Community-based care to protect children doesn't come cheapBy DEBORAH HARDIN WAGNER
© St. Petersburg Times
published February 16, 2003
A caseworker fails to check on the home, and a foster child pays the price. Incensed, the state and nation demand heads on a platter. A blue ribbon panel is convened -- and pleads for more caseworkers, better salaries and training, and broader services for troubled families. But it's a tight budget year, you see, and the Republican governor is on a tear to shrink state government, while the leader of one legislative chamber is dead-set against new taxes. Advocates say the state could find the money in the billions in sales tax loopholes lawmakers endorse each year.
Sound familiar? It should, but not for the obvious reason. The foster child above is not Miami's Rilya Wilson, the toddler who went missing for 15 months before the state even noticed. It's another forsaken Florida child from another decade: 4-month-old Corey Greer, who died of severe neglect in 1985, the 12th child crammed into a filthy foster home licensed for four. Caseworkers never caught on to the hell that was Corey's short life, because they were too swamped with work to monitor the home.
Back then the downsizing governor was Republican Bob Martinez, the no-new-taxes chamber was the Democrat-led Senate -- not Johnnie Byrd's "live within our means" House -- and the man chiding state leaders for protecting wealthy investors over children was former legislator Dick Batchelor. But the names are substitutable, along with the years and political parties.
The sad reality is, adjust a few details here and there and that opening script could apply to just about every high-profile child tragedy in Florida, a state where a troubled history of child protection is merely prologue. For two decades, Florida has been caught in a child welfare cyclone, spinning in and out of a painfully predictable pattern every time a child known to the system dies -- or, in Rilya's case, poofs into thin air. Leaders always pledge to solve the agency's chronic problems. But when crunch time comes -- and they have the chance to heed the state panels and make critical investments in the system -- leaders fail to follow through with a full and balanced plan.
Less than 10 months have passed since the Rilya debacle, and already those who remember history are asking the question: Is Florida on the verge of repeating that cycle again?
Not all signs are encouraging.
Secretary Jerry Regier has come in like gangbusters and made impressive headway filling the gaps at the Department of Children and Families identified by Gov. Jeb Bush's blue ribbon panel in June. Regier has also offered up his own ambitious reform plan, and he and Bush are saying the right things about the need for more prevention.
But their 20/20 vision takes money, and already Bush -- who handpicked and touted the straight-shooting Regier -- has shaved Regier's request for additional funding almost by half. Both men want to speed up privatization without being straight about the costs. Meanwhile, lawmakers are debating yet another plan to reorganize DCF, while neither the House nor Bush are willing to entertain the tax reform Florida may need to fix DCF's chronic problems and start building families.
These are rough budget times, just as they were back in 1987, when Martinez faced a $500-million shortfall and a prison overcrowding crisis. A modest boost for child protection may be the most advocates can expect, absent some effort to generate new revenue. But it will take more than that to break Florida's historic cycle of child tragedies. If not this year, then soon, state leaders will have to realize that the cost of child protection failure is greater than the price of reform.
Children like Corey and Rilya will keep reminding us, with their lives, until they do.
Corey to Rilya: A Cycle of Legislative Shortchanging
Corey Greer was not the first child to die when caseworkers were not paying attention. But he was the first whose death prompted leaders to invite what had to that point come free: outside criticism.
The panel, convened by Gov. Bob Graham but later reporting to Martinez, traced Corey's death to the same problems DCF faces in 2003: sky-high caseloads and staff turnover; low caseworker salaries and morale; and too many children torn from their homes, only to be later abused, or lost, in foster care. Its bottom-line plea would be echoed by no less than 16 panels and grand juries, convened after child deaths, in the years to come: Florida must invest in a comprehensive plan to support both caseworkers and troubled families.
Lawmakers have not been oblivious to those panels. After each death, they have added caseworkers here, changed the laws there. But what lawmakers have never done is fund a work force large and competent enough to handle rising caseloads, while paying for the prevention and family services needed to drive and keep those caseloads down.
Gov. Bush brought to office a commendable focus on child protection, and funding has doubled under his watch. Yet even those enhancements have not kept pace with the dramatic surge in caseloads, fueled by changes following Kayla McKean's 1998 death, expanding the cases that must be reported and investigated.
The Rilya blue ribbon panel, presumably familiar with the record of the governor who convened it, was unswayed by the argument that Florida's investments under Bush have been enough.
"Throughout its history, Florida's child welfare agency has borne the stigmata that stains it today. DCF is underfunded, understaffed, underappreciated and overworked. So it has ever been.
"So it remains."
Regier's Vision: More Support for Caseworkers and Families
Staff turnover has come down from the incredible 193 percent it was for some workers in Corey's day, but not by enough. Most DCF workers leave because the job -- with caseloads up to 100 families, when the national average is 17 -- is simply impossible to do.
"We could bring in Christ. We could bring in Moses. No one can get the job done with the resources these people have been given," Palm Beach retired Judge Walter Colbath said at a recent public meeting.
Turnover is a complex and costly problem to solve, but Regier has the right idea. He wants money to hire more workers, raise their pay to the national average and beef up training, all with an eye toward reducing caseloads to 15 by December.
While Bush and many lawmakers support the call for higher salaries, Regier may not reach his admirable, if ambitious, goal. Bush's budget has little of the money Regier requested for new workers and, so far, few lawmakers appear inclined to buck the governor. Rep. Sandra Murman, R-Tampa, who chairs the subcommittee over social service spending, dubs Regier's request "a bit idealistic."
Caseworker support is only half the budget battle, though. Even if reduced by a stronger staff, turnover and caseloads will inevitably bloom again unless leaders stanch the flow of kids coming into the system.
Lawmakers can help DCF better manage the foster care gate. The law now forces DCF to investigate all calls from certain professionals and respond within hours to reports of abuse inside juvenile facilities, no matter the severity of the alleged abuse. Investigators say that many such calls can be weeded out without jeopardizing safety. More than a dozen states have "dual-track" investigations, where less serious calls receive less intensive followup. Those avenues should be explored.
But the real key to driving down caseloads lies in driving up prevention and crisis services for families. Bush and Regier say they know that -- and that's encouraging -- but their vision appears much grander than the budget fine print.
Both want to put $12-million more into Healthy Families Florida, the statewide home visitation program for new, at-risk parents. HFF is a resounding success and deserves every penny. But even with the increase, funding would lag far behind what candidate Jeb Bush called for in 1998 and leave thousands of high-risk families without help.
Caseworkers have complained for years about the lack of crisis services for DCF families, especially to address mental health and substance abuse problems. Regier's $2-million request for more drug treatment would be a good first step -- and only that.
"Florida has never come close to funding family preservation adequately," said former DCF Secretary Ed Feaver. "The idea that a few more dollars will get us there is a pipe dream and deceptive."
Unfunded Community-Based Care: Passing on the Cycle
Within weeks after the state revealed it had lost young Rilya, lawmakers began mulling the idea of dissecting DCF. They always do. No Florida agency has undergone more surgery than DCF and its predecessor. Lawmakers have sliced and diced the agency 22 times in three decades. This session could make that 23.
Sen. Evelyn Lynn, R-Ormond Beach, is among those pushing to parcel out DCF's duties. Her bill would send its mental health program to the Department of Health and open the door for other programs to follow. Regier is not averse to all transfers but wants to keep DCF's mental-health and substance-abuse programs, at least for now.
Instead of coming up with new ways to shuffle the deck, lawmakers need to support the hand they've already dealt DCF, community-based care. Without more resources to shore it up, community-based care will merely inherit DCF's chronic problems -- and the deadly cycle with them.
It is hard to fully appreciate the massive nature of the changes already under way. By the end of next year, community agencies, not DCF, will be handling all family-supervision, foster care, and adoption duties. So far, 12 counties have taken over, including Pinellas and Hillsborough, and another 14 are in the process. In the meantime, five sheriffs have assumed the lead in child abuse investigations, including in Pinellas and Pasco. Hillsborough's sheriff is eyeing the job.
Even under the current deadline, that transition -- the most ambitious privatization experiment in the nation -- is a tall order. But Bush and Regier want to speed things up by six months in the remaining 41 counties and shift investigations to all sheriffs. Neither has proposed extra startup money, beyond the $10-million from last year, and both downplay the long-term state investment needed.
Bush's meager budget has communities and sheriffs demanding: Show us the money.
"Communities are very worried that community-based care smells like a bait-and-switch," said Jack Levine, president of the Tallahassee-based Voices for Florida's Children.
Even Hillsborough Kids executive director Chris Card, who heads the county's community-based effort and supports the accelerated timetable, worries about the lack of startup funds.
"That $10-million is not enough to start up all the sites in the queue right now, let alone the new ones coming on board," Card said.
Still a work in progress, child welfare privatization does hold promise. In Hillsborough, for example, mental health "crisis teams" work with DCF investigators to drench high-risk families in counseling and wraparound services. The program, already at capacity, is showing some early success in keeping children safe and at home.
Sheriffs are winning over converts as well. In Pinellas, where Sheriff Everett Rice took over abuse investigations three years ago, investigators are better trained, paid and supported. Early concerns that sheriffs would criminalize cases where families needed help have been allayed, for the most part.
But Bush should know by now that privatization cannot be bought on the cheap. Some privatized counties, such as Volusia, are having severe problems, while others are balking altogether. As recently as August, evaluators from the University of South Florida reported it would be "very risky" not to give communities even more time and resources -- while Bush is talking about giving them less.
Apart from money, there are steps lawmakers can take to increase the odds of success. They should consider using contract incentives to nudge providers toward keeping families together and children out of foster care. They should also call for a more objective mechanism, such as an estimating conference, for projecting caseloads and costs.
But the resource issues cannot be wished away.
"[E]very witness . . . warned us -- and we hereby alert the governor and Legislature -- that community-based care costs more, not less, than the services now provided via DCF," said Bush's blue ribbon panel.
Until leaders honestly confront and bear the costs of community-based care, history will keep repeating itself. The only difference next time will be the name of the child -- and the letterhead of the agency that failed her.
-- Deborah Hardin Wagner is an editorial writer for the Times.
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