DCF and Judicial Department Review Policies After Death of 10-Month-Old Marcello Meadows due to Fentanyl Overdose

Following the tragic Fentanyl-related death of a 10-month-old baby in 2023, officials from the state Department of Children and Families (DCF) are in the process of reviewing and enhancing the systems they use to assess child safety in families where substance abuse is present.

The infant, Marcello Meadows from New Haven, passed away in June 2023 after ingesting a lethal combination of Fentanyl, Xylazine, and cocaine, according to authorities.

This week, the Office of the Child Advocate (OCA) released a detailed 26-page investigative report, urging for improvements within both DCF and the Court Support Services Division of the Judicial Branch (JB-CSSD).

According to the OCA report, DCF had an active child abuse/neglect case involving Marcello’s family until just three weeks before the tragic incident. Marcello’s mother, Alexandra Polino, who is now facing a first-degree manslaughter charge in connection with the death, had outstanding warrants for probation violation issued shortly after Marcello’s birth but were not served until after the tragedy unfolded.

“This is the third fatality report that OCA has published in the last year concerning the death by homicide of a child under or recent DCF supervision, with two of the children succumbing to Fentanyl intoxication,” the report stated. “DCF is making numerous efforts to strengthen practice. However, case reviews and DCF systems data continue to show persistent deficiencies in safety planning and case management. Available data indicates a significant decline in DCF’s risk and safety assessment and case supervision over the last two years.”

The report highlighted several instances where records were incomplete, and communication breakdowns occurred between different offices, hindering the relay of crucial information.

Several lawmakers expressed concerns, viewing this case as another indication of a system that failed to protect a vulnerable child.

“What we, as lawmakers, and the people of Connecticut deserve, is accountability. They want the government to learn from its mistakes and prevent them from recurring,” said a joint statement from Senate Republican leader Stephen Harding, of Brookfield, and Sen. Lisa Seminara, R-Avon, ranking senator on the Committee on Children. “We must hear directly – as soon as possible – from state child protection officials on the steps they are taking to ensure accountability and prevent future senseless tragedies.”

DCF Commissioner Designate Jodi Hill-Lilly, in a statement, acknowledged that DCF staff, along with an intensive in-home provider, had deemed the children in the home safe three weeks prior to Marcello’s untimely death.

“To honor Marcello’s legacy, we are collaborating with state, local, and national experts to revise our substance use disorder policy and will continue to partner with the Department of Mental Health and Addiction Services (DMHAS), the adult substance use community, law enforcement, medical professionals, and others to enhance the systematic approach to this public health crisis,” Hill-Lilly’s statement reads.

According to the statement, DCF will focus on enhancing processes related to:

• Assessing child safety in families where substance misuse and Fentanyl are present;
• Improving Fentanyl testing and access to that testing;
• Collaborating with providers working with families;
• Addressing provider staff turnover; and
• Improving engagement with and assessment of fathers.

Due to the alarming number of Fentanyl-related overdoses involving adults and children, DCF established an advisory council in 2022, comprising DCF staff, legal experts, and substance abuse specialists, to evaluate the impact of the drug. The council’s efforts led to the development of new guidelines. Over the past 16 months, DCF has held approximately 745 multidisciplinary team meetings in cases where substance use is present in homes with children, with over 550 consultations specifically related to Fentanyl.

In response, Gary A. Roberge, Executive Director of the Court Support Services Division at the Judicial Branch, stated that his office has closely collaborated with OCA during its investigation.

“The Branch has addressed the policy violations identified in this report to ensure similar violations will not occur in future cases. Although the Branch’s policies and procedures were found to be sound in the areas reviewed, we will continue to review and discuss whether additional modifications should be implemented,” Roberge said.

Key Findings of the Report

Polino’s first-born child tested positive for non-prescribed opioids 12 days after birth in 2019, but this critical information was not communicated by the hospital to DCF, as revealed in the OCA report. Polino was sentenced to three years of probation but had irregular participation in treatment services.

The report highlighted concerns about Polino’s substance use in probation records, but no home visits were conducted – despite having another newborn at the time – and no reports were sent to DCF.

In February 2023, JB-CSSD implemented a new policy requiring staff to report concerns to DCF if an adult under their supervision tests positive for Fentanyl and has a child in their care. However, results of a 2022 urine screen from Polino were unaccounted for, and there were no consistent efforts to serve Polino’s outstanding warrants.

When Marcello was born in August 2022, he had to remain in the hospital for several days due to opioid withdrawal symptoms. DCF conducted background checks on both Polino and Marcello’s father, Colt Meadows, uncovering prior arrests for both individuals. Meadows faced charges for risk of injury to a child, assault, and robbery.

Records did not indicate whether DCF staff discussed this history with Colt Meadows. Additionally, no records were obtained by DCF regarding his history with adult probation, according to the OCA report.

“The DCF investigations protocol documents an inaccurate finding on the DCF background check on Marcello’s father, which would have shown that he had his own history with DCF due to concerns about his substance abuse,” as stated in the OCA report.

“DCF investigation records document that no concerns were assessed for [Marcello’s father] during the course of the investigation. DCF staff identified him as the central sober caregiver in Marcello’s Safety Plan.”

However, the safety plan, extended to a 3-year-old sibling, did not specify how Ms. Polino would supervise both a newborn and a 3-year-old child adequately. The records also lacked a sufficient assessment of family members identified as sober supervisors. During OCA’s investigation, DCF shared an amended safety plan image but failed to produce the original plan, the report highlighted.

In December 2022, Polino tested positive for Fentanyl, while subsequent unsupervised screens in January 2023 were negative. DCF lifted the safety plan in February, followed by Polino testing positive for Fentanyl in March and April. In May 2023, Polino tested negative for the drug, leading DCF to prepare to close the case that same month.

On June 27, 2023, Polino’s methadone provider requested a welfare check as she had not been seen since June 6. Police discovered Marcello’s lifeless body in a relative’s home where Polino was reportedly staying with the children, according to the report.

OCA Recommendations

In the OCA report, State Child Advocate Sarah Eagan outlined several recommendations for DCF, JB-CSSD, and providers to enhance their practices. These include:

• Implementing clear safety plans in cases involving substance abuse, including frequent drug testing, monitoring, visitation, and communication with service providers;
• Addressing staffing challenges and community service gaps in collaboration with policymakers;
• Developing best practices for safety planning in cases of parental substance misuse through the state’s Alcohol Drug Policy Council;
• Promoting public health messaging on the safe use of Naloxone with infants and young children.

With the rising number of child fatalities and near-fatalities due to Fentanyl and opioid intoxication, the state’s public health response must be robust and effective.

“Marcello is the 11th young child to die from opioid ingestion. Notably, Connecticut has consistently ranked in the top ten states for adult opioid overdoses per 100,000 adults,” the OCA report highlights. “Public health responses must include specific attention to the needs of caregivers with opioid use disorder and their children.”