A child welfare caseworker for the Maine Department of Health and Human Services is pictured in Portland on Friday. "I remain concerned about the amount of cases that we are carrying and the workload. It’s not manageable," she said.

Two years after the high-profile deaths of two Maine girls, the state’s child welfare system still appears to be overwhelmed. While those on the ground see some encouraging signs, three caseworkers and one manager said they continue to experience a key problem that has plagued the system in recent years: too much work for the number of staff.

One caseworker, who spoke anonymously because she feared losing her job, put it bluntly. “We are drowning, still,” she said.

Experts, meanwhile, cautioned that it takes several years to turn around a complicated system and train dozens of new workers, and that improvements to other programs that help children and families are key to relieving pressure on the Office of Child and Family Services, which oversees investigations into reports of child abuse and neglect.

“I would say it will take several years to turn this around. We had eight years of just a starving beast,” said Pamela Day of Portland, a former director of child welfare services and standards for the Child Welfare League of America who is familiar with Maine’s system. “What happened over time was, not only were there fewer and fewer workers to really try to manage the cases but so many fewer resources to provide to these families, that I think it all just tailspinned down.”

The state hired 33 caseworkers this fall, increasing the workforce by 10 percent over the previous December. But many have only finished their training recently, and the state is still short 40 caseworkers, according to the results of a state “workload analytic tool” released Jan. 31. The tool determines staffing needs based on the volume of cases, the time required for various components of cases, caseworker tenure and travel.

“We would need additional caseworkers, additional staff to handle the amount of workload that we currently have with the number of calls, assessments and children in care. That’s clearly what the analytic tool shows,” said Todd Landry, the director of the Office of Child and Family Services. The estimated need for 40 more caseworkers, which would bring the total statewide to 386, is not a budget proposal, he said.

Gov. Janet Mills’ supplemental budget, which needs legislative approval, would add half that number of positions, 20 caseworkers.

If the state isn’t going to heed its reports, it shouldn’t produce them, one caseworker said. At the same time, three caseworkers, who all spoke anonymously, expressed distrust of the tool, saying they believe an algorithm can’t capture all the nuances and complexities of their jobs and is therefore undercounting the need for workers.

Credit: Courtesy of the Kennedy family

One caseworker said she and her colleagues feel as though they have two choices: work around the clock and not put in for the extra time, or not get their work done, with children’s lives on the line. “Things are moving in a positive direction in general,” the caseworker said, but she has opted to work nights and weekends, without pay, to catch up on her required paperwork and avoid getting reprimanded for falling behind.

On Feb. 19, Program Administrator Denise Merrill reminded staff in an email obtained by the Bangor Daily News that only emergency work qualifies for overtime pay. Face-to-face contacts with children or families, paperwork, training and assessment work after 5 p.m. do not qualify unless staff get prior approval, she wrote.

Caseworkers frequently meet with people connected to their cases after hours, however, because children have school, and parents work. “It’s not possible to see your school-age kids without working after 5,” a caseworker said.

Since January 2019, the Mills administration and the Maine Legislature have added more than 130 staff, including the additional caseworkers, to the Office of Child and Family Services, spokespeople for the administration said. In addition to asking for more caseworkers, the governor’s supplemental budget proposes $2.5 million to support reimbursements to foster families.

“The administration is focused on rebuilding the child welfare system at a pace that allows new staff to be trained and for existing staff to be supported in their work,” Scott Ogden, Gov. Janet Mills’ communications director, and Lindsay Crete, her press secretary, said in a statement.

“Our greatest responsibility is to protect our children,” Mills said, and her administration will continue to make “critical changes” to the state’s child welfare system.

Under the LePage administration, there was a culture of fear within the Office of Child and Family Services, said an employee in a supervisory position who asked to remain anonymous. Now, after an initial period of hopefulness, the culture is one of frustration.

The office has done more public outreach and is taking some steps to improve, she said, but none of it will matter if it can’t keep workers. Retention depends on people at all levels feeling heard and valued, which they don’t because of management that operates with a crisis mindset, she said.

“Child welfare casework takes a long time to learn and gain competence — like, years. If you turn over more than 30 percent of your workforce every year,” she said, “workers will not have what they need to be skilled at the job.”

On Tuesday, two years will have passed since Marissa Kennedy died from abuse inflicted by her stepfather and mother in Stockton Springs, after more than two dozen people reported the family to the Maine Department of Health and Human Services. A judge sentenced her mother to 48 years in prison on Friday; her stepfather got 55 years.

Credit: Robert F. Bukaty | AP

Just weeks before the 10-year-old’s death, 60 miles down the coast, a caregiver beat 4-year-old Kendall Chick to death in Wiscasset after the state removed the girl from her parents’ custody.

Kennedy and Chick weren’t the only Maine children connected to the child welfare system to die in recent years. Since 2017, at least 22 children died after the state received concerns that they were being abused or neglected, according to a Bangor Daily News analysis last year. Four deaths were classified as homicides and 13 as accidents — eight of which were co-sleeping incidents.

But the publicity surrounding Kennedy and Chick’s deaths triggered a spike in reports of abuse and neglect, in addition to a wave of changes to a child welfare system in turmoil.

Several months after Kennedy’s death, the state ended its practice of relying on informal methods to immediately place unsafe children with relatives and instead began seeking court orders to remove children from their homes. But without enough foster homes, some children who had just been removed from dangerous situations had nowhere to stay but hotels — a practice that caseworkers said added trauma to children’s lives on top of the shock of the separation from their parents.

The practice also contributed to caseworkers’ increased workload. Six months after Kennedy’s death, 54 percent of surveyed caseworkers felt their workload was “never or rarely” reasonable. In addition to an overall increase in the number of cases, they said frequent turnover, vacancies and inexperienced staff made the work harder.

They reported enduring frequent changes in work practices that added unnecessary hours of work, such as directives to reassess low- and moderate-risk families, requirements to get more supervisor input on decisions and new rules that resulted in more paperwork, according to the survey.

An administrator detailed more changes in a Nov. 21 email to staff. Now, no workers may sleep when they stay overnight with children in hotels.

The new policy aims to ensure children’s safety, said Landry, who became director of the office nearly a year ago, in April.

“Certainly we would not want them leaving the room without anyone knowing about it, for example. Or if the child wakes up and is having a particularly distressing feeling, we want someone to be awake and provide appropriate care for that child,” Landry said.

It is unreasonable, however, to expect caseworkers to continue their jobs the next day after not sleeping the night before, the three caseworkers said.

“At 8 a.m., I’m expected to report back to work,” one caseworker said. “There are so many more considerations to have in regard to our own personal lives and how it impacts us.”

The state is trying to eliminate the need for hotel stays entirely by working to increase the number of foster homes and available beds within the children’s behavioral health system, Landry said. In addition, a bill took effect last year to grow the number of foster homes by easing up on stringent fire inspection requirements for applicants’ houses.

The practice of hoteling children appears to be in decline. In October, 10 children stayed in hotels, according to the Department of Health and Human Services. In November, there were three, and in December, there were none.

[2 years after high-profile murders, child welfare workers still struggle to know when kids are at risk]

Caseworkers may also stay the night with children in hospital emergency rooms. Since the fall, the state has contracted with local agencies to help look after those children, to reduce the burden on caseworkers, Landry said. He would like the agencies to expand their work to also stay with children in hotels.

The state is now making clinicians available to caseworkers to both help consult on cases and provide mental health help to caseworkers who want to debrief, Landry said. The state is also working with the University of Southern Maine School of Public Service to improve training.

The Mills administration pointed out the steps it’s taken to improve child welfare, “beginning with the hiring of DHHS Commissioner Jeanne Lambrew and OCFS Director Todd Landry,” Ogden and Crete said.

The child welfare system has “modernized” its intake telephone system responsible for collecting reports of child abuse and neglect, increasing the number of calls answered live and decreasing the rate of abandoned calls and wait times, they said.

The state is developing a new information system for child welfare, launched a public education campaign on safe sleep for infants, and extended public health nursing eligibility to all newborns. It also won $5.5 million in federal funding to improve care for pregnant and postpartum women with opioid use disorder and their babies.

Still, the caseworkers who spoke with the BDN expressed concern that the public and lawmakers will lose a sense of urgency as time passes.

Many of the “people who were in charge when those kids died are still the people who are in charge,” one caseworker said. The best thing Landry could do for morale, she added, would be to fire them.

The three caseworkers who spoke to the BDN are all permanency workers, meaning they manage the cases in which children have been removed from their homes. Despite their base in southern Maine, the workers may have to place children hours away, depending on where the nearest available foster home is, and visit them regularly. Sometimes the cases last years.

They are supposed to continuously assess the safety of foster parents’ homes and biological parents’ homes, build relationships with children to figure out what they want for their future and manage biological parents’ plans for their own wellness, helping them, for example, find housing and addiction treatment.

They arrange services such as transportation for parents, make sure kids are in school or getting to extracurricular activities, testify in court and have to follow stringent documentation requirements. They are required to sign up for on-call night shifts but, if there are too many emergencies and not enough on-call workers, they may be “bumped” into overnight work for which they hadn’t planned.

That after-hours coverage might involve responding to a dead infant or staying in a hotel with a child with a severe intellectual disability who is nonverbal and violent, followed by filling out what caseworkers described as duplicative paperwork.

“I should be the one who does this job and makes sure kids are safe. That’s where my strength is, in being able to handle the tough stuff,” one caseworker said. “I didn’t come into this to do stupid … paperwork that doesn’t help me do my job.”

Credit: Courtesy of Debbie Ferris

Children are most at risk of dying in homes where the state has already established that there is abuse or neglect, and those homes need to be prioritized by experienced caseworkers who have knowledgeable and supportive supervisors, said Michael Petit, the human services commissioner under Gov. Joseph Brennan from 1979 to 1987.

Perhaps more importantly, families need help when their babies are first born, so child protective workers don’t get involved in the first place, he said.

Indeed, the national Commission to Eliminate Child Abuse and Neglect Fatalities, on which Petit served, was able to find only one practice proven to reduce fatalities, according to its 2016 report: home visits from registered nurses to low-income, first-time mothers through the nonprofit Nurse-Family Partnership, which has locations around the United States.

The strength of services depends on the administration in power, Petit said. Former Gov. Paul LePage largely dismantled the state’s ranks of public health nurses, Petit and Day pointed out. The administration redirected federal public assistance money away from its intended recipients, poor families with children. And the number of child welfare workers did not keep up with the number of cases requiring investigation, leading annual turnover to reach as high as 60 percent, according to the union for state workers. The staff turnover rate was 18 percent in 2019, according to Landry.

“Families weren’t getting what they needed. Workers were reduced. Kids were at greater risk,” Day said.

Maine Focus is a journalism and community engagement initiative at the Bangor Daily News. Questions? Write to mainefocus@bangordailynews.com.

Erin Rhoda

Erin Rhoda is the editor of Maine Focus, a team that conducts journalism investigations and projects at the Bangor Daily News. She also writes for the newspaper, often centering her work on issues of sexual...