Cumberland County’s child services department is trying to get back on its feet after losing, and subsequently re-gaining, its full social services license from the state amid issues with turnover and heavy caseloads.
Cumberland County Children and Youth Services operated on a provisional license from July 19, 2018, until March 8, 2019, due to lapses in casework reviewed by the state during the renewal process in late 2017, according to state records.
Most, but not all, of those issues had been corrected as of late 2018, with a full license re-issued this spring.
“It was a stressful six months but it got us reorganized and reinvigorated,” said Necole McElwee, Cumberland County’s CYS director. “When we were put on a provisional license, we really sat back and looked and divided apart every one of those citations and looked … at the areas we needed to improve upon.”
The Pennsylvania Department of Human Services routinely inspects county agencies that carry out the state social services programs by spot-checking an agency’s records and noting violations.
The inspection report on Cumberland County Children and Youth, issued last summer for inspections conducted in December 2017, logged 44 pages of problems, resulting in the revocation of the agency’s full license and the issuing of a provisional status.
Many of these issues involved CYS not making contact with a family or completing the required Safety Assessment Worksheet within the required time frame. In some cases, people who are supposed to be contacted per state investigatory standards were not contacted at all.
In one citation, for instance, “a report was received alleging lack of food and improper feeding of an infant with kidney issues.” The referral was listed as a 48-hour response time, but should have been assigned 24-hour status, according to the state. Ultimately, no contact was made with the family until six days after the report was received.
Another citation found that, in five of the 14 cases reviewed, a preliminary SAW was not completed within the 72 hours prescribed by the state. One case took 13 days to have a SAW completed, and another had a SAW dated a day before the agency actually made contact with the family, according to the state inspection.
The state’s December 2018 inspection found significant improvement, with the number of violations cut roughly in half, something McElwee credited to better oversight and organization among her staff.
“The department determined that significant and continuous progress has been made in the implementation of your plan of correction,” the state wrote in re-issuing Cumberland CYS’ full license. “The department commends the agency for implementation of the plan of correction in a timely manner and demonstrating the agency’s commitment to ensuring the health, safety, and well-being of the children served.”
But some lapses remained. In one citation, law enforcement was not notified of a relevant case for a month despite the 24-hour notification statute. In another, one of the children in a home under supervision was not listed on the SAW and was not assessed at all, according to the state.
McElwee agreed with the assertion that those issues are likely an indication of rushed or sloppy work by caseworkers who are overloaded.
“Staffing is an ongoing issue absolutely, getting qualified applicants, training them, staying ahead of that,” McElwee said.
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Cumberland CYS is down five caseworkers, out of 47 total caseworker positions, McElwee said. Turnover for the 2018-19 fiscal year is already at 23 percent, meaning roughly one in four positions has or will change hands.
But it has been worse, McElwee said. Turnover in 2015-16 and 2016-17 was around 30 percent, before dropping down to just 7 percent in 2017-18. The number of open positions was also 12 at one point.
While this would be rapid by most standards, it doesn’t appear to be uncommon for social workers. Casey Family Programs, the nation’s largest foster care nonprofit, estimates caseworker turnover of 20 to 40 percent in the child services field. York County’s caseworker turnover was 23.8 percent last year, according to county spokesman Mark Walters.
“I work really hard with our current staff on morale,” McElwee said. “These folks deal with a lot of things. … It’s a lot of nontraditional hours. When we hire new people I don’t’ think you realize how much time you’re going to spend away from your own family.”
Cumberland County pays relatively well, with starting salaries around $48,000 for caseworkers, about $10,000 higher than surround areas of central Pennsylvania, McElwee said. The state pays 80 percent of the salary and benefit cost for local social service agencies, with the county responsible for the other 20 percent.
But Cumberland is also one of the few counties in the area to still staff its human services through the state’s civil service commission, McElwee said. When positions are open, the county relies on a list of qualified applicants from the state, with a hiring process run by the commission.
Cumberland County has submitted its letter to withdraw from the civil service system and set up its own state-qualified recruitment process, but this can take up to two years, McElwee said.
“There are a lot of technical rules that don’t make hiring easy,” McElwee said. The department has just hired six new caseworkers via the civil service system.
“This past month we have seen a more positive hiring [outlook],” McElwee said.
The department is also planning to double its clerical staff, from the current three employees to six, to allow caseworkers to spend more time out visiting families rather than filling out paperwork. McElwee praised the willingness of the county commissioners to approve new positions, with a total of six — the three clerical staff, two caseworkers, and one manager — in the process of being created.
Cumberland CYS’s caseloads include backlogs of cases that are awaiting a final clerical detail or clearance before they can be fully closed. One caseworker who does intake and initial evaluation — the most difficult role in the department to staff, McElwee said — was working 23 cases in March, for instance. But that person also had another 67 cases waiting for clearance from backlog, according to department documents.
Some of the violations cited by the state involved excessive delays, sometimes months, before supervisors were able review and sign off on safety plans. McElwee said she hopes to get the department’s caseworker-to-supervisor ratio down to four-to-one, from the usual five-to-one.
Cumberland CYS has 227 children in its custody, McElwee said, of which 189 are in foster care or are placed with a relative under CYS supervision, and the rest in a group home, treatment center or other accommodation. The department also works with between 200 and 250 families in a given month who have experienced issues but whose children are not subject to removal.
High rates of removal often go hand-in-hand with parental drug use, which is often cited by social service agencies across the state and nation who are overburdened with the surge in opioid addiction.
Cumberland County’s opioid crisis is, by some measure, beginning to subside, with overdose deaths dropping last year versus 2017. While still elevated, McElwee said that the caseload appears to be leveling out, along with the rate of drug-related cases.
Last year, 48 percent of new placements were due to parental drug use, McElwee said, down from a peak of 74 percent a few years ago. But these cases are still difficult when it comes to the necessary standards for safety planning.
“When you’re dealing with a parent with an opioid issue, they’re at a higher risk,” McElwee said. “It does make safety planning with them harder … and if we can’t safety plan, we’re asking for removal.”