Maine’s system to protect children from abuse is under siege and strained by a multitude of factors, including staffing, the opioid crisis, caseloads for Child Protective Services workers and a surge in complaints of suspected abuse.

Since 2011, the number of children in state care has increased by 40 percent, and since the late 2000s caseloads for child protective workers have gone up by about 50 percent. Physical abuse cases increased by 52 percent from 2008 to 2016, while reports of suspected child abuse and neglect jumped 31 percent, from 6,313 cases in 2008 to 8,279 in 2016, according to the Maine Department of Health and Human Services.

The state is struggling to protect children, according to child abuse experts, social services workers, Democratic and Republican leaders and Gov. Paul LePage, who on Thursday said the system has “major, major holes.”

Child Protective Services, a division of the Department of Health and Human Services, is under intense scrutiny after two girls who suffered prolonged abuse died in the past three months: Marissa Kennedy, 10, of Stockton Springs and Kendall Chick, 4, of Wiscasset. Their parents or caregivers are facing criminal charges.

Government investigations have been launched, but three weeks after Marissa Kennedy’s death, it’s unclear yet exactly what the problems are with child protective services or how they could be solved.

LePage said on Thursday that systemic changes are needed in a department that his administration has run for nearly eight years, including addressing caseworker “burnout.”

The number of child protective caseworkers declined slightly after LePage took office – from 155 to 145 in 2011 – while the state was on the cusp of a major upswing in child abuse being reported, according to a federal report.

LePage did not commit to increasing the child protective workforce but said two reforms would likely be an upgrade to the child protection computer system and additional training for employees.

The Legislature’s watchdog agency, the Office of Program Evaluation and Government Accountability, is also reviewing the two child deaths and child protective practices. The OPEGA investigation could take three months or longer.

Health and Human Services Commissioner Ricker Hamilton was not available for interviews last week, according to DHHS spokeswoman Emily Spencer.

Whether the caseload and abuse trends signify a degradation of the child protective system, or whether other factors are more significant – such as the opioid crisis and cuts to public assistance programs under the LePage administration – is unclear.

Experts and those who have worked either for or closely with the child protective system say the system is complex, problems are not easy to identify and solutions are not simple.

Mark Moran, a social worker and family service and support team coordinator at Eastern Maine Medical Center in Bangor, said more children may be in harm’s way, in part because of the opioid crisis. In 2016, DHHS removed 411 children from Maine homes where a parent’s drug use put them at risk, a 45 percent increase from 2009.

“We’re seeing that in the hospitals; more kids are showing up with serious injuries for evaluation,” Moran said. “Removing kids from families is not a benign intervention. But we have to protect children.”

AFTER MAKING PROGRESS, ‘MAINE IS NOW REGRESSING’

By the end of former Democratic Gov. John Baldacci’s second term in 2011, Maine was considered one of the top states in the nation for protecting children, and was winning national awards, including from the Annie E. Casey Foundation, a leading nonprofit that advocates for child welfare.

Now, many of the indicators of a well-functioning system are showing signs of deterioration, said Richard Wexler, executive director of the National Coalition for Child Protection Reform, a Washington-based nonprofit think tank.

“They had made a great deal of progress, but Maine is now regressing and the horror stories are returning,” Wexler said.

Wexler said Maine’s “rate of removal,” which measures how many children are removed from the home and placed into state care, has gone from 2.1 children per 1,000 in 2011 to 3.6 children per 1,000 in 2016, a worrisome trend.

Maine had the third-lowest “rate of removal” in 2011, and now 19 states have better removal rates than Maine.

Wexler said the research is overwhelming that children do best when staying with their parents whenever possible.

“Family poverty has often been confused with neglect,” Wexler said. “Taking the children away from their families and ripping families apart makes children less safe. Foster care is extremely toxic, and should be invoked sparingly.”

LePage, speaking to reporters at the State House on Thursday, seemed to come to the opposite conclusion, saying Maine had gone too far in reuniting children in homes where abuse had occurred.

“I think (family) reunification in the state of Maine is the priority. I think it’s the wrong priority,” he said. “This is the dialogue we are not having. What is best for the child? It could be reunification in some cases. In other cases it might not be.”

Heather Gosselin, a Bangor social worker and child protective caseworker from 2008 to 2013, said when she worked at Child Protective Services she experienced the change in emphasis to keep children with their families more often, and in most cases it was better for the children to keep families together.

“While I was there, there was a major push to keep children at home and do our best to keep them safe there,” Gosselin said. “In the vast majority of cases, what families need are support and help.”

‘NO ONE WANTS THE STATE TO BE THEIR PARENT’

Wexler said nationally, there was an uneven but positive trend from the late 1990s to about 2013 to reduce the number of children removed from the home and placed into foster care, with great disparity among states. Since 2013, both trends have started reversing and going back toward more removal. Wexler said some states are using the opioid crisis as an excuse to remove more children, a “knee-jerk” reaction.

Maine used to much more frequently remove children from the home. In the early 2000s, nearly 3,000 children were in state care. That number dipped to 1,322 in 2011 but has since increased to 1,852 in 2017, according to the DHHS. Compared to the early 2000s, the number of placements with relatives has increased.

Research shows kinship placements are considered better alternatives than foster care with non-relatives, but outcomes are best if children stay with their families when possible, Wexler said.

About 15-20 percent of all state care placements in Maine were with family members in the mid-2000s, compared to about 30-35 percent in recent years, according to the Annie E. Casey Foundation.

Jim Beougher headed the Office of Child and Family Services in the Baldacci administration, during the most dramatic downturn in children in foster care. Beougher said Baldacci hired him to reform the system after the tragic death of Logan Marr.

Logan died at age 5 in 2001, after being bound with duct tape and found in a tipped-over high chair in the unfinished basement of her foster parent, who was also a Child Protective Services caseworker. Sally A. Schofield, the foster parent, was convicted of manslaughter and sentenced to 17 years in prison.

Beougher said staffing levels weren’t the problem back then, but a lack of good policies and procedures and maintaining a priority on what was best for the children.

“No one wants the state to be their parent,” said Beougher, who was dismissed from his position about six months into the LePage administration in 2011. “When I got there, there was no sense of urgency to get children into a permanent setting.”

Under his management, the agency made an array of small but powerful changes, such as cutting response times to complaints from 14 days to three days; improving training for child protective workers; limiting travel time; placing children in nearby foster homes; and reducing bottlenecks by taking back into the agency certain tasks that had been outsourced.

He said engaging with extended families to get them all involved in improving conditions in the home also helped. Maine now places more children with extended families – such as grandparents, aunts and uncles – a big turnaround compared to 15-20 years ago, when children were routinely placed with strangers.

“We weren’t even asking kids if there was any relative they wanted to stay with,” Beougher said.

Gosselin, the former caseworker, said keeping children in the home has other benefits. To remove children required going to court, and the state would sometimes lose cases, which took time and resources away from the agency and other families.

It also made caseworkers more effective if the families did not fear removal.

“If they knew that DHHS wasn’t there to take their children away, that helped a great deal,” she said.

Caseworkers focused on helping families get counseling and learn how to improve relationships. Often there was domestic violence among adults, which can lead to child abuse and is also emotionally damaging for the children.

“Many of the parents grew up in poverty and in abusive situations. There’s this attitude of ‘If it was good enough for me, it’s good enough for the kids,’ ” Gosselin said. “But if we gave them help, they could work through that.”

‘SMART’ SCREENING, BUT THAT TOO CAN HAVE PITFALLS

The job even in the best circumstances is stressful, Gosselin said, as workers have to navigate each family’s personal problems while looking out for children. She left two years into the LePage administration to pursue a graduate degree. She had 21 cases at the time she left, a level she called manageable but still higher than the 13-17 cases she had under Baldacci.

“There were certainly times when all I was doing was putting out fires because I had so many cases,” Gosselin said.

The U.S. Department of Health and Human Services measures caseload by completed investigations per worker per year, which has increased from about 50 per year during the Baldacci administration to more than 70 under LePage, including 73 in 2016, the latest year measured. Maine had one of the lightest caseloads per worker in the country a decade ago, and now it’s about the national average, according to the federal report.

Wexler said a “smart, sensible” screening process helps identify cases for child protective workers without overwhelming them with cases that are not likely to be abuse.

“If you try to look into everything, you end up looking at nothing,” he said. “Workers can then concentrate on finding kids in real danger.”

But Shawn Yardley, a former child protective services worker, cautioned that aggressive screening has its pitfalls.

“When too many reports are screened out, something that can seem like it’s not abuse, if you just looked into it, you might find it was a lot more serious than it first appeared to be,” said Yardley, who is now CEO of Community Concepts, a social service nonprofit in Lewiston that runs child abuse prevention programs.

The opioid crisis is a major factor contributing to strains in the system, said Moran, the Eastern Maine Medical Center social worker. Drug overdose deaths hit a record in Maine in 2017, with 418 deaths compared to 155 deaths in 2011.

“How many of the deaths were parents, and then how many of the kids had to then be put into foster or kinship care?” Moran said. “When a parent overdoses and dies, the kid has to go somewhere.”

Gosselin said some form of substance abuse is present in about 80 percent of all child abuse and neglect cases.

However, Wexler contends that states are too quick to place the blame on opioids, when good policies and programs can still help keep families together despite substance use struggles. He points out that some counties in Ohio, for instance, reduced the number of foster care cases despite a raging opioid crisis.

“It’s not the opioid crisis, it’s the child welfare (system’s) typically shortsighted, knee-jerk, take-the-child-and-run response to the opioid crisis,” he said.

Joe Lawlor can be contacted at 791-6376 or at:

jlawlor@pressherald.com

Twitter: joelawlorph

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