As a child, Julia Milam followed around her grandmother, a certified nursing assistant, as she took care of patients, some of whom stayed at their house. Her grandmother showed her how to use the blood pressure kit and stethoscope, how to feed patients.

Milam was captivated by the sight of her grandmother comforting those in need and could see the appreciation etched on their faces. She decided she would one day become a nurse. After graduating from high school, she got her nursing assistant certification, just as her grandmother had.

Today, she is finishing the courses that would allow her to apply to nursing school, everything from biochemistry to anatomy. She overcame squeamishness to complete the lab in which she had to dissect a sheep’s brain.

But the dream of becoming a nurse will likely slip through her fingers for a reason that has nothing to do with her determination or aptitude.

Instead, she’s caught up in a Catch-22 in which the state marked her for life as a neglecter of her children, but never told her of the implications or gave her a chance to appeal.

In 2012, the state took custody of her two children after child welfare workers concluded she had failed to prevent them from seeing fights she was having with her boyfriend. That’s considered a form of neglect.

Milam, while acknowledging her boyfriend battered her, denies that the children ever saw it — a fact she says is borne out in police reports.

Without notifying her, the state put her name on a list of people confirmed to have neglected or abused their children or put them at risk of that.

If Milam were to become a nurse, the hospitals and other health care facilities that might hire her would first be required by law to check the child abuse registry. Potential employers would be barred by law from hiring her in any position that involved contact with patients or residents.

She could have fought it in 2012 if she had known that being put on a registry would have such dire consequences. Now, there’s apparently nothing she can do.

“My kids and I once again will be punished for a man choosing to beat me,” she wrote in an email.

An unknown number of people were also put on the registry without notice before 2015. But like Milam, they apparently have little recourse.

Use Of Registries Expanded Nationwide

Milam’s future was tangled up in a snare unknown to most people.

Every U.S. state maintains a registry of people believed to have abused or neglected a child. These registries began in the 1960s as a way for those who dealt with child abuse and neglect – doctors and social service workers, for instance – to maintain information for internal use.

Over the years, the use of child abuse and neglect registries expanded. Legislatures required them to be consulted in screening foster or adoptive parents, people who work in day cares and – in Hawaii, at least – hospitals and health care facilities.

Julia Milam is caught up in a Catch-22 in which the state marked her for life as a neglecter of her children, but never told her of the implications or gave her a chance to appeal.

“It became something to deprive people of employment and other things,” said Robert Hatch, a Honolulu lawyer representing a plaintiff, Courtney Bird, who was not notified her name had been put on the registry, preventing her from later adopting a child.

The Department of Human Services pointed out that Hawaii law requires it to maintain a registry, and that it is one of several factors crucial to determining whether a home is safe for children.

“With a person’s permission, we can also provide this kind of context to third parties, like employers, who must also use registry checks to understand a person’s history and whether they’re able to care for children or other vulnerable people,” DHS spokeswoman Keopu Reelitz wrote in a prepared statement.

She said that federal law mandates when DHS must remove someone from the registry, adding “we work within the confines of state and federal law to maintain this registry and achieve our mission of keeping children safe.”

All states use registries for employment and to screen potential foster or adoptive parents, according to a federal survey. In Hawaii, the Department of Human Services handled 6,445 registry checks in 2018, including 3,362 from employers. The others were for people seeking licenses to run a child care business or take in foster children, as well as other categories.

Forty-four states give people the right to contest being on the registry in a hearing. The length of time someone’s name remains on the registry also varies by state, with some, such as Hawaii, including it for life and some tailoring it to the seriousness of the offense.

A Broad Definition Of Neglect

The registries differ in crucial ways from the much better known sex offender database, which can be checked by anybody with an internet connection.

For one, a person doesn’t have to be convicted of a crime to end up on the child abuse and neglect registry. In many cases, like Milam’s, it is child welfare workers, not a court, who find that parents abused or neglected a child. The definition of neglect, in particular, is very broad, and includes many actions that would never be charged as a crime, Hatch said.

If the parents or other accused abusers stipulate to family court taking over jurisdiction of their cases, they essentially are owning up to the findings of the state social workers.

Parents have strong incentives to admit to mistakes and do what the state wants, such as receiving counseling, to regain custody of their children as quickly as possible, said Margery Bronster, a Honolulu former state attorney general whose firm is representing Courtney Bird.

Fighting the accusations of neglect and abuse will likely draw out the proceedings, she said.

Given that choice, Bronster said, “Most people would take their children back.”

But some do take the other route, refusing to accept CWS services because their lawyers advise them it would be an admission of guilt, said Kayle Perez, social services division administrator for the Department of Human Services. DHS says there’s nothing to prevent people from receiving DHS-prescribed services to regain custody at the same time they are seeking a trial on whether they were abusers.

The registry no doubt includes the names of people who deserve to be there, preventing them from taking care of or working with vulnerable children.

But in Hawaii and across the U.S., critics have decried the lack of due process, even when a state follows its own rules and the information is recorded accurately.

California lawyer Esther Boynton represented a couple falsely accused by a rebellious teenage daughter of abuse. Their names ended up on the state’s registry even after a judge declared them innocent, and county and state officials would not remove them. Fifteen years later, the state and county paid them $4.1 million.

“We all want to protect children, let’s start with that,” Boynton said in an interview. “But the potential for harm is enormous … There are few things worse than being labeled a child abuser. Think about the danger of an incorrect label. What if the allegation isn’t true?”

Regaining Custody

That’s what Milam said happened to her.

In 2011, she reconnected with a man she’d known in high school. They had only dated for a brief time when he became abusive.

She says she took many steps to get away from him – filing restraining orders, moving, testifying in court against him.

Her abuser never threatened her two children, she said. And he had a mental block against hitting her when they were around, Milam said, though they no doubt sometimes heard them arguing.

One of the worst incidents happened after the children had already been placed in foster care. The man asked to meet her so he could achieve “closure,” and she agreed, hoping it would truly mark the end. But he ended up trying to kill her that night, putting her in the hospital and making the news. Child welfare workers saw that as evidence that she was still involved with the man, she said.

Milam said she met with CWS officials to ask them to correct what she saw as inaccuracies in the record, but that they refused.

Child welfare workers transferred jurisdiction of the case to family court, which it does in many cases. In accepting the family court’s jurisdiction, Milam was in effect admitting to everything in CWS’s report.

That report had identified Milam and her boyfriend “as the perpetrators of harm to the children due to their ongoing violent behaviors to each other.”

In court, Milam said she wanted to correct misstatements about her conduct. But she said her lawyer warned her not to. She might be perceived as hostile, he said, which could lead to her children being taken away from her for good.

Two years later, Milam regained custody. The state, in other words, had concluded that she provided a safe home.

What she did not know is that her name had been put on the registry, and that it would remain there for the rest of her life.

State Failed To Send Milam A Notice

For decades, CWS had been sending notices to people who had been put on the registry without ever appearing in family court, which can happen in shorter-term cases. But it was not until 2015 that CWS also made sure to notify all accused perpetrators, whether they were in family court or not, Perez said.

Milam said she never even heard about the registry until 2017. She read about it on a website run by an advocate for accused parents and decided she’d better find out if she was on it.

A CWS supervisor told her she was, for life, and that she should have received a notice shortly after her case closed.

But Milam, who kept every scrap of paper from her case, could find no such notice.

She worried about what it would mean for her nursing career to be on the registry, but had not yet finished the courses she needed to apply for nursing school, and so put it to the back of her head.

But in January, with her course work nearing an end, she pushed CWS again to document that she had been informed.

A CWS worker responded by email, “I will request your closed file and forward you a copy of the disposition letter that was sent to you.”

Nothing came. Finally, Milam put in a formal request to the department.

In early April, the state responded. It turned out there was no letter from 2012. So DHS sent her one dated April 2, 2019. It stated that the allegations of “threatened physical abuse” and “threatened physical neglect” from seven years earlier had been confirmed.

If her case had not been transferred to family court, she would have had 30 days to appeal in an administrative hearing. But since it was, she couldn’t.

Like anyone, she is free to file a motion in family court to reargue her case. But Hatch, one of Bird’s lawyers, said that his client went that route, and that it’s a dead end. To have the case dismissed, a prerequisite to regaining custody of a child, a parent has to waive the right to a trial, he said.

Dashed Dreams?

So Milam’s nursing aspirations may be doomed.

In effect, the state with its mix of laws is saying that, though it ultimately agreed she could provide a safe home for her children, she is not to be trusted as a nurse.

DHS says that’s not the intent.

“We’re not saying she’s not safe to be a nurse.” — Kayle Perez, Hawaii Department of Human Services

If an employer asked for more information about a case, and the parent consented, DHS would provide it – explaining, for instance, the nature of the accusation and what programs the parents did to regain custody.

But such explanations would not matter in Milam’s case. Janice Okubo, a spokeswoman for the state Department of Health, said that state law bars someone on the registry from working in a job that involves contact with patients in any facility licensed by the department. That includes hospitals, nursing homes, assisted living facilities and an array of other types of health care providers.

In fact, the department also requires periodic checks of the registry even after a person is hired, in case their names have been put on recently.

“We will investigate, and if confirmed, require the discharge,” Okubo wrote in an email.

The Department of Education, by contrast, does not require registry checks for teachers, as some states do.

Some people who’ve applied for jobs might not even know that the reason they were turned down was the registry, attorney Hatch said.

And it’s unreasonable to expect employers to look into the nuances of every case, said Boynton, the California attorney.

“They’re not going to take the risk of hiring someone the state has labeled a child abuser,” she said. “That has great weight.”

Lawsuit Challenges State Registry Rules

One ray of hope for Milam would be the success of the Courtney Bird lawsuit, which raises some similar issues.

In 2007, Bird and her husband at the time, Frank Fontana, who was in the Navy, had their second child. A month or so later, Bird returned home from a dentist’s appointment to find her husband administering CPR to the infant. The child died, and Fontana later confessed to manslaughter.

The CWS investigation “confirmed” Bird as an abuser as well and put the couple’s other daughter into foster care, even though she maintained throughout that she had no reason to believe that her husband was abusing the infant and certainly had done nothing herself.

Like Milam, she eventually regained custody of her remaining child, with DHS concluding she could provide a safe home.

She moved to Tennessee to live with her father and later remarried. But in 2012, when she and her new husband tried to adopt an HIV-positive child from Africa, she was rejected. That’s when she learned for the first time that her earlier child welfare case in Hawaii had landed her on the registry.

Unlike Milam, she did not even receive documents from CWS saying that her alleged abuse or neglect had been confirmed, Hatch said. Even if Bird had known her name was being put on the registry, why would she have delayed getting back her remaining child, stayed in a state where she had no housing and paid legal fees to fight it, her lawyers ask.

“An adversarial action deserves a right to appeal. Or at the very least, the parent should know about it.” — Parent advocate Marilyn Yamamoto

In 2015, after failing to get the state to budge, she sued, challenging the constitutionality of the state registry law that was in place when her name was put on.

Under that earlier version of the law, amended in 2017, Bird would have had to show that the complaint against her was either frivolous or made in bad faith. Her lawyers say this is an almost impossible burden, since most reports of child abuse, even if they are later found to be untrue, were sincere and serious enough to warrant investigation.

A federal district court found that she had not filed the suit in time, and she appealed to the U.S. Court of Appeals for the Ninth Circuit, arguing that the harm of the state’s action was ongoing as long as she was on the registry, making her legal action timely.

Mediation between the parties recently failed, leaving it to the appeals court to issue its decision.

If Bird were to prevail in a class action lawsuit, other people in the same position would have to be notified and given some meaningful method to have their names removed, Bronster said.

Marilyn Yamamoto runs the internet group where Milam first heard about the registry. She advises accused parents who believe they’ve been denied due process in child welfare cases.

“An adversarial action deserves a right to appeal,” she said. “Or at the very least, the parent should know about it.”