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High turnover, low morale plague Missouri child welfare agency

by Clara Bates | September 20, 2022 at 4:02 a.m.
Darrell Missey (left), director of Children’s Division, speaks at an Aug. 13, 2022, hearing, alongside Todd Richardson, director of MO HealthNet. (Clara Bates/Missouri Independent)


Eighty open cases of child abuse and neglect sat on Matt Cordova's desk in 2017 during the height of the "hole I found myself buried in," he remembers.

Twenty open cases would have been a lot to handle; 80 was impossible.

An investigator at Missouri's child welfare department for two years, Cordova was tasked with following up on reports made to the child abuse and neglect hotline. Investigators make home visits to any child allegedly abused or neglected and assure their safety within a set timeframe.

For Cordova, who worked in a rural circuit spanning four counties, that could mean hours on the road each day, sometimes driving hundreds of miles.

Stretched thin in part because of high staff turnover rates at Missouri's Children's Division, Cordova found himself triaging. He only had time to establish the "bare minimum" safety requirements were met in each case before he would need to move on to the next.

It was what Cordova calls "an endless cycle of trying to keep up" that left little time for building close relationships to help struggling families avoid falling even further.

He was on-call for one week each month and could be summoned at any point, day or night, to investigate a hotline tip. The most urgent calls required a 3-hour response time, often leaving him scrambling for child care.

"You could spend your entire weekend or all night going out and looking for kids," he said.

He was paid $35,000 a year.

For Cordova, like many of his fellow Children's Division colleagues, the job became too much. He left in 2018.

"It's so easy to get burnt out," he said, "so easy to get overwhelmed and you start to lose your grasp on that passion to help children.

"I don't think they see the correlation between burnout and treatment of children."

Since Cordova left, the situation in Missouri's Children's Division has only gotten worse.

The Missouri Independent over the past two months has spoken with current and former employees of Missouri's Children's Division who, like Cordova, experienced the effects of high turnover rates and low morale -- as well as with advocates, researchers and attorneys concerned about the system's far-reaching effect on children and families.

For the agency tasked with handling child abuse and neglect investigations, and overseeing the state's foster care system, the ramifications can be severe.

Foster children are missing visits with their parents and languishing in care of the state for longer than they should be, according to several of those interviewed. Some foster children's cases outlast their caseworkers' tenure at Children's Division and are handed off to a new caseworker, which lowers children's chances of reunifying with their families.

On the investigation side, some worry with such high caseloads and the loss of veteran workers, mistakes could be made which, at either extreme -- needlessly removing a child, or overlooking signs of abuse and neglect -- would be life altering for the child and family. At the margins, the investigators don't have the time to connect with lower-risk families in ways that might prevent future allegations of abuse or neglect.

Children's Division Director Darrell Missey, who was appointed to the job in January, has been candid about the issues facing his division and has committed to solving them.

Last month, he acknowledged the staffing issues as a "crisis."

"We need to work to stabilize the (work)force," he said. "Then, we've got to get enough people so that they can actually have a number of cases they can manage. And we have to work on prevention."

Missey said the system has long trended toward the "reactive" over "proactive," and is "driven by our fear of what might happen later, (which) results in a lot of kids in foster care." Now, the state is faced with a dual crisis: Too few staff to oversee far too many children.

'Families get put on the back burner'

Missouri's Department of Social Services (DSS), which oversees Children's Division, has long faced staffing issues, budget cuts and high turnover. But in recent years, the challenges have been especially severe.

DSS, which includes three other program divisions plus Children's Division, had an overall staff turnover rate of 35 percent last fiscal year, ranking second among state agencies of its size after only the Department of Mental Health.

In the Children's Division, it's even worse. Among frontline Children's Division staff -- including child abuse and neglect investigators and foster care case managers -- the turnover rate last year was 55 percent, according to data provided by DSS. That means more than half of the frontline staff working at Children's Division across the state at the start of the last fiscal year had left by the end of the year.

Turnover is highest in the metro areas. In Kansas City earlier this year, the rate was 88 percent.

The agency has struggled to hire in pace with the departures. There were 228 full-time equivalent front-line vacancies in Children's Division staff as of Aug. 31, according to DSS's spokesperson.

Turnover leads to higher workloads for those who remain, which begets more turnover.

"Families get put on the back burner," said Mike Herrin, a Kansas City child welfare attorney. "We sometimes have months where kids don't get to see their parents."

Staff turnover and high caseloads are linked to worse outcomes for children in foster care, in terms of their likelihood to reach reunification or adoption, studies have found. Once a case was handed off to a new caseworker, a Wisconsin-based study found, the chances of a child reunifying with their families within a year dropped from roughly 75 percent to 18 percent.

Staffing challenges have been compounded by Missouri's historically high rate of children in foster care.

In terms of its rate of removing children from their homes, "Missouri has been an outlier for decades," said Richard Wexler, executive director of the nonprofit National Coalition for Child Protective Reform.

Some, like Wexler, argue the deeper issue is Missouri needs to shift funding away from bringing so many children into foster care, which is often traumatic for children, and toward funding preventative measures which would also reduce the need for so many staff to manage them.

When the population of children in poverty is taken into consideration, Missouri ranks 13th for the rate of removing children from their homes, the nonprofit National Coalition for Child Protective Reform found. The state removes children at a rate 50 percent higher than average, NCCPR found.

There are almost 14,000 children in foster care, an umbrella term which refers to several ways the state can serve as the stand-in parent for the child. States generally prioritize placing children in temporary care with relatives, often grandparents -- half the children in Missouri's foster care system are in placements with relatives. Roughly one third are in traditional foster families with strangers, and under one tenth are in group facilities.

DSS does dedicate some resources to preventative work, though Missey and others argue it's far from enough. Family Centered Service workers are called in when the state has concerns that don't rise to the level of removing the child. Those workers are also stretched thin, though: Cordova, the former investigator who once had 80 cases, remembers there were only one or two Family Centered Services workers covering his four counties.

The number of open Family Centered Service cases has dropped during the past five years, according to DSS's annual reports. Other DSS services to prevent families from being separated, like the privately-contracted Intensive In-Home Services, have fewer openings than demand, resulting in children each year going directly into foster care who can't get the services. Last year, 19 children entered foster care who were denied Intensive In-Home Services due to availability.

Once children are in foster care, the state has consistently failed to meet the federal timeliness standard for placing children in a permanent home, through reunification or adoption. The national standard is 42.7 percent of children finding a permanent home within a year of entering custody. In Missouri, the rate last year was just over 30 percent.

Long in the making

The strain on staff has been long in the making.

During the past two decades, the number of full-time personnel at DSS shrunk by a third. In fiscal year 2003, there were over 9,000 employees at DSS.

Today, there are fewer than 6,000.

In the Children's Division, there are 558 fewer full-time staff as of Aug. 31 than there were in July 2009, a reduction of almost 25 percent. In its highest ranks, the last decade has seen nine different Children's Division directors. Missey is the sixth director of the division under Gov. Mike Parson.

A 2003 study of Missouri by the National Coalition for Child Protective Reform diagnosed the system as "so overwhelmed with children who don't need to be in it, that workers do not have the time to find all the children who do."

By 2014, the state had created a recruitment and retention initiative which eventually resulted in "hiring blitzes" to conduct on-the-spot hiring and expanding acceptable degree types for hiring.

Shelly Stillman worked at Children's Division in St. Charles County, starting in 2006, first as a caseworker and then a Children's Service specialist for three years training new workers.

For most of her time with the department, Stillman investigated abuse and neglect allegations that came in through the state hotline.

Stillman said she typically received up to 35 new reports a week on top of the reports already piling up on her desk. When state-level supervisors complained about the backlog, she wondered why they didn't realize "this job is impossible."

She recalls working long nights when she was eight months pregnant with her second child, "and you're getting paid $35,000."

During the three years she worked as a trainer for the agency, she trained 55 workers.

"When I left," she said, "three were (still) there."

Most, she said, didn't make it over four months. Such frequent turnover meant many workers lacked the experience necessary to, for instance, properly discern abuse-inflicted injuries, she said. That knowledge could take years to build.

She left in 2019 to work as a counselor for a private company. After 11 years with the Children's Division, her salary only reached $39,000.

Samantha Lame joined the Children's Division in March 2014 and left four years later. She spent time working on foster care and investigations.

In alternative care, "I think I had up to 35 cases at one point in time," she said, "which was just extremely unmanageable. Because you're talking about 30, 35 kids where you have to do monthly visits, plus their parents, and on top of that, court hearings."

The work was rewarding, she said, especially when parents succeeded and got to reunite with their children, or when adoption cases were finalized.

"That was a driving force," she said.

But it wasn't enough to stay.

She left the state in 2018 to work for a community health center. The hours were shorter, and she got "almost a $15,000 (pay) increase."

2020 cuts

Staffing challenges were bad during Stillman's time, but intensified over COVID-19.

In 2020, Parson targeted social services with staffing cuts, citing a COVID-related drop in state revenue. He cut 300 jobs statewide that had been previously filled, 200 of which were in DSS. Of those, 96 jobs were from the Children's Division -- mostly supervisors and mid-level management.

For Dan Johnston, a Children's Division supervisor in Jasper County, Parson's cuts stood out as a "blow to morale."

"I lost my supervisor and she became my peer overnight," he said.

Candice Hastings experienced the challenges of being new to the job in a moment of mass exodus.

She accepted an entry-level position at Missouri's child welfare agency last December without hesitation, excited to "make children's lives better."

She worked at the Children's Division office in St. Joseph, training for two months to become a child abuse and neglect investigator.

Panic set in for Hastings once she was on her own. As she'd knock on strangers' doors to investigate hotline calls of abuse and neglect, Hastings would imagine all the scenarios she might encounter when the doors would swing open, and how clueless she would be to respond to them.

The gulf between her level of responsibility and her skillset, she felt, was enormous.

"I wasn't adequately equipped to do my job as they expected me to," she said she felt at the time.

Herrin, the child welfare attorney in Kansas City, said since COVID-19 he has seen instances where in a six-month span there have been as many as six new workers on a child's case.

"It's very difficult to keep clients moving forward," he said. "Sometimes it causes the parents to almost start from scratch, proving to the new worker that the child can return home."

The case manager's role is to facilitate and to help make sure the parents are getting the services they need to work toward reunification, as the court ordered, such as helping set up drug testing and treatment.

When they're focused on other cases though, Herrin said, "some things will slip through the cracks," and the caseworker might not have the time to ensure the parents get all the services they need. Some contracted services like parents aides, who provide weekly visits, and counselors are in short supply, too, he said.

"What we end up seeing is a lot of the families get put on the backburner with getting services put in place, visitation with their children," Herrin said.

That can all delay reunification prospects, prolonging the child's stay in foster care.

On the abuse and neglect investigation side, some worry that trying to move as quickly as possible will cause a caseworker to make a mistake, be it on the side of overlooking abuse or neglect or removing a child prematurely from their home.

"My real concern is something terrible is going to happen, and that is the history of child welfare: Reform comes with terrible cases of children getting harmed, or families being broken up unnecessarily," said Clark Peters, associate professor of social work at the University of Missouri.

Solutions

Robert Knodell took over as acting Department of Social Services director in October 2021. Soon after, Missey stepped down as a circuit judge in Jefferson County to become head of the Children's Division.

Both acknowledge staffing as a major issue and emphasize wages as a potential solution.

Missouri state employees are among the lowest paid in the nation. Two years ago, lawmakers approved a targeted pay increase for the Children's Division that was vetoed by the governor. This year, a 2 percent cost of living pay hike for all state workers was built into the budget.

But Knodell and Missey say more is needed.

"We have quite a bit of a ways to go in making our pay more competitive," Knodell said at a briefing last month.

DSS's director of human resources, Karen Meyer, said last month they are also continuing to host "hiring blitzes" across the state for same-day hiring, and are "focused on training" so workers "can get out into the field sooner."

Missey has consistently discussed shifting the system to be more preventative, but the immediate crises have dominated his time so far.

When Missey first arrived on the job, he said last month, he was "very excited" about making the state's welfare system more "proactive," which would result in fewer children in foster care. But "then I walked in and discovered we've got crises going on" -- one being staffing issues, the other being "too many kids and not enough placements for them."

"We need to put a lot of work into prevention that we're not able to do right now because we have to have the offense," Missey said in a hearing last April. "The family centered service work, the prevention work, goes on the backburner ... and that's where I think the real work is done."

Because of staffing issues, workers "can't spend time referring someone to services they need, establishing relationships," he said.

Even if they could fill all the gaps, Missey said in the April hearing he suspects their allotted staffing numbers might still be too low.

Rep. Sarah Unsicker, D-Shrewsbury, agrees the state should be focused on prevention services, including bolstering the social safety net.

"That would be a good start," she said, "helping with the needs that result in what Children's Division calls neglect, like housing needs and food."

The Family First Prevention Services Act, enacted by Congress in 2018, set out to provide federal funds focused on prevention resources, and to reduce the use of congregate homes for foster youth, also called residential treatment facilities. Missouri's plan is still awaiting approval from the federal government, after DSS says the federal government required revisions in 2021 and 2022.

The state has spent $140,141 of the $9.9 million it was alloted in 2020 to help transition to the program, and they say they will use the funds for pilot site implementation once their plan is approved. The transition funds can be used through fiscal year 2025.

Johnston, the supervisor for workers who oversee foster care cases, said pay raises and reduced case counts should be prioritized.

Many of the workers put in more than 45 hours per week, he said, and they often have second jobs to supplement their DSS income and are already run ragged by their high case counts.

Shortly before an interview with the Independent last month, Johnston had just finished donating plasma "to make ends meet."

"You don't have the time to walk the biological parents through the system to get their kids back," he said. "It's something we have to overcome."

The Missouri Independent, www.missouriindependent.com, is a nonprofit, nonpartisan news organization covering state government and its impact on Missourians.


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