason I was made a ward of the state was that my parents couldn't afford my treatment. My mom is a saint." Like her mother, Megan has opinions about what should be done to help the families of troubled teens. She'd like it if more parents could access help through Medicaid without having to give up custody. She thinks parents who do surrender their rights should nonetheless have unrestricted visitation. Most important, she says, Nebraska's policies should reflect a simple philosophy: "Help, don't judge." It is something everyone watching the Safe Haven controversy might want to keep in mind.