Odonnell twins. Photo supplied by family.

by Health Impact News/MedicalKidnap.com Staff

A battle to get insurance to cover necessary medical care for teenage sisters with bulimia nervosa has ended up with those teens being taken by Child Protective Services in Florida. Their mother is asking how it can be that an insurance company is able to direct CPS to remove children from their homes.

The Florida Department of Children and Families (DCF) has accused Laura Dalton of “medical neglect,” but the evidence provided to Health Impact News demonstrates that she is a dedicated mother who has been working tirelessly to secure the proper treatment for her daughters. In fact, one of the twins was seized from the hospital, where her mother had taken her the week before due to her dangerously low blood pressure and pulse.

The twins have suffered eating disorders after they were put into foster care in Michigan, where they were allegedly abused. They were healthy girls prior to that time, but as a penalty for allegedly smoking marijuana one time, they were removed from their home, and that is when their real problems began.

Bulimia is a very serious eating disorder that can be life threatening. Permanent organ damage and even cardiac arrest can be a result of the binging and purging that characterize bulimia.

Laura Dalton is well aware of that fact and has been trying to get coverage for an eating disorder specialist team that many have referred them to, including doctors the girls have seen and NEDA, the National Eating Disorders Association.

Up to the day that DCF seized custody of the twins, both Laura and the director of the Body Image Counseling Center believed that the treatment was going to be approved by the insurance company CMS – Children’s Medical Services of Florida, a Medicaid program that is both state and federally funded to provide, per their website, “special services for children with special needs.”

However, it is now apparent that CMS was working behind the scenes with DCF, even attaching a medical foster care supervisor to emails between Laura and CMS.

Laura fears for her daughters’ safety. Not only is she concerned about the effect that the separation will have on her twins, but she is worried that they will not get the care that they truly need. DCF has already missed one scheduled appointment with a nutritionist since the state seized custody. She fears that they are not taking the bulimia seriously, which could have devastating consequences.

“The Twins Were Healthy” Before Being Seized by CPS

Just a few years ago, Abbie and Alexis, now 16, were thriving. The Michigan natives were on a national level competitive cheer team and cheered in front of thousands. They did well in school.

Abbie and Alexis – happy and healthy at home. Photo provided by family.

When they were 13, the family moved to a new home and a new school district. There, they got into trouble, a kind of trouble which is not uncommon among teenagers, which should never have carried with it the devastating price tag that it has cost them. They listened to some poor advice and allegedly smoked a joint. Word reached the school principle and CPS was called.

As a result, the girls were seized from their home and placed into a foster home that had a reputation of being abusive. The foster parents reportedly locked up food, and the foster children in the home sometimes went without food. While their mother fought the system to try to get her children back, the twins ran away, escaping the abuse of the foster home.

By the time they were located, one had developed anorexia; the other, bulimia. The state of Michigan punished their escape from abuse by adding further abuse. They were placed into juvenile detention. It was a nightmare for the family, and a huge battle for their mother to get them back home. Both girls almost died in state care.

Health Impact News followed their story, and we rejoiced when they were finally returned to their family in August of 2016, battered and beaten down, but alive.

See:

Once Thriving Michigan Teenager Now Facing Death in CPS Custody

Michigan Teen Girl in CPS Custody Near Death – Twin Sister Pleads for Her Life

Kidnapped Twins in Michigan Physically Abused: Being Shipped out of State to Destroy Family Ties

To this day, the girls have not disclosed all of the horrors that happened to them while they were in state care. After they were returned home, both have been diagnosed with Post Traumatic Stress Disorder. Like the anorexia and bulimia, PTSD is not something that they had before the Child “Protective” System took over.

The twins were healthy when CPS took them, but they were in very poor condition when they were returned to their family. In fact, our coverage of their homecoming was delayed because of their poor health and numerous hospital and doctor visits once they came home.

See:

CPS Kidnapped Michigan Twins Return Home – In Worse Shape Than When the State Took Them

Because their condition was so serious, they were immediately approved for Social Security disability benefits after they returned home. Both girls were diagnosed with PTSD.  Alexis was diagnosed with bulimia. Abbie has been diagnosed with both anorexia and bulimia.

Foster Children 7 Times More Likely to Develop Eating Disorders But State Will Not Cover Expenses to Treat Them

Once the girls were free, Laura Dalton had a new battle to fight – getting help for her girls who had suffered so much while they were held captive.

As many other families who got their children back from foster care have reported, Abbie and Alexis experience nightmares and night terrors. They would often wake up screaming, battling unseen monsters who were holding them down. Eventually in their mother’s care, this ceased.

The once-confident teens struggled with feelings that no one cared and that they were worthless. But all that paled in comparison to the battle with the eating disorders.

Statistics show that children who have been in foster care are 7 times more likely to develop bulimia and other eating disorders. Foster children are more likely to develop PTSD than veterans of war.

Eating disorders have been called the deadliest mental illness, because they have a higher rate of mortality than any other mental disorder. (Source.)

It is vital that those suffering from anorexia or bulimia get appropriate treatment. The disorders are treatable, but many of those who suffer with them require outside help to get better. They don’t just “get over it.”

Abbie developed anorexia and bulimia in foster care. Photos supplied by family.

As common as eating disorders are in foster children, it is not common to find effective treatment for those children. The majority of children coming out of foster care rely on Medicaid for health care, and it appears that Medicaid is reluctant to cover treatment for the injuries suffered by children in state care.

It would seem that the state should be responsible for treating a condition that arose in their care, but that does not appear to be the case.

This begs the question: how many children suffering from eating disorders acquired in foster care die from those disorders because they cannot get adequate treatment?

If parents are fortunate enough to get their wounded children home, they are often forced to rely on Medicaid and government assistance. Even if they were financially well-off before CPS, the system seems designed to destroy them. Many parents lose their jobs, homes, and savings fighting for their children, paying for attorneys’ fees and required classes and therapies, and jumping through all of the ever-changing hoops imposed on them by the social workers.

Heroic Efforts by Mother to Help her Daughters

Laura is no different. Before her children were taken, she had a stable career and a comfortable income. They were able to travel and have nice vacations. Since the twins have been home, seeing to their health care has been a full-time job.

Laura searched the nation to find treatment for eating disorders and insurance that would cover it. They moved to Wisconsin, hoping to get Abbie into a program there, but due to rules for Wisconsin Medicaid, SS disability, and HMOs, they were turned down.

Meanwhile, she was able to secure a one-month scholarship at a residential eating disorder clinic in Chicago for Abbie, the sickest of the twins. When the funding ran out for Abbie to be in Chicago, they moved back to Michigan, and Laura continued to search for answers for her daughters.

In April 2017, Laura packed her family up and moved to Florida, a state with programs specializing in eating disorders. Before the insurance kicked in on June 1, she paid out-of-pocket to have labs run on the girls to monitor their condition.

As soon as she got CMS insurance, she began working to get Abbie into another residential treatment center for eating disorders. Abbie spent 30 days at the Renfrew Center near Fort Lauderdale.

Unfortunately, both residential programs failed. Therapists at both centers said that, instead of inpatient, residential treatment, Abbie would likely do better in an out-patient program. When she was separated from her family, she was prone to falling into depression, which hindered her progress in dealing with her eating disorders.

Also, they quickly realized that any time either of the twins was in a situation where they were locked in or restrained, they did not do well. It became obvious that these situations trigger a terror response. Their PTSD comes to the surface, and they feel trapped and afraid.

Alexis once told Health Impact News that when they were in state custody in Michigan, they would often be restrained for hours at a time either to keep them from purging or as punishment for their eating disorder. They were sometimes beaten and abused while they were restrained, and both she and her sister are terrified of being locked up or placed in restraints.

In our earlier coverage of their story, we included photos of bruises that the twins suffered from being restrained in Michigan.

Bruised and battered in state care. Photo provided by family.

Their mother learned that it was important that her daughters’ vital signs be monitored. She learned that, while the health impact of anorexia is more readily seen, bulimia can be every bit as deadly. Bulimics may not be terribly underweight, but the constant purging, often by vomiting, can severely damage organs. Electrolytes get out of balance and can lead to cardiac arrest. Bradycardia (low heart rate) and hypotension (low blood pressure) are not uncommon.

For this reason, Laura has been diligent to monitor her daughters’ vital signs. An eating disorder specialist told her that she needed to call Emergency Medical Services or take them to the emergency room if their blood pressure fell below 90/50. When that happens, they are in danger of passing out or going into cardiac arrest. Hospital admission is usually called for in order to get them medically stabilized.

Alexis is involved with a therapy program and has steadily improved. She has reached the point where, unless she is restrained, locked in a room, or faces another trigger, she generally does well. She is on a gluten-free diet now, and she rarely purges any more. She has been hospitalized a couple of times. In one facility, she passed out in the shower.

Neither of the twins have ever passed out at home. That only happens when they are in a facility that is not monitoring their vital signs.

Since June 1, Abbie has been hospitalized 18 times, due to her dangerously low blood pressure and low heart rate, which requires medical treatment to get her stable again. Each time either of the twins sees a doctor, Laura has to explain, once again, that they did not get sick in her care, and that she is trying to get them healed from what happened to them in Michigan state care.

Laura has worked continuously with the insurance company to try to get the help the girls need, as evidenced by numerous email conversations sent to us.

After 2 different month long stays in residential treatment centers, it has become apparent to Laura that a different approach is needed for Abbie. Instead of getting better in the inpatient facilities, she has gotten worse. Doctors have attributed this to the depression from being separated from her family and her trauma-related issues. Inpatient care further traumatizes her.

DCF Seizes Custody Based on False Allegations

While Laura was working day and night to help her daughters and find effective medical help for them, she was shocked to see an email that she says was mistakenly sent to her.

On Wednesday, October 25, 2017, Laura received the following email from Doreen R. Livers, RN, the Behavioral Health Nurse Coordinator for CMS. It was sent to her and to Tina Kapusta, a medical foster care supervisor with DCF.

Accidental tipoff from insurance company. Source: Laura Dalton.

The CPI refers to Child Protective Investigator Mindi Padgett.

Almost an hour later, Ms. Livers tried to recall her email:

Source: Laura Dalton.

At the time, Abbie was in Wolfson Children’s Hospital due to low blood pressure related to the bulimia. Laura asked the doctor if he knew anything about this, but he assured Laura and Abbie that she would be discharged to go home the next day. That never happened.

While Laura waited for the phone call to pick up Abbie on Thursday, Alexis went to hang out with friends. Just before 7 pm, Mindi Padgett with DCF showed up at their home. She had no warrant and no court order, but she demanded that Laura let her in.

Laura was terrified. She knew that she had done nothing wrong, but she also knew that Child Protective Services sometimes seizes children without legitimate reason.

We were on the phone with Laura as she left her house and heard the DCF worker ask where Alexis was. She also told Laura that court would be at 10:30 the next morning.

When Laura arrived at court on Friday, she found out that they had moved the shelter care hearing to 9 a.m., so she missed it. Later, she received a copy of the Shelter Care order, and was shocked at all of the inaccuracies contained therein.

Almost every single point made in the order can easily be refuted with emails and texts of conversations between Laura Dalton and the insurance company, the DCS worker, and medical providers, as well as with medical documents.

It is a sad reality in family courts across the United States that parents can lose their children based on false allegations and outright lies, without any real evidence.

What evidence is provided to the courts by social workers is often twisted, manipulated, and spun to paint the parents in a bad light, while exonerating evidence is sometimes ignored.

Due process and basic human rights are frequently trampled in these courts, which afford parents far fewer rights that a mass murderer or bank robber would have in criminal court.

In the 2016 case of Preslie Hardwick v. County of Orange, judges on the 9th Circuit Court of Appeals made the common sense ruling that, no, social workers do NOT have the right to lie in order to take someone’s children. The Duval County, Florida, social workers would do well to look into this case and see that the presentation of perjured evidence can result in their losing their immunity.

See the story and watch the exchange with the judges here:

Judges Reject Claim That Social Workers Didn’t Know Lying In Court to Remove Children Was Wrong

Shelter Care Order Filled with False Allegations

Even something as simple as who the twins’ father is was inaccurately stated in the report, which says that “paternity has not been established.” It has been definitively established. Michigan CPS terminated his parental rights to the girls while they were in custody there, even though this was not the wishes of the family.

The petition alleges that “the mother is unable and unwilling to get the children the proper treatment or services to meet their needs, placing the children at risk of harm.” Laura has been fighting tooth and nail to get the proper treatment that will help her children. She has an extensive paper trail to back it up.

Several doctors have recommended that Abbie have out-patient treatment with the recognized eating disorder experts at the Body Image Counseling Center with the team of specialist Lori Osachy, “a nationally recognized authority in the treatment and prevention of eating disorders, depression, anxiety, and related mental health issues.” (Source.)

On October 14, Orange Park Medical Center stressed the urgency of following up with Body Image:

On October 16, Laura wrote to Flora Santamaria, a care manager with Concordia, which coordinates mental health care for CMS:

Abbie needs and deserves appropriate baseline medical care [with Lori Osachy and Body Image]. This one approach has not been tried and I think it will benefit Abbie tremendously having her family by her side and being in home receiving appropriate care.

Abbie met with Lori Osachy on October 18, and they “clicked.” Abbie and her mother had high hopes that this team would be able to help her to overcome her debilitating bulimia.

Apparently, CMS insurance doesn’t want to provide that coverage. This would require a “single case agreement” between CMS insurance and the provider, since Body Image Counseling is not a covered provider. If both parties agree, it can be covered, per CMS guidelines.

Regarding this very case, CMS told First Coast News that:

we work diligently to ensure all medical services needed are provided. This includes going outside of our regular network of providers and utilizing safety net funds to meet all medical needs.

Laura wrote to Concordia on October 24 to ask again about the single care agreement with Lori and the Body Image Counseling Center:

Lori Osachy has told Laura Dalton that she would agree to provide care under CMS. On the day before the twins were seized by DCF, she texted Laura:

It looks like they [CMS] are going to approve treatment for Abbie with us but I wanted to make sure before I called you. We should know in a few days.

The Concordia coordinator, Flora Santamaria, wrote to Laura about the approval for Body Image on October 26, the very day that the girls were seized by DCF:

However, the shelter care order states that Body Image “declined” to work with them.

That is not true. They were waiting on CMS insurance to approve the agreement.

CMS assigned Dr. Sherry Shenoda to be the primary care doctor. According to the petition, Dr. Shenoda “stated that she is concerned for the children’s health, due to severe medical neglect, and that the child, Abbie, is at risk of death, due to her disorder.”

Dr. Sherry Shenoda. Photo source.

However, it was Laura, not the doctor, who has continually expressed concern for Abbie. Laura contacted Kena at Dr. Shenoda’s office on October 2 to ask when Dr. Shenoda wanted to do follow up care with Abbie after her last appointment. Per her text:

When does she want to see Abbie? She didn’t request any follow up care.

Doreen Livers sent an email to Laura on October 24, just 2 days before custody of the girls was seized, that Dr. Shenoda is leaving Florida. “She has to move to California due to family crisis.”

Laura reports that, from the very beginning, Dr. Shenoda wanted the twins to go to Daniels Kids Memorial facility for care. They are a non-profit organization that specializes in working with foster children and at-risk children. It is also a contract agency for the Department of Children and Families. The twins were not in state care, so it didn’t make sense to Laura that they would be sent there. More than that, Laura’s research into Daniels showed that they do not have any specialists in eating disorders. It didn’t make sense that they go there.

The CMS coordinator, Doreen Livers, and Dr. Shenoda continued to push for Daniels.

Laura consulted a number of professionals and gave it a great deal of consideration. The shelter care petition accuses Laura of denying the referrals to Daniels, but she didn’t. She did, however, continue to advocate for Abbie to receive care with the specialists at Body Image Counseling.

When Dr. Shenota’s office assistant scheduled a psychological evaluation for Abbie at Daniels on September 26, Laura drove her there, only to find out that they had scheduled the wrong appointment. An intake appointment had to occur first. She rescheduled for 2 days later, but Abbie’s blood pressure plummeted and Laura had to take her to the hospital for medical care.

According to messages from Daniels, the referral for Alexis didn’t even go through to Daniels until October 31, which was 5 days after DCF seized custody. Meanwhile, Alexis was participating in therapy at Youth Crisis Services and was doing well. She had also begun attending a school that her mother fought to get her into that also provided therapy.

Alexis was doing better in her mother’s care, and her vital signs were back to normal.

Another allegation in the petition is that Laura “is not willing to engage in services.”

After CMS provided the referrals for the children to receive services, and has come up with a plan for the children, the mother requests for other service providers to work with the children that are not covered under their medical insurance. … The mother continues to believe that whatever CMS offers the children need something different.

In actuality, other doctors and hospitals have recommended that the girls receive out-patient care with Body Image Counseling. Besides recognizing that Lori Osachy’s team can provide the most appropriate care, they have recognized that being locked up and separated from their family only serves to traumatize them more. That kind of “medical help” doesn’t help; it hurts them.

The plan that CMS “has come up with” was not presented to Laura until October 17, just 3 days before Abbie’s most recent hospitalization for her low blood pressure and heart rate. She didn’t leave the hospital until she was taken into custody and placed into a foster home. There was no opportunity for Laura to reject it.

However, the plan included Dr. Shenoda, who was leaving the state, as well as 2 psychiatrists and 2 therapists at Daniels who “have experience in eating disorders.” CMS wrote to Laura previously that:

the best that there is under CMS is a Psychiatrist that has previously dealt with eating disorders.

Laura says that “experience is not the same as a specialty.” Eating disorders are very complex. The girls have been around plenty of people with experience who were not specialists who have caused more harm than good. Many of those with experience have failed to monitor their eating habits or vital signs, and the girls have passed out in various facilities (but never at home.) Because Abbie’s health especially is so precarious, her life is literally at risk.

The twins’ health was so poor when they were released from Michigan custody that the court ordered them to be taken right to Children’s Hospital upon their release home. This is Abbie that day. Photo provided by family.

Another suggestion made by CMS was a residential mental health facility more than 600 miles away. When Laura looked into information about the facility, she was horrified by the reviews which showed that kids were traumatized there, and others have died. There is little wonder that Laura rejected that recommendation.

It looks like CMS insurance wants to “try this” and “try that” and see if something works. Laura has tried just about every approach available to them. Residential care has only served to further traumatize them. She moved her family cross-country in search of care that would work. The only approach left that has not been tried is out-patient care, so the girls can stay together in their home, with specialists who truly understand the complex nature of eating disorders.

The petition says that:

The Department was able to shelter Abbie, as she was in the hospital. However, the mother took the child, Alexis, inside her home, and has refused to produce the child for the Department.

The DCF worker knows that this is false. Alexis was not home when she came to the home without a court order or warrant. When Laura went to her car and left, our reporter heard the social worker ask Laura where Alexis was.

She was clearly not with her. There was no refusal involved. Alexis simply wasn’t home. A few minutes later, Mindi Padgett texted Laura to ask where she was, demonstrating that she was aware that Alexis was not home.

According to the petition:

The home is not calm and consistent enough to implement an in-home safety plan, and there is nothing short of removal that will ensure the children’s safety.

This is puzzling to Laura and to her friend who spoke with us, because the social worker has never been inside the home. Their home is as calm as it can be with teens trying to recover from eating disorders and PTSD.

Our reporters have spoken to the twins numerous times since they came home from Michigan state custody, before they were taken by Florida DCF. Both Abbie and Alexis have expressed their deep gratitude to be home with their family again.

All of their issues with the eating disorders, depression, and Post Traumatic Stress arose from their time being held captive in state care. They were deeply traumatized by the abuse and events that happened to them IN CARE.

They were broken. They expressed to us that they knew their mother loves them and has been fighting for them. They asked for us to pray for them because they want to get better. Certain situations, such as being held in restraints or being locked up, are triggering for them.

Their mother didn’t do that to them.

Because Laura Dalton has continued to fight for the proper care for Abbie and Alexis and their eating disorders, the insurance company got Child Protective Services involved. Is this to be the new normal?

If the insurance company doesn’t want to cover a provider or a procedure, but the parent persists, they can call Child Protective Services and remove the child, thus avoiding responsibility?

Is it to be considered medical neglect when a parent cannot afford to pay out-of-pocket for any care that their insurance provider, including Medicaid, doesn’t cover?

How You Can Help

Laura Dalton has court on November 20 at the Duval County Courthouse in Jacksonville, Florida. She has a court-appointed attorney who has told her that it wouldn’t do any good to file for a dismissal of the case, despite all the errors and falsehoods in the petition. It would be great if a good attorney would step up to help the family pro-bono.

The girls, especially Abbie, need real help for their eating disorders. Being held prisoner will only serve to further traumatize them. Besides appropriate help for their eating disorders, they greatly need prayer for protection, healing, and hope.

Governor Rick Scott is the governor of Florida. He may be reached at (850) 717-9337, or contacted here.

Representative Jay Fant represents the district where the family resides. He may be reached at (904) 381-6011, or contacted here.

Audrey Gibson is the Senator representing their district. She may be reached at Phone: (904) 359-2553.