Child welfare agencies are buckling under staffing shortages as Pa. debates using opioid money to help

HARRISBURG — Pennsylvania counties are tapping into opioid settlement money to support child welfare programs as they face staff shortages, increased risks for children, and other challenges.

Most of these initiatives have received approval from a powerful state oversight board — including efforts to train staff, support parents in treatment, and provide medication lock boxes to families. An official in Erie County cited a rise in accidental overdoses involving fentanyl as a reason officials there dedicated money toward a child welfare effort.

But another county’s plan to use the money to address staffing turnover has sparked debate over whether the plan aligns with the requirements of settlements with drug companies.

“My reaction was, ‘Well, this is just a way to give people raises,’ if you want to be very frank about it,” Robert Postal, a member of the state oversight board, said. He later added: “I’m not so sure that’s the purpose of the settlement.”

Pennsylvania expects to receive billions of dollars from settlements with drug companies over their role in the opioid epidemic. A court order last year estimated the state could receive up to $1.8 billion from two major groups of settlements. Additional funds, including up to $212 million from a deal with Purdue Pharma and members of the Sackler family, could also arrive.

This money is coming in as child welfare offices across Pennsylvania face significant staffing shortages, with some officials describing the situation as a crisis.

Brian Bornman, executive director of the Pennsylvania Children and Youth Administrators Association, told Spotlight PA that before the coronavirus pandemic, if a county child welfare office had around a 30% vacancy rate, “that was kind of considered a pretty serious crisis, and all hands on deck to try to get that resolved.” But he said now most counties have those types of shortages or worse ones.

“We’re nowhere near where we need to be,” Bornman said.

“The staff have to kind of run nonstop. They’re carrying way too high of caseloads.”

County child welfare offices investigate and assess allegations of child abuse and neglect in Pennsylvania, and these caseworkers have “one of the most important positions in government,” top officials with the state’s Department of Human Services said in testimony to lawmakers last year. Those officials — Laval Miller-Wilson and Brinda Penyak — described the life-altering decisions child welfare workers are tasked with making and warned that “an increasing number of counties lack the staff to complete their investigations in a timely manner.”

In rural Cameron County — which has fewer than 5,000 residents, making it the smallest county in the state — local officials say they have faced these staffing challenges for years. They looked to opioid settlement money as a solution.

‘Seems fine to me’

In 2022, Cameron County officials reached out to the Pennsylvania Office of Attorney General, which negotiated the opioid settlements, for guidance. At the time, the office was also providing administrative support to the state trust distributing and overseeing the funds here.

The north-central Pennsylvania county decided to use settlement money “to increase/retain employees wages” in the children and youth services department, as well as the probation office, according to an email exchange obtained by Spotlight PA through open records requests. The email’s signature block included the names of Cameron County Commissioners Lori Reed and Ann Losey, who have both since left office.

“They have been severely impacted by the opioid crisis in our community,” the county email said of those offices.

“Furthermore, staffing continues to be an issue due to educational requirements and low wages,” the message continued.

Cameron County officials moved forward with the plan. In a spending report filed last year, the county said child welfare and probation offices have prioritized “seeking out care, treatment, and rehabilitation offerings,” and that the offices historically were not “compensated fairly or equitably for the additional requirements the opioid epidemic has caused.” In one recent year, 75 out of 95 family cases were opioid-related, according to a county child welfare report.

But in August 2024, board members for the Pennsylvania Opioid Misuse and Addiction Abatement Trust rejected the county’s use of funds. It was a significant decision — trust members have the power to withhold future settlement money if they decide counties spent the funds inappropriately.

The county appealed, citing Wade’s email and challenging “how the trust board can make a program determination that undermines the approval of a senior advisor within the Attorney General’s office.”

Brett Hambright, a spokesperson for the attorney general’s office, now led by Dave Sunday, told Spotlight PA that Wade’s email was “not official guidance and not offered under the current administration.”

Hambright noted that the agency is not a member of the trust. Separately, trust Chair Tom VanKirk at a recent public meeting also highlighted Wade’s disclaimer that the response was not official guidance of the trust.

Beyond the Wade email, Cameron County officials have made other arguments in favor of their plan. Edwin Tompkins III, an attorney for the county, emphasized its small population, high poverty rate, lack of other resources, and the broad assistance that child welfare and probation workers there provide.

“Our caseworkers are performing these services. They’re frontline,” Tompkins told trust officials in January. “We don’t have anybody else. I wish we did.”

The total disputed amount is nearly $23,000 for child welfare and probation positions. While that’s a relatively small sum, the trust’s decision could set a precedent.

Cameron County meeting minutes from late 2022 highlight the relatively low salaries for these child welfare positions. Starting salaries are listed as $37,000 to $39,000 for caseworkers and $46,000 for the children and youth director.

How other counties are using opioid funds

Across Pennsylvania, settlement funds have supported a range of youth-focused programs. In some cases, public records show those programs are directly related to child welfare programs or offices. To identify these efforts, Spotlight PA reviewed spending reports and a searchable database the newsroom launched in November, including by looking up “CYS,” the common acronym for children and youth services.

Spotlight PA’s findings include:

$500 for Somerset County’s child welfare office to provide lockboxes for families who are approved for certain prescriptions and medical marijuana.

About $4,600 that Fayette County reported dedicating to a women’s support group program through its child welfare office.

$18,000 in Tioga County for a program to provide certified recovery services at a homeless shelter. The program is designed to provide a wide range of services to people, including help with housing, employment, treatment, legal, and CYS and family issues, according to a spending report from the county.

$30,500 for overdose prevention connected to Erie County’s Office of Children and Youth. The county purchased medication lockbox kits in order to “equip families with essential education and resources to prevent accidental overdoses, particularly in households with young children,” a county official told Spotlight PA in a statement. The county also used the funds for staff training.

$200,000 for a program known as the Family Healing Center that “is exclusively available to Allegheny County families referred by child welfare,” according to records released by the trust. The residential program helps parents undergoing treatment stay with their children.

Officials with some of the counties supported by settlement funds told Spotlight PA the opioid epidemic and substance use disorders have had a deep impact on their child welfare offices.

“You could ask every child welfare worker in the state, and it’s going to be a top three issue, and it’s probably … number one most of the time,” Erin Dalton, the director of Allegheny County’s Department of Human Services, told Spotlight PA. “And so it feels incredibly pressing and challenging.”

In Erie County, the opioid epidemic has had a significant impact on the child welfare office, “increasing cases where children are exposed to substance abuse and requiring greater intervention to ensure their safety,” Scott Coughenour, director of the county’s Office of Drug and Alcohol Abuse, said in a statement.

In Fayette County, the opioid-settlement-funded women’s support group has 15 adults as regular members, according to Gina D’Auria, administrator for the county’s child welfare office. Women do not have to currently be involved with the office to participate. D’Auria said the program is “seeing tremendous successes,” and has helped women maintain sobriety, find appropriate housing for themselves and their children, and connect with other services.

One of the initial challenges for the support group was its association with the county child welfare office. Any time programs are affiliated with the agency, “the community at large tends to think, ‘Oh, they just want to take our kids,’” D’Auria said.

“That is most definitely not our goal. We want parents to safely parent their children. And we want to offer them as much support,” she said. “So it took a while for us to overcome that CYS distinction, but I think we’ve come a long way.”

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Ed Mahon reported this story while participating in the USC Annenberg Center for Health Journalism’s 2024 Data Fellowship and received engagement mentoring and funding.

Spotlight PA is an independent, nonpartisan, and nonprofit newsroom producing investigative and public-service journalism that holds power to account and drives positive change in Pennsylvania.