Part one of a series on child welfare and drug use in Door County.

Door County’s government this year is on pace to receive more child welfare referrals than it has during any year in history, far exceeding a previous record and alarming county leaders.

Child welfare referrals are handled by the county Health and Human Services (HHS) department’s child protection and youth justice division. They can range from reports of child abuse — cases in which the county is required to intervene if they meet a legal definition of abuse or neglect — to calls from law enforcement or a school with concerns about a child being hungry or not having enough clothing.

In extreme instances, the county or a court can enforce written agreements with parents or remove children from the home and place them with relatives or in foster homes, a practice called out-of-home placement.

The numbers often are staggering. Based on data from January through June of this year, the total number of child welfare referrals in Door County is on pace to increase by more than 20 percent compared to the previous record-high year, 2019. The number of referrals that meet a legal definition of abuse or neglect is on pace to more than double compared to 2020. The number of cases that result in what the county considers a formal intervention — in which a court sometimes is involved — is on pace to triple this year compared to just three years ago. And the number of children removed from their homes is on pace to nearly match 2019 levels, despite a shift away from the practice of out-of-home placement overall.

Door County has roughly 5,000 residents under age 18, according to 2020 census data.

Among the most complicated cases — and those most likely to result in out-of-home placements for children — relate to meth addiction among parents, said HHS deputy director Cori McFarlane. Such cases first arose within the past several years. While still relatively few, they have been increasing rapidly.

Meth addiction has risen quickly in the county over the past few years as the drug has become more available, McFarlane said. Meth has gradually moved across Wisconsin from west to east after first becoming a problem in the western part of the state more than a decade ago, said McFarlane and Sheriff’s Office Chief Deputy Patrick McCarty.

Child welfare cases involving parental meth addiction often result in longer out-of-home placements, McFarlane said, because meth addiction is difficult to treat. That problem is exacerbated by Door County’s relative lack of treatment and recovery resources for addiction.

People struggling with meth addiction usually are using multiple other substances, as well, McFarlane said.

In addition to drug use, mental health issues among parents are a factor in many child welfare cases the county sees, McFarlane said. In some cases, those mental health concerns can be the result of the parents’ own childhood trauma, she said.

The surge in overall child welfare referrals and cases also has stressed county HHS staff resources, resulting in social workers in the child protection and youth justice division taking on larger caseloads than the department would prefer. State funding for HHS services has not kept up with the county’s needs, McFarlane said.

Why cases are on the rise

County HHS managers don’t have cut-and-dry answers in terms of why child welfare referrals have increased in recent years, or why they’re spiking this year.

“In the vast majority of those cases, I would say there are mental health issues on the part of the parent,” McFarlane said.

McFarlane referenced a 2018 report produced by Children’s Hospital of Wisconsin and the state Child Abuse and Neglect Prevention Board on Adverse Childhood Experiences (ACEs), a definition of childhood trauma developed by the Centers for Disease Control and Prevention (CDC).

The report showed that 57 percent of Wisconsin adults surveyed from 2011 to 2015 had experienced one or more such traumas in childhood, and 14 percent had experienced four or more such traumas. In Door County, based on survey data from 2011 and 2012, 15 to 20 percent adults had experienced four or more such traumas, McFarlane said.

“The new trends with drug use in our county are alarming to us. This is very different than what we’ve seen even two years ago, so (we’re) concerned about what that might mean in future years.”

HHS deputy director Cori McFarlane

Counties statewide are seeing increases in child welfare referrals, McFarlane said.

“The new trends with drug use in our county are alarming to us,” she said. “This is very different than what we’ve seen even two years ago, so (we’re) concerned about what that might mean in future years.”

County residents currently struggling with meth addiction likely were already susceptible to some type of addiction, McFarlane said. The difference, she said, has been access: As meth has become more available in Door County, addiction cases have increased quickly.

Among the 15 child welfare cases that advanced to the formal intervention stage during the first six months of this year, four were drug-related and seven were alcohol-related, said Doreen Goddard, the child protection and youth justice division’s manager.

In terms of mental health and substance abuse issues, the pandemic could have made things worse, McFarlane said.

The process of handling a child welfare referral

The intent of the person contacting the county matters when it comes to how a child welfare referral is processed, Goddard said.

If someone calls to report child abuse, the county must process the call as a child protective services referral. If someone calls asking for services — such as help with housing, food or other family needs — the county processes the call as a child welfare referral. (“Child welfare” is an umbrella term used to encompass both categories, as well as a descriptor for the category of cases in which the county provides voluntary services to a family.)

In either case, child protection and youth justice staff use a screening process to determine how to proceed. Referrals that the county opens as cases for further investigation or services are called “screened in;” those that are not are “screened out.”

Most child welfare referrals (requests for voluntary services) have been screened in in recent years. Goddard said such referrals can be screened out if the family in question already is working with the county, if there are multiple reports with the same information or if the county cannot locate the family.

The vast majority of all referrals the county receives — about eight in 10 on average in recent years — are for child protective services.

To be screened in, child protective services referrals must meet Wisconsin’s legal definition of child abuse or neglect as defined in state statute. If a referral does not meet that threshold, the county cannot compel a family to accept services or make any changes, but can offer voluntary services.

When a child protective services referral is screened in, the case is assigned to a social worker for further investigation, a process that includes interviewing all members of the household.

The goal, Goddard said, is to determine whether there are present or impending threats of danger to the child. If so, the county will move toward a formal intervention; if not, the county will offer the family voluntary services or close the case.

Formal interventions, which require the approval of the district attorney, have made up between roughly 10 and 30 percent of screened in child protective services cases in recent years.

These fall under three categories:

  • The first, called informal disposition agreements, are a written agreement between parents and the county to make changes in the home and ensure the child’s or children’s safety.
  • The second, called consent decrees, are similar to informal disposition agreements, but a court also is party to the agreement.
  • The most intensive formal intervention is a Child In Need of Protection and/or Services (CHIPS) order, which is an order from a judge.

The county is shifting away from the practice of out-of-home placement, McFarlane said, as a result of a push by the state and federal governments to move toward a “family-first model” in which the county provides services to a family in the home, rather than separating children from their parents.

Despite that shift, the county placed seven children in out-of-home placements in January through June of this year, putting it on pace to nearly match the high point of 15 children placed in out-of-home placements in 2019.

When considering out-of-home placement options, Goddard said, the county is required to try to find a placement among a child’s relatives first, before looking at licensed foster homes. The county also tries to place children as close to home geographically as possible to make parent-child visits easier, Goddard said.

“Our primary goal is to return that child to their parents as soon as possible as long as it’s safe,” Goddard said.

Increase in cases stresses HHS staff capacity

At an August meeting of the county’s Health and Human Services Board, HHS director Joe Krebsbach said the department would request the hiring of an additional staff position working 20 hours per week to help handle the volume of incoming child welfare referrals. Staff members from other areas of the HHS department had been helping with those calls, he said.

Part of the strain on county staffing resources is a result of stagnant state funding over most of the past three decades, McFarlane said.

In a category of state funding called community aids, McFarlane said, counties saw small increases through the mid-1980s and early 1990s. Community aids did not generally increase from the early 1990s until the past two biennial state budgets, she said. In the past two budgets, the county has seen some increases in community aids funding for child welfare and behavioral health.

“We are very appreciative of these increases, as they helped to meet the increasing needs,” McFarlane said in an email. “However, these increases did not fully make up for the many prior years of stagnant funding, and the needs of families coming to our county for child welfare services continue to exceed the funding provided.”

The county ordinarily could make up for that shortfall with property tax revenue, McFarlane said, but state-imposed limits on county property taxes constrain the county from fully funding its operations.

“Workers are carrying caseloads higher than we would like to see, and this causes significant stress on individuals and systems.”

HHS deputy director Cori McFarlane

The county is struggling with staffing resources for child protective services, McFarlane said, as well as comprehensive community services, a case management program to support people with mental health and/or substance use-related needs.

“In both of these areas, workers are carrying caseloads higher than we would like to see, and this causes significant stress on individuals and systems,” McFarlane said. “The increased workloads in these areas cannot be entirely attributed to an increase in drug use within the county, but that is one factor.”

The more complicated child welfare cases can put an additional strain on county social workers, Goddard said. Social workers are required to conduct regular visits to children in out-of-home placements, regardless of whether the placement is in Door County. The county has had rare cases in which children are placed with relatives out of state, McFarlane said, meaning social workers have to drive back and forth to conduct visits.

Somewhat similarly, in cases in which parents are undergoing addiction treatment outside Door County, social workers transport parents from those facilities to accommodate visits between parents and children, Goddard said.

“The cases that we open for long-term case management are really complex (and) need a lot of case management,” Goddard said. 

McFarlane said she doesn’t see the trend of increasing child welfare concerns changing any time soon.

“Looking down the road,” she said, “there’s no reason to think this increase we’ve seen will change in the coming years.”