"Boarder babies" became a rallying symbol this year of Washington's urgent need to take better care of its foster children.
Area residents, appalled that infants were being abandoned by drug abusers and were staying for up to a year in the hospital, long after they could have been discharged, donated hundreds of thousands of dollars to build new homes. Dozens of adults enrolled in foster parent classes. The District government streamlined its process for moving babies out of the hospital.
The Estee Lauder cosmetic company got into the act by offering December revenue from its new "Origins" perfume for a boarder baby house.
Yet the number of boarder babies continues to climb, according to local hospitals, and most of the babies who leave the hospital go into temporary facilities, where they stay as long as or longer than they stayed in the hospital.
The persistent boarder baby phenomenon is but one small example of how the District's foster care system remained overwhelmed in 1990 despite good-faith efforts to improve it. Foster care experts in and out of government say the system is so antiquated that only a total overhaul will bring significant change.
"For a long time, I thought we could fix the system," said Fred Taylor, president of For Love of Children, a private agency that has provided foster homes for District children for more than 20 years. "But there's no way we can do any better under the current system. It's Humpty Dumpty."
Social service officials say they are frustrated with a fragmented bureaucracy that inhibits prompt decisions and that has switched spending priorities from human services to public safety.
"I've seen improvement," said Barbara Burke-Tatum, who as social services commissioner runs the D.C. foster care operation. "Am I overly happy? No . . . . We need to look at all our policies, but we don't have enough people to do it."
In the past year, the city has made several improvements in its care of about 9,000 children allegedly abused or neglected. A new group home for boarder babies has opened, and two more are planned. The number of social work positions has more than doubled, new workers are hired at higher salaries, and the backlog of cases under investigation is smaller.
But the problems that remain are substantial. More children are in foster care now than a year ago, and they stay longer, an average of 4.5 years. There are fewer foster homes. Social workers are handling more cases than ever.
Contributing to the flow of children into the system are poverty, the shortage of affordable housing, family instability, drug abuse and mental illness, city officials say.
The situation is so grave that the city's Report of the Commission on Budget and Financial Priorities, known as the Rivlin Report, recommended that private contractors, who now manage about one-third of the city's foster caseload, run virtually all of it, with the city acting as monitor.
Asked whether she was prepared to turn foster care over to private agencies, Burke-Tatum said, "Give me a decentralized system that works and I'd do it in a minute."
Burke-Tatum's frustration is echoed by the men and women who actually take care of children. Sometimes the most basic information on the city's tiny charges is missing. When Sharon and James Crane, foster parents in the District, took in a 6-month-old boy, all the city told them was that he had been abandoned in the hospital.
It was only when a previous foster mother went to court to have the baby placed back in her care that they learned he had been in another home. Then they learned the child's birth mother might want him back. And more than four months after he arrived in their home, they learned that he had tested positive for the HIV virus.
"Then we were told we should be careful when he was around other children," Sharon Crane said.
In September 1989, The Washington Post reported that hospitals were caring for as many as 20 "boarder babies" at one time.
After the articles were published, hospitals were flooded with donated cribs, blankets and toys.
Patty and Lynne Gartenhaus, of Gartenhaus Furs, set out to establish a group home for boarder babies. They raised more than $100,000 and persuaded a Bethesda architect, an interior designer, contractors and utility companies to help renovate a row house in Northeast Washington for free.
Howard University Hospital raised $150,000 to rehabilitate another group home, and Grandma's House, a city-subsidized program for HIV-infected babies, announced it would open a second home, now operating and called Grandpa's House.
The city's Department of Human Services, which oversees the city's social service agencies, started requiring hospitals to file weekly reports on how many boarder babies they had and hired a person to act as liaison between the hospitals and social services.
As a result of the increased attention, the seven city hospitals where the boarder babies live were able to reduce the number of boarders they had at any one time. Howard University Hospital, for example, reported five on one recent day.
But the totals for the year are higher than ever. From January through August 1989, hospitals reported 101 boarders; for the same period this year, the total was 126.
And the stays are still lengthy. The typical boarder baby at Howard lives at the hospital for about six months, said Ann Street, Howard's social services director. One boarder baby had lived at Howard for more than a year when a spot finally opened at a foster home, only to be filled by a baby removed from a crack house.
Of the three new group homes for boarder babies, Grandpa's House is the only one that has begun serving children, and it has four. The Howard University house, with 16 spaces, is awaiting final permits and staffing by the city. The Gartenhaus project, with five spaces, is supposed to be running by spring.
Joan McCarley, director of Grandpa's House and Grandma's House, said "boarder baby mania" obscures the problems children have once they leave the hospital.
Most children come into foster care on an emergency basis, either because their parents request temporary help or because they are persuaded to give up their children after allegations of abuse or neglect.
D.C. law says these youngsters are to remain in temporary shelter no more than 90 days while social workers counsel the family. If, after that period, the city determines the child should not return home, the social worker must go to court to obtain agency custody.
Three-fourths of the children now in emergency care have been there more than 90 days, a proportion that has remained about the same since 1989, according to statistics provided by the city.
This period before the social worker goes to court "is the best chance the department has for keeping kids out of the foster care system," said Christopher Dunn, a children's rights lawyer for the American Civil Liberties Union. The ACLU has filed a lawsuit it hopes will prompt the city to upgrade its foster care.
While a child is under emergency care, his parents often need housing assistance, drug counseling and other services to help hold the family together. Too often, according to Dunn and other critics, D.C. social workers refer family members to city agencies located miles apart.
One result is that family members either don't seek help or don't get it, according to a study this year of 203 families. The report, prepared by psychiatrist Theodore Stein for the ACLU, found that only 29 percent received any city services.
When children are placed in foster homes, those homes are often crowded. City officials use the homes anyway because they face an acute shortage of foster homes. In August 1989, the city reported having 329 foster homes; that number has declined to 290.
Of 400 people who telephoned the city wanting to become foster parents after The Post series, 237 enrolled in classes and 42 completed the training, said Elizabeth B. Parker, acting administrator of the Child and Family Services Division, one of the agencies Burke-Tatum oversees.
One reason more people probably don't volunteer, according to foster parents, is the stipend they receive of $320 to $350 a month.
That barely covers baby-sitting costs for parents who work and is about $200 a month less than suburban jurisdictions pay.
Burke-Tatum said she asked that the reimbursement be raised a year and a half ago; N. Anthony Calhoun, human services director, said the department is considering her request.
Recruiting more foster parents and reuniting children with their families take time, time that social workers say they often don't have. Although Burke-Tatum's deputies have been touring job fairs and graduate schools and often hiring people on the spot, their older, more experienced workers are leaving, and the caseload keeps rising.
While the city has more than doubled the number of social workers in the last 15 months, the average caseload has risen from 61 to 81, compared with a caseload of 20 to 25 for private social workers. Caseworkers now are in charge of about 2,400 foster children.
The city's social workers are burdened not just by too many cases but by a tracking system that is, by all accounts, outdated and unreliable. Index cards are used to keep track of thousands of children and hundreds of foster homes.
The lack of a computerized tracking system means that data on children gets lost or leaves the department as social workers leave. Foster parent Carole Jones said the D.C. social worker who helped her with her oldest child's adoption -- his third or fourth caseworker -- had to research all over again the first 3 1/2 years of the child's life.
Burke-Tatum said she was "totally shocked" when she arrived three years ago and found her department did not have an automated services system. She said she has requested one.
"There may be a lot of things I think about doing," she said in a deposition last month for the ACLU lawsuit, "but if you don't have the money, you don't come up with grandiose ideas."