High staff turnover, burnout puts child welfare system in crisis

Up to a quarter of Ohio’s child welfare caseworkers leave the job each year.

Credit: DaytonDailyNews

After spending eight years “putting out fires” as a child welfare caseworker, Leslie Bassler became another casualty of burnout in a field known for its long hours, punishing caseloads and frustrating outcomes.

“It got so overwhelming,” said Bassler, who left her job with Montgomery County Children Services in August. “You never get caught up.”

Bassler represents what many in child protective services say is a crisis. Up to a quarter of Ohio’s child welfare caseworkers leave the job each year, a turnover rate that lengthens the time it takes to reunify kids with parents, stretches county budgets and leads to more chaos in the lives of Ohio’s most vulnerable children.

“Children that come into care are already damaged by the loss of not being with their parents or caregivers,” said Janine Elders, a Montgomery County Children Services foster care caseworker. “So if a worker has to leave, (children) can feel like they are not important and (feel) betrayed.”

More than half of the turnover doesn’t involve retirements or promotions, according to a study by the Public Children Services Association of Ohio. In other words, the workers just decided to get out, sometimes for good.

“Obviously we are facing a workforce crisis here in Ohio,” said Angela Sausser, executive director of the industry group. “You’re the first responder often going into these homes, encountering things you never experienced in your life, seeing trauma on a daily basis, having to remove children from their home. It’s extremely challenging.”

Montgomery County Children Services caseworker Janine Elders visits a child in custody currently receiving foster care from Patricia Boring. Elders, with Children Services 22 years, now works with foster parents but spent her first years on the job working directly with families in crisis. She said she was able to cope that long by not taking work home with her. CHRIS STEWART / STAFF

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The yet-to-be-published study by Sausser’s organization found that 450 of Ohio’s good-performing, non-retirement age caseworkers — or about 14 percent of all public child welfare caseworkers — left the job between July 1, 2015, and June 30 of this year.

“They were ones that you wanted to keep, ones you hoped would continue to grow in the field and someday be promoted to a higher position,” Sausser said. “That in itself is a huge loss to our child protection agencies.”

The study also revealed another 300 caseworkers left during that period due to retirement, promotion or termination.

“So in one year a fourth of our workforce is gone,” Sausser said.

Many caseworkers, like Bassler, get into the field out of a commitment to turn around broken lives only to become broken themselves. They cite daily emotional pain — and in some cases threat of physical harm — that accompanies the grim onslaught of child abuse and neglect cases.

A summary of incidents reported from 61 of the state’s 88 counties last year cited 221 instances of intimidation against case workers. Included in the list were 15 physical assaults, 27 reports of personal or agency property damage, and 104 verbal or written threats. Law enforcement was contacted in 105 of the incidents and 46 of the victims required medical attention.

“You’re in the worst of the worst,” said Bassler, who juggled between 12 and 18 cases at a time in Montgomery County after starting her career in Preble County.

While Bassler is typical in one sense, she is unusual in another. After all, she lasted longer in the field than most.

Nationally, child welfare worker turnover is estimated between 30 and 40 percent with an average tenure of fewer than two years, according to a U.S. General Accounting Office report.

Credit: DaytonDailyNews

Damaged by loss

High turnover acutely affects those the system is designed to protect: Ohio’s most vulnerable children, said Elders, whose 22 years with the agency also included child neglect and abuse investigations.

“We try to reunify as our main goal,” she said. “If we don’t have staff we can’t accomplish that.”

Getting shuffled from one case worker to another can also have long-lasting impacts, studies have shown. According to one study, a child with one caseworker through a year has a 74 percent chance of permanency, a term used when a child is reunified with their own family or placed permanently with an adoptive family that has obtained legal custody. However, that rate drops to 17 percent when two caseworkers are involved and 5 percent with three, the study found.

“Given that people who seek social work services or who have to have social work services are vulnerable in the first place, it’s not a good model to keep switching from one worker to the next,” said Natallie Gentles-Gibbs, who places students in internships as part of her role as field educator coordinator in Wright State University’s Social Work Department. “It does mean a whole lot to families to be able to have that stability to build a trusting relationship with as few people as possible.”

The turnover is particularly harmful during the initial phases of a child welfare intervention, said June Cannon, executive director of Miami County Children’s Services, where 20 percent of her caseworkers left this year.

“Turnover affects the timeliness of investigations, the quality and amount of contact with families and children, service delivery, and overall safety and well being of the children and families,” Cannon said. “Families and children have to constantly re-establish a trusting relationship with the caseworker and there are breaks or delays in service delivery.”

Cannon said children in foster care and those awaiting adoption or placement have more continuity — in large part because those cases tend to be less stressful.

Difficult transition

County agencies say they do their best to transition kids when a caseworker leaves, but even the best-made plan can stymie progress, said Ebony Speakes-Hall, who handled cases on a contract basis for Clark County Family and Children Services before moving to a full-time teaching position at Central State University a year ago.

During her stint in Clark County, Speakes-Hall was set to go on maternity leave and arranged for a co-worker to take over one of her cases.

The family balked, however, and refused even to meet with the new caseworker.

“It wasn’t anything my co-worker did, not at all,” Speakes-Hall said. “It was just the family was not willing to take that leap again and develop a new relationship. They felt like I knew the family history, the dynamics of the family, and was very familiar with what’s going on in the family.”

Montgomery County Children Services caseworker Janine Elders visits children in custody currently receiving foster care by Patricia Boring. Elders, with Children Services 22 years, now works with foster parents but spent her first years on the job working directly with families in crisis. She said she was able to cope that long by not taking work home with her. CHRIS STEWART / STAFF

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A ‘huge demand’

An examination of turnover in area counties shows a wide disparity, from 34 percent in Greene County to 12 percent in Montgomery County, which pays a starting caseworker about $20 an hour — higher compensation than they get in the smaller counties.

But job stress among caseworkers is a huge issue in Montgomery County, said Jewell Good, Children Services director at Montgomery County Job and Family Services.

“They are just burned out,” she said. “They’re thinking I’m going to go in and save these poor, abused, neglected children and these kids are going to be so happy that somebody came in and did this for them. And oftentimes that’s not what they find.”

Instead, caseworkers find children who are “angry, kicking and screaming and spitting,” parents who lash out, and courts and the media taking aim when something goes wrong. It adds up to caseworkers feeling demoralized and devalued, Good said.

The region’s opioid crisis, which has devastated thousands of families locally, has made an already thankless job even more difficult, Good said.

“It used to be that you had a dirty home and you could go in and work with the family to mitigate the conditions of the home to create safety for the kids, reunify the family and go on to the next case,” Good said. “But what they are finding with this whole opiate epidemic is you are not able to reunify families quickly because recovery is not happening quickly if at all … So social workers in child welfare are not having that sense of accomplishment that you can go home feeling like you did a good job because you got this family put back together.”

Not in it for money

Nationally, the median annual pay for social workers was $58,560 in May of last year. Those in child, family or school settings earned less, or $42,350, according to the Bureau of Labor Statistics.

But even those numbers are somewhat misleading. Those leaving universities with social work degrees — and often carrying large amounts of student debt — typically earn much more modest salaries as beginners in the field, said Danielle Smith, executive director of the Ohio chapter of the National Association of Social Workers.

“It’s probably the worst profession for requiring a higher advanced degree with low-end salaries, said Smith. Data collected by the organization shows the average master’s-educated social worker’s pay in Ohio for all practice areas is between $37,000 and $38,000 a year.

“If you have just about that in debt it can be very difficult to pay your loans off at a social worker’s salary,” Smith said.

Nobody goes into social work for the money, said Wright State’s Gentles-Gibbs. As part of her dissertation research, Gentles-Gibbs found factors like large caseloads and stress of higher concern than compensation.

“People go into it because they really want to make a difference in people’s lives,” she said.

In Greene County, where turnover reached as high as 36 percent in 2013, most new child welfare caseworkers are recent college graduates, said Beth Rubin, director of the county’s Department of Job & Family Services. A caseworker in Greene County with a bachelor’s social work degree or related field starts at $15.12 an hour.

New hires, often in their first social services job, immediately experience children and families in chaos, she said. Caseworkers are summoned to emergencies at all hours, get cross examined on a witness stand and are thrust into potentially dangerous situations like the removal of a child from a home.

It’s a lot to handle, she said, particularly for someone young and inexperienced.

“After gaining experience in the field, some newer caseworkers decide to look for employment that doesn’t involve field work or after-hours work,” Rubin said. “Others have a strong passion for this work and make this their career.”

The turnover takes a toll on county budgets.

Sausser said a turnover calculator used by the National Child Welfare Workforce Institute shows the cost of replacing a worker when totaling the overtime paid while a position is open and expenses for recruiting, hiring and training a new caseworker is at $54,000.

“Based on last year’s turnover, the conservative estimate to Ohio’s child welfare system would equate to $24.3 million,” she said.

‘Those agencies are hiring my staff’

One factor in the turnover of public-sector social worker jobs is the huge growth in those jobs in the private sector, driven locally by Medicaid expansion and managed care companies like CareSource and United Healthcare.

According to the Bureau of Labor Statistics, overall employment of social workers is on pace to grow 12 percent from 2014-2024 — faster than the average for all occupations. The fields impacted include those in child, family and school programs as well as mental health, substance abuse and other health care providers.

“Managed care companies are hiring hundreds of social workers at salaries that pay much more than community mental health is able to afford,” said Smith. “So those community mental health agencies that are really the foundation of our state’s system are not able to keep people in positions very long.”

Local Medicaid provider CareSource currently has 140 social workers on staff in Ohio, Indiana and Kentucky and is actively recruiting more, said Karen Borgert, vice president for strategic human resources.

CareSource starts entry-level social workers with bachelor’s degrees in the mid-$40,000 range with full benefits and educational assistance, according to the company.

“Health care as a whole is beginning to recognize the skill and value of social workers,” Borgert said. “They are able to navigate the social services systems and they understand how to incorporate health partners.”

Good said she’s lost workers to both CareSource and United Healthcare.

“Those agencies are hiring my staff. Because what’s happening right now is my kids are all getting ready to move over to managed care,” she said. “They’ve taken not less than five of my staff since July.”

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