Baby's death brings foster care reforms

Nurses will evaluate children, caseworkers will increase visits

Gina Barton and Meg Kissinger

the Journal Sentinel

Every child age 3 and under who has been in foster care in Milwaukee County for nine months or less will be evaluated by a nurse, as part of sweeping reforms to the child welfare system announced Friday in the aftermath of the death of Christopher Thomas.

The reforms are needed to address a series of mistakes that occurred in Christopher's case, including an inexperienced caseworker who missed clear signs of abuse, a supervisor who didn't keep a close-enough eye on her, and a contractor that didn't fulfill its obligations, state officials said.

The caseworker has been reassigned and placed on probation. Her supervisor has been demoted. The agency that employs them, La Causa, is in jeopardy of losing its state contract with the Bureau of Milwaukee Child Welfare.

Christopher, 13 months old, died in foster care last month. Police say he and his 2-year-old sister were abused for months by Crystal Keith, their aunt. They had been removed from their mother's home because of neglect. Keith, who told police that she regularly beat the children, has been charged with reckless homicide and child abuse.

Bringing nurses into the foster care system is one way to ensure other children don't suffer as Christopher and his sister did, said Reggie Bicha, secretary of the state's Department of Children and Families. After all the youngest foster children have been examined, nurses will examine the 4- and 5-year-olds in the system.

"We will see each of those kids and make sure that they are safe," Bicha said.

The nurses will likely be hired and begin their work early next year. In addition, caseworkers will be required to double the number of home visits they make for children under 3 - from once a month to twice a month.

The results of the department's preliminary investigation into Christopher's death were first made public Friday. Bicha said that under state law, the information could not be released until the review had been completed and several other conditions had been met.

Cyrus Behroozi, administrator of the department's Division of Safety and Permanence, which oversees the foster care system in Milwaukee, said the system failed Christopher and his sister repeatedly.

"These are not minor missteps," Behroozi said. "There were a series of lapses that led to the death and serious injury of these children."

The state blames La Causa, a contractor that oversees about 650 cases - about one-third of the foster children in Milwaukee - for those lapses. If major improvements are not made immediately, the state could cancel the agency's $11 million annual contract within three months, Bicha said. Oversight of La Causa and other contractors, as well as evaluation of the Bureau of Milwaukee Child Welfare's programs, will now be conducted by the state Office of Performance and Quality Assurance, he said. Previously, bureau staff had reviewed its own practices.

In Christopher's case, part of the problem was that a young, inexperienced caseworker was assigned to Christopher and not properly supervised, Behroozi said. The caseworker is no longer working with Christopher's sister but still is responsible for about half a dozen other cases, he said.

The woman was hired in June and was supposed to train for three to six months in close cooperation with a supervisor who would accompany her on home visits, Bicha said. Instead, she was immediately given primary responsibility for a few cases, including that of Christopher and his sister. She went on the visits herself and simply gave the reports to the supervisor for review.

"It appears La Causa was doing this with all of their trainees," Bicha said. "They feel that they followed the protocols. We don't think so."

The caseworker relied on the children's relatives to tell her how things were going instead of checking it out for herself, Behroozi said. She didn't talk and play with the children, but rather observed them from a distance. More interaction would likely have revealed injuries authorities say had been present for months. The worker made visits to the Keiths' home on Sept. 23 and Oct. 31, Behroozi said Friday. The October visit was not mentioned in autopsy and court records made public earlier.

"There was evidence that she should have seen," Bicha said.

Caseworkers also failed to confirm that the children were given routine health care.

Behroozi emphasized that the young caseworker is not entirely to blame.

"Key people in this case did not exercise reliable judgment," he said.

Hugo Cardona, president and CEO of La Causa, agreed, saying the young caseworker had not worked in foster care before.

"Just because the public is saying she should be crucified, I can't do that. We have rules, regulations and policies. These people are killing themselves day in and day out in one of the hardest jobs you can imagine."

Cardona said that he was drafting a letter to the bureau outlining the changes that need to be instituted "to ensure this never occurs again." He did not specify the changes.

"We are working to improve and it's not because the contract is threatened," he said.

Christopher's sister was discharged from the hospital Nov. 24, Behroozi said.

She is now living with an experienced, licensed foster parent who has been trained how to care for her. The girl continues to receive medical care as well as counseling, and occupational, physical and speech therapy.

Keith remained in custody Friday in lieu of $500,000 bail. She has pleaded not guilty by reason of mental disease to one count of first-degree reckless homicide and one count of intentional child abuse causing great harm. If convicted of both charges, she faces up to 75 years in prison.

Keith has a biological child, who is now in foster care and is receiving counseling because of being traumatized by witnessing the abuse of Christopher and Christopher's sister, according to state officials.

Georgia Pabst of the Journal Sentinel staff contributed to this report.