case workers – Child Welfare Monitor

March is National Social Work month, and there has been a lot of talk about the importance of social workers. But for all of the gratitude, there certainly seems to be a lack of support for people willing to do the job.

In Oregon, caseworker turnover was 23% in 2016, according to an audit. About one-third of child welfare staff were in their first 18 months on the job. The Pennsylvania State Auditor cites county turnover rates for direct child welfare service personnel of up to 50%. There appear to be no national data on worker turnover, but news articles across the country continue to report high turnover rates as a major problem facing child welfare systems.

I know first-hand the reasons for high social worker turnover in child welfare. I abandoned an easier and better-paying career in policy research and analysis to become a child welfare social worker in the District of Columbia. I worked for a nonprofit agency that provided foster care and case management to children under the jurisdiction of the District’s Child and Family Services Agency. I lasted almost five years before giving up in exhaustion and despair.

At first, I loved my job. I loved the feeling of making a difference in children’s lives. I loved trying to find the right services to meet the needs of the children and their birth parents. I loved teaming with teachers and service providers to help my kids and parents achieve their goals. I was thrilled when I was able to find a family friend or relative who could provide a temporary or permanent home for a child.

Every day I came to work with a long to-do list. But I never knew if all my plans would be derailed by one of the frequent crises that characterize foster care. A foster parent was fed up with a defiant teenager and wanted her out today. A client said she wanted to die and had to be taken to the hospital, where we would wait for seven hours for her to be seen and evaluated. A client was sick and the foster parent couldn’t (or wouldn’t) pick her up from school. The best foster parents do the emergency pickups and doctor visits, but the need for foster parents meant the agency tolerated those who do little but provide room and board.

A huge part of my job involved driving. Some of my clients lived as far as 30 miles–over an hour’s drive in the congested Washington D.C. metro area–from the office. One was at a juvenile justice placement 90 miles away, just under the 100-mile limit so that I was still required to visit him twice a month.

When foster parents said they could not leave work and our overworked paraprofessionals were unavailable, I had to take my clients to the doctor, dentist, therapist, and for family visits. I spent as much as 10 hours a week driving and I logged as many as 300 miles per month. I don’t see how it makes sense for a person with a master’s degree in social work to serve as a paid driver.

Finally, there was the endless list of things I had to do that did not help my clients at all. All of these requirements stemmed from a reasonable goal but they were often badly designed and became ends in themselves.

A case in point is the Youth Transition Plan (YTP). This arose from the valid concern that many youth were becoming homeless after aging out of foster care. The YTP was supposed to be a road map that would be modified periodically by a youth’s team starting at the age of 15, to ensure that the youth would age out with education, skills, and a job. When I first started as a social worker, these plans were actually useful. For each area (like education and employment) the plan listed specific actions, who was responsible, and the deadline. When I met with my clients we would go through the plan and make sure we were on track, and it served as a basis for our periodic team meetings.

Unfortunately, the child welfare agency (CFSA) decided in 2014 that we had to use a new “Transition Toolkit,” which was 36 pages and consists of over ten separate forms. It is so complicated that the agency eventually distributed at two-page guide to social workers outlining all the steps involved in preparing a transition plan for a youth. Using the plan was so difficult that CFSA eventually stopped requiring completion of the individual forms and instead allowed workers to cut and paste a short section of each form together, essentially recreating the previous template, in a much more cumbersome and time-consuming form.

Another required but useless task adopted partway through my tenure was the “Child Needs Assessment” (CNA), a tool that collected information about the child’s characteristics and needs that is designed to match the child with an appropriate placement. This new requirement apparently stemmed from the realization that children were not being adequately matched to placements, resulting in frequent disruptions. Agency policy required that these be completed for every foster child after 30 days in care, then every 90 or 180 days, regardless of whether the child needed a new placement. Unless the worker happened to have a client needing a new placement exactly 90 or 180 days after the last “CNA” was filled out, she would also have to complete another one whenever a new placement was needed.

I do not know how many times I had to stop doing something important in order to spend an hour on the phone with a placement specialist in order to complete the “CNA” on time. The form was then filed away, never to be seen again. Three or six months later, the process started again with the same questions, because the placement workers started with a new form each time. The sad thing is that these frequent exercises did nothing to prevent the continued mismatches that occurred because a child came into care or was told to leave immediately–and was placed in the first or only available home.

A major priority of CFSA is to ensure that its wards get proper medical care. Butbecause this concern was taken far beyond its logical conclusion, wards of the city often were medically screened many times a year, or even several times a month, resulting in missed school for the clients and wasted time for staff. All children who come into foster care were screened before placement at CFSA’s in-house clinic to determine if they had any immediate medical needs. They had to return to the clinic within two weeks for a “comprehensive screening.” This is basically an annual physical without the shots, so a child also needing shots had to be brought in for a physical at a clinic or doctor’s office as well. Unfortunately, that physical could not be used to substitute for the screening at CFSA. Even if a child had had a physical within the last year and documentation had been obtained, the child was still required to have a the comprehensive screening at CFSA within 14 days of entering care.

Wait, it gets better. Every time the child changed placements, even if for a “respite placement” of a few days, he or she had to be screened again! One one occasion, a client entered a respite placement that was supposed to last for a month while her foster parent recovered from heart surgery. The respite changed into a regular placement when the original foster parent suffered complications and could not take the child back. Because the placement changed from respite to regular, the client had to have another screening at the clinic, even though she remained in the same home! And of course she had to miss school, and a social worker or family support worker had to spend four hours taking her.

Just to make things even more fun, the CFSA clinic closed from 1:00 to 2:00 for lunch every day no matter how many children are waiting. The last time I was there, it was with four children who were moving from a foster home to a kinship placement and we got there at 11:00—a bad choice. We waited for an hour before one of the children was seen. The clinic then closed for an hour. We could not go out to lunch because we might lose our place on line, but we were not allowed to eat at the facility. (We did anyway). I think we got out at 4:00. I certainly envied the clinic staff. They might be idle all morning until a client comes in at 12:30 but they still get to go for lunch at 1:00. I did not get many lunch breaks as a social worker.

Things were at their worst whenever one of my colleagues left the job. I would then get two or three more cases and things became totally out of control. For the next two to three months, until a replacement was hired and trained, proactive case management took a back seat to crisis management, and the stress became almost unbearable

I received frequent praise from supervisors, attorneys, and judges because my clients got the services they needed and my cases actually moved toward permanency. But after five years, I could no longer maintain the brutal pace and the constant stress.

For most child welfare social workers in D.C. around the country, there are simply not enough hours in a day to do the work that matters plus the work that is required, as described brilliantly in a column about a social worker in Maine. Too many hours have to be spent doing things that others should do, or completing meaningless forms that don’t help the clients.

At the same time, the proliferation of standards and requirements has engendered top- heavy bureaucracies, with a proliferation of managers and specialists to ensure that the standards get met. All of the specialists were supposed to be there to help us but they seemed to be more likely to make burdensome requests for information. I have not seen data on this, but it seems that the ratio of client-serving personnel to those who do not serve clients has been decreasing every year.

I worked in a private agency which had a supervisor and a program manager to manage five social workers and three case aides. I assume that a ratio of two managers to eight client-serving staff is hardly an approved model taught in schools of public administration. Of course the managers did not spend most of their time managing us. Instead, they were busy preparing performance reports and responding to demands for information from the CFSA.

To what extent is increased funding necessary to retaining social workers? Clearly it depends on the state or county. In many jurisdictions, the ridiculously low salaries and high caseloads can be remedied only by increased funding. In better funded systems like the District, a reallocation of resources away from managers and specialists, shiny new projects and initiatives, along with an elimination of meaningless requirements and paperwork, might allow for a great improvement without increased funding.

In addition, social workers must be relieved of the burdens that more properly belong to paraprofessionals and foster parents. While this would represent a more efficient use of taxpayer dollars, it might require increased outlays to ensure there are enough paraprofessionals and foster parents who are willing to act as parents and and not expect social workers to do their job for them.