TAMPA — A state investigation into the death of a Tampa infant has raised concerns that many child welfare workers in Hillsborough County are overburdened.
This summer, at least 40 percent of case managers working for agencies hired by state contractor Eckerd Kids were responsible for more than 25 children, according to a report into the death of Miracle Collins, an 8-month-old who died July 19 in state care.
While the report does not blame the infant's death on a too-heavy caseload, it questions Eckerd's decision in 2015 to reduce the number of care agencies it contracts with from six to four. That increased the burden on case workers and led to higher turnover, the report states — a combination experts warn can leave vulnerable children stuck longer in the child welfare system.
Florida law does not limit the number of children under the care of a single case manager but it mandates that the Florida Department of Children and Families provide enough funding so that case managers have a maximum caseload of 19. That is based on a "best practice'' standard set by the Child Welfare League of America. A single case, however, can involve two or more siblings.
DCF officials said that $14.8 million in new funding went into the hiring of 272 more case managers across the state this year. And additional money to hire more case managers will be part of the department's request for the upcoming legislative session, said DCF spokeswoman Jessica Sims.
But in Hillsborough, an unusually high rate of children being taken into care is putting significant strains on the county's child welfare system. In the 2016 fiscal year, 1,672 Hillsborough children were removed from parents or guardians, the highest number in Florida and the most in more than 10 years.
Earlier this year, Eckerd acknowledged that 43 children were forced to sleep in offices and other unlicensed locations because they had run out of foster beds.
And case managers here have an average of 22 children under their watch, according to a Nov. 23 Eckerd report. By comparison, case managers in Pinellas and Pasco counties — which is also run by Eckerd — are responsible for an average of 18 children.
Eckerd officials said their decision to reduce the number of care agencies they contract with in Hillsborough has not increased workloads for case managers.
In response to a spike in the number of children being removed earlier this year, it increased the number of case manager positions from 181 to 210, said Eckerd spokeswoman Terri Durdaller.
Still, 14 of those positions remain unfilled. Eckerd pays care agencies $37,500 for every case manager.
"Eckerd Kids is committed to keeping individual caseloads below 25 to ensure the quality and stability of services we provide to children," Durdaller said. "We fund case management positions by the number of children in our system of care."
If case managers are responsible for too many children, it increases the risk that children and families will not get the services and help they need, said Robin Rosenberg, deputy director of Florida's Children First, a statewide advocacy organization focused on children's rights.
"They can't give sufficient attention to the families," Rosenberg said. "They don't have time to work with the parents and things can fall through the cracks. They physically can't be everywhere."
That concern was echoed by Julie Collins, vice president for practice excellence at the Child Welfare League, a nonprofit group that sets national standards for the field.
"It would create challenges for them to do the type of work they need to be doing with the child — the monitoring, the support that needs to be provided," Collins said. "Many states are struggling with caseload for their staff. It's an underfunded system."
And the bar may soon be set even higher for care agencies. With many states requiring additional documentation and visits, Collins said her group is reviewing its standards and may next year recommend even fewer cases for child welfare workers.
The report into the death of 8-month-old Miracle also found that the Hillsborough Sheriff's Office is struggling to hang onto child abuse investigators, with an average of 30 percent of positions unfilled in the first quarter of 2016.
The job pays about $45,500 a year once initial training has been completed.
Maj. Jim Bradford, who heads the child protective investigations division, said he has boosted training and support for investigators. As of October, 82 percent of positions were filled and retention of new hires has risen from 54 to 88 percent since last year, Bradford said.
Miracle's death was the result of suffocation, according to the Hillsborough County medical examiner.
The child was taken into state care in February after her mother, Rolanda Angelique Cusseaux, was arrested in her east Tampa home following a report of domestic violence.
A case manager placed Miracle with a friend of the mother's. In July, the baby fell asleep on a sofa next to the caregiver's 10-year-old girl. Her mouth and nose were covered by sofa cushions. Miracle never woke up.
Through the five months Miracle was in the care of the state, her case manager had three different supervisors resulting in inconsistent support and guidance. But that was not a factor in the child's death, the investigation concluded.
"Although workforce stability in general appears to be impacted by staff turnover and consequently resulting in higher caseloads for both child protective investigators and community-based providers, this did not have a bearing in this particular case," the report states.
Contact Christopher O'Donnell at firstname.lastname@example.org or (813) 226-3446. Follow @codonnell_Times.