Targeting at-risk kids may be key to reducing child deaths

The state hired a Florida-based company, Eckerd Kids, to implement the model, which is credited with reducing the number of bad outcomes in that state. The cost of the two-year contract is $520,000.

The Eckerd Rapid Safety Feedback program identifies high-risk cases and implements a protocol for staff to follow. It then tracks the entire case to ensure best practices are implemented.

In Florida, Eckerd reports improvements in the sharing of information among various case plan providers, followup by case managers and effectiveness of safety plans.

Florida’s most recent annual child welfare report shows the state performed better than national standards in several key measurements.

A Dayton Daily News investigation found Ohio performed worse than the national standard in a number of categories, including the percentage of abused and neglected children who were revictimized within a year. The state also had a higher percentage of kids who leave foster care and then re-enter it within a year, and a higher percentage of children who are harmed in foster care.

The newspaper’s investigation revealed that more than half of the 474 Ohio children who died from suspected abuse or neglect between 2009 and 2016 had been on the radar of a local child protection agency prior to their deaths.

And in at least 19 cases, the child had been initially removed from the home because of an unsafe living situation and then returned — sometimes just days before their deaths.

In the most recent local case, Dayton resident Claudena Helton had numerous encounters with Montgomery County Children Services before May 18, when she allegedly shot two of her children in the head and then dragged their bloody bodies outside.

Eight-year-old Khmorra Helton and her 6-year-old brother, Kaiden Helton, died several days later at Dayton Children’s Hospital. Their mother is facing multiple counts of aggravated murder. Her attorney did not return a call for comment.

Police and court records show Claudena Helton was in direct contact with child welfare officials in the weeks leading up to the deaths because her son had made an allegation of sexual abuse against a janitor at his school.

She also faced a previous child abuse allegation in 2014 when a teacher noticed bruises on Khmorra and a cut on her lip. The girl said she’d been hit repeatedly with the buckle end of a belt by her mother, according to a police report.

Khmorra’s aunt took the children for multiple days as part of a safety plan following that incident and Claudena Helton was convicted of disorderly conduct in Juvenile Court, which often handles Children Services cases.

Montgomery County

Jewell Good, assistant director of Children Services for Montgomery County, said if the Eckerd system is successful and made available to all Ohio counties it could help better identify red flags and prevent tragedies.

The software used in the pilot study could allow child safety decisions to be made more on data and less on “a caseworker’s gut,” she said.

Bryan Lindert, Eckerd senior quality director, said the program won’t fix every problem but can be used to identify the children who are most vulnerable.

“High-risk cases get reviewed by experienced staff who provide coaching to front-line workers as to how to best handle difficult cases,” he said.

Richard Wexler, founder of the National Coalition For Child Protection Reform, did throw out a caution flag: Similar data programs have run into issues of racism.

“They consistently overstated the risk if the person was black and under-predicted if the child is white,” he said.

Ohio is facing an immense shortage of foster care families, particularly in the wake of the opioid crisis, which is sending more children to foster care and keeping them there longer, the newspaper’s investigation found.

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Ohio Attorney General Mike DeWine told the newspaper the state needs to “take a hard look at the foster care system,” and increase state funding for child protection.

Ohio has about 15,000 children in the custody of children services agencies, up about 3,000 from seven years ago. The number of foster families licensed with the state is about 7,200.

To limit the number of removals into foster care, Montgomery County is using a model implemented about three years ago that gives families access to services even when no formal case has been opened.

“Our caseload numbers are down compared to history,” said Good, who added that social workers and others can work with families under the new system without “taking that more punitive approach where we are looking for a disposition on the case.”

Removals have declined in the county from 478 in 2010 to 362 in 2016, according to data provided by the state on each county agency.

Butler County

After the 2006 death of Marcus Fiesel, a Middletown boy who was bound and left in a closet by his foster parents, Butler County was the subject of a scathing report by Wexler’s organization, which said the system is too quick to yank children out of troubled homes and place them in foster care, where they may not get the same level of supervision.

Butler County took many of the report’s recommendations to heart and has seen success in the years since, according to Butler County Job and Family Services Director Bill Morrison.

The county has achieved a 20 percent reduction in removals and did not have a child death from abuse or neglect post-reunification in the years examined by this newspaper.

“We initiated a series of significant organizational and structural changes, in order to normalize our practice,” Morrison said. That included switching to an intervention permanency model, which ensures that families keep the same caseworker longer.

“Through that time we were able to gradually decline the number of kids in foster care,” Morrison said.

Clark County

Clark County also did not have a single death after reunification in the years studied by the newspaper. Pam Meermans credited her agency’s group decision-making process for improving outcomes.

When a child has been in foster or kinship care for 10 months, a group of staff members meets to discuss whether reunification is possible and what steps can be taken to get the family to that point, said Meermans, deputy director of Clark County’s Family and Children Services Division.

“It’s a group of supervisors and ongoing workers,” she said. “So there’s no burden on any one person.”

The county has also had success putting kids back into their homes on a temporary basis to see how the family does before closing the case and granting permanent custody, Meermans said.

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The newspaper investigation did reveal that temporary visitation was used in a Cincinnati case involving a 2-year-old boy named Demarcus Jackson, who was then sent to live permanently with his birth parents. He died two months later, and the foster parents who raised him say warning signs were ignored during his temporary stay with the parents.

Reducing the number of children who go into foster care is always the best practice, said Meermans, and in the past four months Clark County has had more children in kinship care — placed with a family member — than in foster care.

“Thirty years ago (removing kids) was how we did business,” she said. “It’s not the solution.”’

Why so secret?

Wexler’s group advocates for a change that no Ohio counties have yet adopted: making Children Services records and court hearings open to the public.

“In child welfare, the only time usually you can see anything is when a child known to the system dies. Everything else they can keep hidden,” Wexler said. The argument for keeping records confidential is that public exposure would harm or traumatize children, he said.

Some large states — New York, Florida, Texas, Illinois and Michigan among them — have increased transparency without harmful effects to children, according to Wexler.

In New York, opening all court hearings was credited with improving the quality of defense council for families and even the condition of the courtrooms, he said.

“Once (New York) courts were opened, reporters saw the shabby conditions families had to endure,” said Wexler’s 2006 report on Butler County’s system. “That led to funding for repairs. It’s also helped increase pressure to raise fees paid to the lawyers who defend impoverished parents.”

Allowing more scrutiny, said Wexler, would shine a light on potential system failures. “We all do better when someone is looking over our shoulder,” he said.