Confidentiality Kills

July 18, 2010 permalink

Nigaila Gibbs was born HIV positive. She was a ward of the St Louis Missouri Children's Division until her arrest at age 20. She has been engaged in prostitution over the last two years, exposing dozens of her clients to HIV. The Children's Division found about her prostitution in February but for three months privacy rules thwarted notification of the police. They are still resisting full disclosure on grounds of confidentiality. In the Gibbs case confidentiality exposed dozens of men to risk of death. Anyone for abolishing confidentiality?

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Police weren't told of woman's HIV, alleged prostitution

BY NANCY CAMBRIA • Nancy.Cambria@post-dispatch.com - 314-340-8238 | Posted: Sunday, July 18, 2010 12:15 am

July 16, 2010 - Nigaila Gibbs, 20, crosses her fingers in luck as she speaks to a reporter Friday morning in a visitor booth at the Buzz Westfall Justice Center in St. Louis County. She is being held in county jail after she was charged with engaging in prostitution while knowingly having HIV. Police alleged she has been engaged in prostitution in the city and county for the past several years.

Erik M. Lunsford elunsford@post-dispatch.com

Months before a Richmond Heights woman was arrested for prostitution and potentially spreading HIV, representatives from at least two state agencies and two private nonprofit groups were aware of her alleged illegal behavior.

Why? Because Nigaila Gibbs, who police reports indicate may have spread the virus to at least 20 repeat clients and a number of one-time customers, was a foster youth still under the legal guardianship of the St. Louis City Family Court and the state Children's Division. These authorities knew she had carried the virus since birth.

But documents and interviews point to at least a three-month lapse in the reporting of her alleged dangerous sexual behavior and her HIV to police in early May. The Children's Division, private foster care agencies and members of the St. Louis Family Court were aware at least since February that she was advertising her services online.

The lapse happened despite a Children's Division rule requiring supervisors to make reasonable efforts to report to law authorities situations where a foster child is a clear threat to another.

Citing privacy laws regarding foster children, the agencies and court responsible for her care have declined to comment on the details of her case. That leaves unanswered many of the questions about why the city family court, presided over by Judge Jimmie Edwards, did not intervene earlier to get Gibbs off the streets.

Yet Gibbs herself, as well as others familiar with her situation, said her caseworkers, the Children's Division and the officers in the family court knew she was HIV-positive and a suspected prostitute for at least five months after she was kicked out of a subsidized apartment she was leasing through a nonprofit foster care agency. Gibbs was arrested late last month.

Seated on a hard plastic chair inside a cinder-block St. Louis County Jail interview room, Gibbs told a reporter last week that caseworkers knew of her behavior and tried to stop her, but she felt she had no choice.

"I'm not this monster that they're making me into," said Gibbs.

She said she'd been a foster child for nearly a decade, living in more than 60 different homes, residential centers and hospital facilities. She suffers from bipolar disorder, she said. Gibbs was 20 at the time of her arrest. Foster children can opt out at 18 or stay in the system with benefits and supports until they are 21.

Speaking through tears, Gibbs said she didn't want to end up in jail and was humiliated that her name and mugshot had been released to the media, along with the warning that she was carrying HIV.

"I really did want to change, and I wanted out of this," she said. "I really did want out of the business. I didn't know how to get out."

Her case illustrates the worst, but not uncommon, outcome for youths 18 and over who age out of the foster care system without a permanent home, said Gary Stangler, executive director of the Jim Casey Youth Opportunities Initiative in Clayton and a former head of the Missouri Department of Social Services. Studies indicate that about 20 percent of women in foster care end up arrested; prostitution within this group is not uncommon, he said.

"For a young woman who has had 50 placements, who has languished in the foster care system without any obvious movement toward what the law requires - permanence - then it's not all surprising that this woman would fall into that statistic," he said. "They're going to make their way on the streets. It's the only way."

ATTEMPTED WARNING

It's unclear how long Gibbs' alleged prostitution was known to the foster care system and the caseworkers, court officials and agencies that handled her case.

What is clear is that at least one of those agencies knew of her activities no later than February, and appears to have taken steps to alert others in her case management.

Gibbs was living in an apartment through Alternative Opportunities Inc. Her rent and utilities were paid through the Children's Division for over a year to prepare her for aging out of foster care. Gibbs said the agency kicked her out of the apartment in February on suspicion of prostitution.

The agency notified her caseworkers, leading to a team meeting, officials close to the case say. Such meetings are held every two months to discuss foster care cases. But they also meet in cases of emergency.

In Gibbs' case, multiple players would have been part of that process. Her case was overseen by the Missouri Children's Division, Children's Foundation of Mid-America, a nonprofit, state-contracted foster care agency, an independent court advocate, and the Family Court, overseen by Edwards.

But it took three months before police were alerted.

Nor did the system exercise its right to forcibly emancipate Gibbs, which would have removed her from foster care and cut off state support.

Gibbs said her court advocate was against it.

Instead, her team gave her more freedom. Gibbs said that after losing her apartment in February she was allowed to move into her own apartment in Richmond Heights, where she was arrested last month. The Children's Division at first subsidized her rent, she said.

When her boyfriend told caseworkers in April that she was engaged in prostitution, Gibbs said Children's Foundation of Mid-America cut off her rent subsidy from the Children's Division.

"Instead of helping me, they said, ‘We're going to stop paying your rent.' " Gibbs said. "Obviously I'm doing alleged things because I don't know how to do things for myself."

Gibbs said health officials also knew of her alleged behavior since about February.

She had been attending a clinic at St. Louis Children's Hospital for youths with HIV. Workers there told her they were planning on contacting the health department, she said.

Yet, it is unclear whether St. Louis County health department officials or the Department of Health and Senior Services in Jefferson City were formally notified about the situation or whether they acted to contact legal authorities as they are allowed by law to do.

Citing confidentiality laws, both agencies declined to comment. Gibbs' social worker at Children's Hospital could not be reached for comment.

According to a St. Louis County Police Department arrest report, it wasn't until early May when the Children's Division came to the Richmond Heights Police Department with evidence that Gibbs was advertising her services online and in a local newspaper.

She was not arrested until June 30, when the St. Louis County Police Department's Special Investigations Unit caught her in a targeted sting at her apartment in Richmond Heights. According to the arrest report, an undercover detective contacted Gibbs and arranged a meeting through a St. Louis Backpage online advertisement titled "dirty deeds done dirt cheap" that included photographs of her. At her apartment, the detective removed his clothes and she hers. Then he said a code word to signal his team to move in for the arrest.

The arrest report said Gibbs later admitted to not warning clients that she had HIV, though Gibbs said she practiced safe sex.

Citing confidentiality laws, James Thurman, CEO of Children's Foundation of Mid-America, would not confirm whether the agency was handling Gibbs' case management when she was arrested; Gibbs said it was.

Thurman said his caseworkers worked with a challenging population of foster youth, meeting with them regularly and always informing all members of a support team - courts, advocates, Children's Division and others - in an emergency.

"If we become aware of something, we don't just sit around and say, ‘Oh, my God.' We start doing," he said.

He noted that any final decisions about a foster youth's case fell to the Family Court and the judge.

ADMITS FAULTS

Gibbs, with silky auburn hair pinned up neatly, looks far different than her mug shot on websites both in St. Louis and around the country.

Aside from a reporter, Gibbs has had one visitor in jail - her longtime court advocate, who told her she had finally been kicked out of foster care, just days shy of when she would have aged out of the system.

Gibbs, who had yet to meet her public defender last week, faces charges that could put her in prison for 15 years. The court could opt to accept a guilty plea in exchange for special court supervision, said a St. Louis Prosecutor's Office spokesman. Her preliminary hearing is set for early August.

By Gibbs' count, she had 63 different placements in the foster care system, including foster homes, emergency placements, residential centers and psychiatric hospitalizations.

She said her life was tumultuous. Her mother died when Gibbs was 4. Her father struggled with alcoholism and a violent temper when he was drunk. He first lost custody of his children when Gibbs was 10 and for good when she was 12. In the past decade her father has served jail time for assault, drunken driving and other offenses.

Gibbs said she, too, once faced charges for threatening a court juvenile officer. She admitted threatening at least one of her recent caseworkers who tried to stop her behavior.

According to her arrest report, she began engaging in prostitution when she was 18 and homeless.

She was squatting in an abandoned house in south St. Louis and working at a Steak 'n Shake. When word spread among her co-workers that she had HIV, Gibbs quit.

That's when she began working the area around South Grand Boulevard, she said.

Gibbs, who turned 21 on Thursday, remains in the St. Louis County Jail in lieu of $50,000 bond. Her father, who talks to her by phone, has no money to put up.

Alone in jail, without anyone to help her, Gibbs says she knows she can change. She's pleading for mercy. She squinted her brown eyes intently as she spoke and wept.

"I want to get a job like a regular person. I will work for every little thing I own. I want to get my life the right way," she said. "I just want a second chance. Everyone deserves one, and I just want mine."

Posted in Metro, Science, Health on Sunday, July 18, 2010 12:15 am Updated: 2:01 pm.

Source: St Louis Post Dispatch