State Ombudsman Kristie Hirschman. (file photo)
A report from the State Ombudsman says the death of Perry 16-year-old in May of 2017 might have been prevented if workers and contractors for the Iowa Department of Human Services had been more diligent and communicated better with one another.
Ombudsman Kristie Hirschman says there were plenty of chances to save Sabrina Ray from abuse that included starvation.
“There was oversight of the Ray’s household through daycare licensing, foster care licensing, foster care workers in the home checking their foster children. And then there were a number of child abuse reports also,” Hirschman says.
Hirschman’s office also investigated the death of Natalie Finn, which was similar to Ray’s death. But she says state officials had trouble getting in to see Finn, while there were 11 child abuse reports against Ray’s adoptive parents Marc and Misty. Hirschman says those reports did not lead to help for Sabrina Ray for a variety of reasons.
“Lack of follow-through between units and communication issues. Lack of the training on identifying malnourishment — which is an issue we identified both the Natalie Finn investigation and the Sabrina Ray investigation,” according to Hirschman. “…another issue identified in both cases — is record retention.” Hirschman says the records in the case were destroyed as required to protect privacy, but that also prevent some of the follow up that was needed. Her office has recommended the rules be changed for record retention, and that DHS contract with health professionals for training on malnourishment.
Sabrina weighed just 56 pounds when she died. Hirschman says those who investigate these cases have a heavy caseload — but she says so many opportunities were missed. “I don’t envy the position of DHS workers making the decisions that they have to make. But, in this particular case when there was a pattern –we believe a significant pattern — and so many warning signs and so many missed opportunities — it was just significantly problematic,” Hirschman says.
She says one missed report on Ray and her siblings in particular sticks out. “In 2015 in a Walmart parking lot, a lady reported to DHS. She got the Ray’s license plate number and reported how emaciated these girls looked, and how thin they looked and how sick they looked,” Hirschman says. “To me, that was one that should have been acted on and malnourishment identified.”
Among the recommendations from the report is that a legislative committee formed in 2002 to review these deaths is actually used. Hirschman says the committee was created in 2002 and they suggest the legislature identify who they want to do the investigation and then provide adequate funding for them to operate. She says the committee was created after the death of Shelby Duis and had never met.
Hirschman says DHS director Kelly Garcia has reviewed and responded to the report. “Director Garcia wasn’t in charge when all of this happened. And she is taking our recommendations very seriously. She has accepted a majority of them,” Hirschman says, “and acknowledges I believe by accepting them that she agrees a change needs to be made and improvements need to be made.”
Misty Ray pleaded guilty to kidnapping charges and was sentenced to life in prison without the possibility of parole plus 20 years. Marc Ray pleaded guilty to child endangerment causing death and three counts of third-degree kidnapping and was sentenced to a total of 80 years in prison.
Here is the report: Ombudsman Sabrina Ray Investigation PDF