The Pinellas County Sheriff's Office is changing its procedures to ensure that children who are removed from their home receive a mandatory health screening within three days.
The changes stem from an investigation into the Jan. 19 death of a 5-year-old girl placed into foster care that revealed major pitfalls in the system — including division of responsibility, imprecise language in agreements and difficulty booking appointments with desired doctors in a timely manner.
"It's a system failure," Sheriff Bob Gualtieri said at a news conference Friday. "I'm troubled by it, and it's something that didn't come to light until this happened."
Of the 884 children removed from their homes by the sheriff's Child Protection Investigation Division last year, 198, or 22 percent, did not get a medical examination within the legally required 72-hour period. In 238 of the cases, records were too incomplete to determine whether the child received a required medical screening.
In all, nearly half the children didn't or may not have received timely medical screening.
To make sure there's no longer any confusion about who ensures that the child gets a timely examination, the Sheriff's Office has given the task to family support workers who are part of the child protection division.
Additionally, the Sheriff's Office is establishing thorough reporting and supervising procedures and has already expanded the network of medical providers available to see the children.
Family support workers will attend 40 hours of training to make sure they understand the requirements.
The case that wrought these changes involved 5-year-old Elizabeth Holder, who, along with her 2-year-old sister, was placed in foster care after their mother was charged with neglect.
Elizabeth died after a day of playing when she clutched her head and screamed, "It hurts!" and then lost consciousness.
An immediate investigation revealed that Elizabeth did not receive a medical screening within the required 72-hour time frame.
In May, the Pinellas-Pasco Medical Examiner's Office released a report saying that Elizabeth died of a heart condition called endomyocardial fibrosis, aggravated by a severe case of tonsillitis.
Officials said Elizabeth's heart condition likely would not have been picked up by a casual health screening. Authorities said they could not say if the outcome would have been different if Elizabeth's tonsillitis had been discovered.
Elizabeth's father, Corey Holder, has filed a legal claim against the county, which is a required precursor to a lawsuit, Gualtieri said. He declined to comment further.
The investigation also prompted Gualtieri to fire family support worker Pamela Wilson, ending a 30-year career. Gualtieri said Wilson was fired because she lied about her actions and had a significant disciplinary history with the department, not because she did not comply with the 72-hour rule in Elizabeth's case.