Tampa — By 2012, a string of horrific child deaths had plunged this southwest Florida community into crisis, raising concerns about the states’s privatized child welfare system — the one that has become the model for change rapidly taking root in Georgia.
When criticism rained down on the agency that Florida had hired to protect kids in Hillsborough County, the state used one of the few levers it has left to ensure private child welfare vendors do their jobs: it fired the company and hired another that promised to do better.
That meant the system was working, its supporters said: market forces and competition had weeded out an under-performing organization.
“It’s a strength of the system,” said Kurt Kelly, CEO of Florida Coalition for Children, the trade group that represents the state’s private child welfare agencies. “They lose their contract. When’s the last time government’s been fired? That’s the ultimate accountability.”
Still, by the time the Hillsborough contract was terminated, nine kids under the agency’s watch had died in two and a half years, including a 1-year-old boy tossed and beaten by his mother’s boyfriend, a 5-month-old girl choked by an adult and a 3-month-old boy thrown from a moving car on the interstate.
As it did in Florida a decade ago, a proposal to fundamentally alter the state’s child welfare system has seized the imaginations of conservative lawmakers in Georgia, who take it on faith that private business can almost always do a better job than government can. The plan, passed by the state Senate last week, would shift responsibility for day-to-day operations of foster care, adoptions and other services for abused and neglected children from the government to private agencies and faith-based groups.
Proponents of Georgia’s proposal point to the successes in Florida after it switched to community-based care. Adoptions went up. Foster care rolls dropped. Fewer kids suffered repeat abuse.
But an examination of Florida’s decade-old privatized model by The Atlanta Journal-Constitution reveals a more complicated story. The progress in Florida has been tempered by setbacks and failures, many of them tragic. Some say the improved outcomes are not considerably better than those in other states that didn’t privatize.
“I think the jury is still out,” said Christina Spudeas, executive director of Florida’s Children First, a watchdog group. “I can’t say we’re doing better or worse. If you compare the numbers across the country we are doing what other states are doing.”
Even with Florida’s improvements, it still has service gaps and quality concerns in some communities where private agencies have been weak or ineffective. Critics still complain about a lack of accountability, bureaucratic snafus, safety breakdowns and too much tax money spent on salaries and bonuses for nonprofit executives running local systems across the state. Many say privatization was never intended to save the state money, and it hasn’t.
“If you think you go to a new model and all your ills in child welfare are going to go away, it’s just not true,” said Mike Carroll, the Tampa region’s director for the Florida Department of Children and Families (DCF). “We deal with some of the same complex issues other folks do.”
‘Everybody puts the finger on somebody else’
When Florida privatized, it divided the state into 20 regions and hired a “lead agency” to oversee child-welfare services in each. Today there are 17 lead agencies that contract with community-based groups — dozens of them in larger regions — to provide foster care, case management and other services.
The stakes couldn’t be higher: children’s welfare, and hundreds of millions of tax dollars the state pays to the lead agencies to ensure it. For example, the Tampa lead agency alone took in $130 million last year from the state.
Last summer, the secretary who oversaw Florida’s child welfare agency stepped down after of a rash of child deaths. His replacement, DCF Secretary Esther Jacobo, ordered an independent statewide review of the child maltreatment fatalities in cases where kids had prior involvement with the state system.
As with the recent tragedies in Georgia, many of the problems were linked to child protective investigations. These investigations were not part of the privatization in Florida; they remain a government function there, as they would under Georgia’s proposed changes. Even so, some of the highest-profile cases have involved children under the watch of the private agencies.
“We cannot lose sight of the fact that each individual case represents a young life that was tragically cut short,” Jacobo wrote in a memo addressed to the CEOs of the private agencies as well as the regional directors in her department.
A statewide scandal erupted after the 2011 death of a 10-year-old Miami girl who was beaten and tortured by her adoptive family. Critics of the new system complained the case highlighted layers of bureaucracy in the privatized system, making it difficult to hold anyone accountable when failures occur.
“It took a task force to figure it out because so many different agencies were involved,” said Spudeas, the head of the children’s watchdog group. “When you have a state agency you know who to put the finger on. You go straight to your state agency. When you’ve got privatization everybody puts the finger on somebody else.”
Kelly, who heads the association of private agencies and is a former lawmaker, counters that even with some of the mistakes, those suggesting the government-operated system worked better are “people who have short memories about how bad it was.”
The system nonetheless has drawn outspoken critics, not the least of whom are some judges who must try to make the whole thing work.
At a legislative hearing in September, for example, Judge Larry Schack from Fort Pierce in southeast Florida testified that he is responsible for the lives of 707 children in dependency court in his circuit, yet the state’s system is so broken that he struggles to ensure their safety and well-being. When the family court judge dug into the problems, he said, he found a “wholesale failure” of case management from private agencies in his district.
“Something fundamental in the structure is wrong,” Schack testified. “We can’t have a system that works in some counties or circuits but not others, or one that doesn’t give the (DCF) secretary the ability to act vertically to resolve problems.”
‘We’re ambassadors on the street’
The current lead agency in Tampa, Eckerd Community Alternatives, rose out of the failures of two other agencies in the area. The nonprofit took over in Pasco and Pinellas counties in 2008 when the lead agency there was not meeting the state’s expectations.
Then, amid the crisis of child deaths in Tampa, the state removed Hillsborough Kids Inc. and again turned to Eckerd in July 2012 to run the local system.
Eckerd’s charity, which was created to serve children in the late 1960s by the family that started the pharmacy chain, receives $130 million a year from the state to serve more than 6,000 children. Like lead agencies in the other districts around the state, the Clearwater-based nonprofit acts as system administrator in its communities, contracting with 120 subcontract agencies that provide the actual services.
“We’re actually ambassadors on the street, meeting with business leaders, meeting with pastors, meeting with stakeholders and providers, always looking at ways to enhance our local systems of care to better meet the needs of children and families,” said Lorita Shirley, chief of Eckerd’s community-based care.
In the months before it took over in Hillsborough County, Eckerd performed a quality review of more than 1,500 open child cases in the county. Out of that, the nonprofit developed a list of nine factors that enabled it to identify children at the greatest risk.
Since launching the “rapid safety feedback system,” Eckerd has had no abuse-related deaths, and the state is now expanding the program to its other lead agencies.
‘It’s something big to them’
Like many top officials in lead agencies across Florida, Shirley is a former employee of the state child welfare system. She was initially skeptical of the private model but later found it was effective in engaging local citizens.
“No one wants to help the government, but they’ll help the community,” Shirley said.
That dynamic is on display in the small L-shaped room inside Eckerd’s offices in Largo. At first glance, the room doesn’t seem like much. It’s lined with shelves of diapers, children’s clothes and shoes, some of them tiny enough to fit an infant. Blankets that many children take with them were made by a church group that prays over each covering. Eckerd partnered with another charity a couple years back to help expand the program.
The children who enter the shop, dubbed the Room of Hope, are often just hours removed from abusive or neglectful homes.
“Some of these children are coming in with their stuff in a paper bag,” said Kelly Rossi, who oversees the room. “This is something small, but it’s something big to them.”
One of the partnerships Eckerd fostered was a deeper involvement by churches and faith-based groups. Earlier this month in St. Petersburg, more than 200 participants attended the Churches as Champions for Children luncheon as photos of kids needing adoption slowly flashed across a large screen. Eckerd’s effort to recruit more minorities to become foster and adoption parents also includes a radio program twice a month on a station that caters to African-American listeners.
“The deliverers of the service have to be connected to the community that is overrepresented in your system,” said Rev. Wayne G. Thompson, the show’s host, who said some lead agencies in the state are better than others about building bridges into minority communities.
'We thought we could make a difference'
In parts of the state, Florida has struggled to find qualified private agencies to do the work. Stephen Pennypacker, an assistant secretary with the Florida DCF, said undergoing a transition from a state-run child welfare system to one based on local, private control will present challenges.
He said there aren’t a hundred companies lining up to be lead agencies.
“You have to have people that want to do it,” said Pennypacker, who heads Florida’s programs that include child welfare. “The expertise to run an agency like this is pretty significant.”
Youth and Family Alternatives is one of the largest community-based subcontractors in the Tampa area. The nonprofit agency provides case management or other services in 13 counties in the region. But it initially was reluctant to enter the new community-based system. The nonprofit’s longtime CEO, George Magrill, said he’d heard stories about how an organization’s reputation could be tarnished doing core services within a child welfare system with such a troubled history.
But after the state switched lead agencies in Pasco County, the nonprofit’s leadership decided to jump into case management. Today, as a subcontractor reporting to a private lead agency, Youth and Family Alternatives has 200 case managers watching over kids and families in crisis.
“It was not an easy decision,” said Magrill. “As an agency we struggled with it. We talked with a lot of people. On balance, the potential reward outweighed the risks. And the rewards for us were primarily that we thought we could make a difference with this population.”
Eric Mitchell and his wife, Lori, have been foster parents in Pasco County for more than a decade, housing more than 200 children and adopting four.
Mitchell said the quality of services and local leadership has varied over time with different lead agencies and their ability to forge relationships with the community. He said it took years of struggle to get their local system working well.
“It really boils down to the folks who are in leadership having a mindset to want to fix issues and make the system work the way it should work,” Mitchell said. “They have to want to do what’s right for the children every single day.”
Foster care: Georgia vs. Florida
Georgia’s foster care and child welfare system scored better than Florida’s in 9 of 17 standard measures. Georgia did well in children being reunited with their families, while Florida scored well in adoptions.
Source: Barton Child Law & Policy Center at Emory University
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