More than two decades ago, Maine deployed a new and less intrusive approach for handling child welfare cases where the allegations of child abuse and neglect weren’t so clear cut and the risk of continued abuse appeared low.
The idea behind the approach, called alternative response, was that it would be less adversarial and more collaborative than a full-fledged investigation by a Child Protective Services caseworker — and that keeping the family together when possible would lead to a better outcome.
Now, following the deaths of two children, the LePage administration has taken away some of the alternative response providers’ flexibility and authority to handle cases in favor of having state child protective workers intervene.
Meanwhile, the administration has not indicated that it plans to add to a staff of child protective workers who had already seen their workloads increase 55 percent between 2010 and 2016 — well before a recent spike in new abuse reports following the two deaths, and before DHHS started assigning them some alternative response cases.
The Maine Department of Health and Human Services said having child protective investigators reopen cases that alternative response providers were handling will allow it to catch more children in potential danger.
But specialists said it’s unlikely the investigators will have more success. Instead, their involvement is making it harder for alternative response workers to reach and engage with some of the families at the center of those cases.
‘Go pound sand’
When a case is assigned to the alternative method, a social worker from a community organization visits the parents and children and tries to work with them to make their home safer. The social worker might connect the parents with needed services such as substance use treatment, and work with them on assembling a support system of family and friends to rely on in difficult times. The service is voluntary.
In contrast, a child welfare investigation could result in the state removing children from their parents’ custody.
Maine’s child welfare system came under close scrutiny this winter following the deaths of 10-year-old Marissa Kennedy in Stockton Springs and 4-year-old Kendall Chick in Wiscasset, allegedly by their caregivers. Child Protective Services had some involvement with both families.
Under pressure from lawmakers, Gov. Paul LePage and the public, DHHS has pursued a number of child welfare changes in recent months. One of them involved turning to a consultant’s 20-month-old recommendation to step up oversight of the four nonprofit organizations around the state that carry out alternative response.
The consultant’s recommendation came in a July 2016 memo to Maine child welfare officials, which the BDN obtained through a public records request.
Starting in March, DHHS instructed the alternative response contractors to begin calling the state child abuse hotline when they don’t make contact with families they’re assigned, when families stop working with their social workers prematurely and when families decline to work with them altogether.
The department also asked the contractors to review past cases and make those types of reports for all cases dating back to Aug. 31, 2017.
Alternative response providers’ new reports to the hotline now trigger DHHS to assign its own caseworkers to investigate child abuse and neglect allegations that department staff previously determined were more appropriate for alternative response.
The changes in protocol have added to an already growing workload for Maine’s child protective workers, who completed 73 investigations each in 2016, up from 47 in 2010, according to federal statistics. They have also sent more calls to a child abuse hotline that has consistently struggled to handle its call volume: In 2016, hotline workers didn’t answer more than 12,000 calls — 22 percent of all calls placed — on the first try.
In addition, the changes have made it more difficult for the alternative response programs to work with families the state assigned to them in the first place, eroding trust they had developed, said Christine Hufnagel, director of family services for Community Concepts in Lewiston, which handles alternative response cases in Androscoggin, Franklin and Oxford counties.
“[Child protective services will] go out [to the family], they’ll do a quick thing and say, ‘We’re going to refer you to alternative response again,’ and [the family will] say, ‘Go pound sand,’” Hufnagel said.
“It’s creating this environment where nobody can do their jobs well or at all because of capacity issues.”
The alternative response organizations have always been required to alert DHHS when they can’t locate or contact families the state assigns them, when the families refuse their services, or when the families stop working with them prematurely.
Under their contracts with the state, the organizations were required to submit the information to the department using DHHS’ child welfare information system, or in some cases through phone calls to DHHS staff in local district offices. The agencies often discussed those cases with district office staff to decide how to proceed, Hufnagel said.
They called in reports to the statewide hotline to prompt an investigation only when they discovered new allegations of abuse or neglect, as the state’s mandatory reporting law requires.
The result of changing how the organizations report information to DHHS is a more rigid, less collaborative process, Hufnagel said.
“When it’s worked really well, it’s worked really well because we were part of the conversation,” she said. “When you create these really rigid, knee-jerk reactions to tragedy — I get it, people want to do something — we’re breaking the system more than it already was.”
Under a range of circumstances now, Hufnagel said, DHHS sends Child Protective Services caseworkers to investigate families whom alternative response workers have already been working with or trying to engage.
“What Maine is doing is taking this broad-brush, cover-my-ass approach and demanding to reinvestigate and take another look at vast numbers of cases where the alternative response providers have concluded that another call to the hotline is not necessary,” said Richard Wexler, executive director of the Virginia-based National Council for Child Protection Reform, one of multiple organizations that years ago held up Maine’s child welfare system as a national model.
“All of this duplication of effort, all this extra work is only further overloading DHHS, making it that much more likely that the workers are going to miss a case of a child in danger,” he said.
In Cumberland County, the agency that runs alternative response, KidsPeace, said families either refuse services or agency workers can’t make contact with families in about 20 percent of cases the state refers to it.
The DHHS protocol requiring new reports to the child abuse hotline in these cases has made the process of reporting the information “more consistent,” KidsPeace spokesman Robert Martin said in an emailed statement.
“We now call any client refusal of service or inability to locate the families into the Child Protective Intake line, and we also document that when possible we have informed the families that failure to accept [alternative response] services will result in DHHS involvement in their case,” Martin said.
When a family’s choice to turn down supposedly voluntary services triggers a DHHS investigation, that fundamentally changes the nature of alternative response, Wexler said.
“That is not voluntary,” he said. “It is basically getting rid of alternative response without saying that is what you’re doing.”
Emily Spencer, a DHHS spokesperson, denied that the department is compromising the voluntary nature of alternative response. Child protective caseworkers have to build a legal case that justifies a child’s removal from a parent’s home, she noted in an email, and “offering voluntary services, and the family’s participation, or lack of participation, in those services plays a role in the development of that case.”
“This practice allows the Department to better identify and follow up with families who are at-risk of child abuse or neglect,” she said. “This ensures that these at-risk children don’t fall through the cracks.”
In addition to Community Concepts and KidsPeace, the other two alternative response agencies in Maine are Community Care, which serves Aroostook, Hancock, Kennebec, Penobscot, Piscataquis, Somerset, Washington and York counties, and Home Counselors Inc., which operates in Knox, Lincoln, Sagadahoc and Waldo counties. Officials from the two organizations didn’t return calls from the BDN.
‘Two systems in crisis’
In July 2016, a consultant for DHHS suggested it rethink oversight of alternative response.
The National Council on Crime and Delinquency highlighted as an area “in need of consideration” how the contractors alert the state when they’re unable to contact families or when they learn about additional abuse and neglect concerns in the course of their work.
But the consultant said helping DHHS implement the change was outside the scope of its work.
Asked why DHHS waited until March 2018 to act on the suggestion, Spencer said, “Since NCCD made their recommendations, we have been evaluating and working to implement them in a thoughtful manner that best prioritizes child safety.”
DHHS hasn’t pointed to any problems with the alternative response providers’ past performance or concerns that they weren’t reporting required information to the state. The department has released little information about its involvement with Marissa Kennedy or Kendall Chick, so it’s unknown whether state child welfare workers referred reports of the girls’ suspected abuse to alternative response agencies.
Hufnagel, of Community Concepts, said the state had never raised concerns about the organization not reporting required information to DHHS, and Child Protective Services reports show the state had been referring more work to alternative response contractors in recent years.
Nationally, several studies have shown that families involved in alternative response are less likely to continue being reported to child protective services for alleged abuse or neglect than similar families subjected to child welfare investigations. They’re also more likely to be satisfied with the approach, which can cost less in the long term.
Meanwhile, since the Marissa Kennedy and Kendall Chick deaths, DHHS has experienced a spike in reports of suspected child abuse and neglect from the public, Spencer said.
DHHS hasn’t chipped away at its vacancy rate among child protective caseworkers in that time, said Ramona Welton, president of the Maine State Employees’ Association, which represents child welfare caseworkers.
And in a report it released in May listing measures to shore up the state’s child welfare system, the LePage administration made no mention of attempting to expand its child protective staff.
The increased call volume to DHHS has also translated into it assigning more cases to alternative response agencies, Hufnagel said. At Community Concepts, alternative response social workers had 147 open cases in May, although the organization’s contract with the state specifies that it should have 115 open cases with families at a time.
“You have two systems in crisis,” Welton said.
To report child abuse, call 800-452-1999.
This story appears through a media sharing agreement with Bangor Daily News.