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Deaths of 8 children put Hillsborough Kids Inc. in limbo

By John Barry, Times Staff Writer
In Print: Sunday, October 9, 2011

TAMPA — The homegrown, nonprofit agency charged with protecting 2,500 of Hillsborough County's most
vulnerable children is at risk of losing its $65.5 million state contract because of eight dead kids.

They died in the last two years while under the supervision of Hillsborough Kids Inc.

The eight stood out in a Department of Children and Families study of child deaths statewide. Seven of the eight
children were under supervision because of reports of abuse, neglect or abandonment. DCF said no other agency
in Florida had so many deaths.

Two agencies — Big Bend Community-Based Care in Tallahassee and Our Kids Inc. in Miami-Dade — each
reported five deaths. Just one case apiece involved children who had previously been abused or severely neglected.

"Any death of a child raises concern," said Mike Carroll, DCF's regional director. "When you have eight, especially
under the circumstances that occurred here, that raises alarms."

He said the future of Hillsborough Kids was undecided, but "performance around child safety is a key success
requirement for any vendor we contract with. If a vendor is unable to perform at a high level in the business of
keeping kids safe, that puts its ongoing contract at risk."

Hillsborough Kids' response:

"Message received," said CEO Jeff Rainey.

The agency's contract runs out in June. DCF issued "Invitations to Negotiate" to both for-profit and nonprofit
agencies. Among the expected competitors are agencies serving Pinellas, Pasco and South Florida counties.

Hillsborough Kids has been DCF's lead social service agency in the county since the state began outsourcing
services to families and children in 2001. The giant office on Florida Avenue sits next door to DCF's Hillsborough
headquarters.

The expiring contract would have gone out for bid regardless of performance, and a decision to renew isn't based
on a single number. Rainey said the vast majority of protected children are living safely. In the past five years,
10,000 more have been kept out of the system through aid to families, and 2,000 others have been adopted. He
also cites the agency's local roots, its 12-year Tampa history, and its warehouse of food, kitchenware and clothing
that keeps the families it counsels going.

"We either bat a thousand, or we bat zero," Rainey said. "When a child dies, we bat zero."

In the last two years, tragedy has struck one child after another.

Among the most publicized: a 4-month-old boy who was beaten and thrown from a car on I-275 in 2009. The ex-
boyfriend of the baby's teenage mother was charged with his murder. Another victim was a 5-month-old girl choked
to death last year. Police charged her mother. Also last year, an 18-month-old toddler, once found sleeping next to
a loaded gun during a drug raid, wandered into the path of car in an apartment parking lot and was killed.

This year, two more child deaths caused Hillsborough Kids to take action against two key subcontractors that
perform home visits:

Mental Health Care Inc. was found at fault in its monitoring of Ezekiel Mathis, a 1-year-old killed last May. Three
workers apparently were unaware that a boyfriend they found living in the home had been barred by a judge. Their
e-mail inquiry to deputies wasn't opened until after the baby's death. The boyfriend is charged with his murder. After
the tragedy, MHC removed the three workers from its Crisis Response Team.

Recently, MHC's $2.4 million contract was cut by $250,000. MHC also received only a six-month extension of its
contract rather than full renewal. At the same time, Hillsborough Kids signed a yearlong, $689,000 contract with an
agency similar to MHC.

Children's Home Society was cited for missing dangers 16-month-old Ronderique Anderson faced when he was
taken from his mother and put in the care of his father. Investigators found caseworkers should have provided the
mother with better services and more closely examined the criminal backgrounds of the father and his girlfriend.
They also said the case supervisor did not provide sufficient oversight or instruction. His father is charged with
beating the baby to death last February.

Children's Home Society, which is paid $5.1 million annually, was stripped of half its caseload.

David Bundy, CEO of Children's Home Society of Florida, said his agency agreed a smaller caseload was necessary
to get a handle on problems.

DCF acknowledges that in the volatile business of protecting vulnerable children, some can die — even when
everything possible is done to prevent it.

But the review of the eight deaths found that, in some cases, everything wasn't done.

The two most common shortcomings identified by DCF: failures of frontline workers in the most potentially
dangerous homes to understand the family dynamics, and failures of their supervisors to give enough guidance.

DCF administrator Carroll says effective casework is based on common sense, intuition and experience as much as
following check lists and completing questionnaires. Supervisors are key, especially when caseworkers are young,

In one federally required quality assurance check this year, Hillsborough Kids scored 25 percent for supervisory
reviews of children's safety, permanency and well-being.

It scored 56 percent on how well supervisors followed up on guidance and direction.

The agency was criticized for considering the mother's needs in just seven of 11 sample cases and the father's
needs in two of nine.

Other Hillsborough Kids subcontractors include Camelot Community Care, Gulf Coast Community Care, Devereux,
and Youth and Family Alternatives.

Among the eight dead children, three fell under Camelot supervision, three under Children's Home Society and one
each was managed by Devereux and Mental Health Care.

Rainey said the number of subcontractors has helped reduce caseloads. But Hillsborough Kids' strategic plan
acknowledges the difficulties of managing so many subcontractors.

Hillsborough Kids has prohibited Mental Health Care from sending a case manager and therapist to a home at the
same time, then counting their visit as two of the three required visits per week — something that happened in the
Ezekiel Mathis death. Rainey said the joint visit was an isolated incident, not a regular practice.

The joint visits were done for safety, the agency replied in writing. "MHC still teams its staff when safety is a concern,
and agrees with HKI to count this as one visit only."

In a review, Hillsborough Kids also criticized Children's Home Society for "a significant number of risk/safety issues"
and performances "below expectations in qualitative guidance by supervisors."

The agency demanded future scores of at least 80 percent on quality assurance reviews.

It ordered Children's Home Society to submit a written plan for improvement.

"We agreed with the findings," said Bundy, the society's CEO. He said his agency is working with the universities of
South Florida and Central Florida to catch red flags earlier. He said the agency found it wasn't making changes fast
enough in Hillsborough and redesigned the program with major staff changes.

At Hillsborough Kids, Rainey said, his agency has reviewed 1,800 cases and introduced changes.

They include the pending creation of a special dependency court for the highest-risk cases. It will be presided over
by Circuit Judge Katherine Essrig.

New software will flag families at high risk for abuse: those with teen mothers, day care problems, past domestic
violence and parents who were abused as children. Most of the factors showed up in the eight deaths. The agency
also has started a Family Finding program to identify biological or adoptive family members, teachers, coaches, and
friends to form support teams for children.

Rainey said frontline workers will have to take an additional 16 hours of training to learn how to size up families and
household environments.

He said supervisors, too, will get more training and will be equipped with devices that alert them to problems found
during home visits.

DCF's Carroll said the changes are all good.

"But in the end, what we are looking for is improved performance."

Robin Rosenberg, deputy director of Florida's Children First, serves on the committee that will review bids when
Hillsborough Kids seeks to renew its contract. She said she hasn't yet formed an opinion, but she said the number of
deaths "is alarmingly high."

DCF, she notes, has shown before that it's not afraid to make big changes to give kids and families a better shot to
survive and thrive.

"Safety is important, but it is not everything," she said. "We could lock kids in padded cells and they would be safe.
We have to do a lot more to make sure they do well."

John Barry can be reached at jbarry@sptimes.com or (813) 226-3383.
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