As first responders face a growing shortage of protective gear, social workers across sprawling Los Angeles County have continued to make visits to the homes of children and families in the child welfare system — at times without masks or gloves, according to social workers with the county’s Department of Children and Family Services.
Social worker David Green, an officer with Service Employees International Union Local 721 told The Imprint that there hasn’t been enough protective gear for social workers, adding fear of infection and uncertainty to an already high-stress line of work.
“I wish all social workers would have masks,” Green said. “But that’s not the case right now.” Green said emergency response social workers who make the initial abuse and neglect investigations are the first to get masks when they’re available during the outbreak. Otherwise, “offices are communicating with each other to make sure everyone has some.”
Many public service fields are scrambling to obtain adequate protective gear, most acutely hospitals, with workers resorting to fashioning masks with supplies from Home Depot. In Los Angeles, child welfare officials said each of the county’s 23 offices has an emergency medical kit for staff that includes masks and gloves which are supplied “as needed.” Those officials did not answer additional questions about whether they have sufficient stock to provide all social workers with the protective gear.
“The department is in the process of scaling up its emergency supplies,” said spokesperson Amara Suarez.
On Wednesday, the Administration for Children and Families alerted local child welfare leaders across the country that in response to the pandemic, federal policy has been amended to allow agencies to immediately conduct routine monthly visits remotely, instead of face-to-face. Under the revised federal policy, social workers can conduct visits via videoconferencing when possible.
But the new directive allowing phone and video communication does not alter the work of child welfare staff responding to hotline calls reporting abuse and neglect. These emergency response social workers will continue making home visits as part of routine investigations.
Emergency response investigations typically involve entering a family’s home, interviewing each family member separately, checking children’s bodies for bruises or injuries, examining kitchen cupboards and refrigerators for a supply of food, and generally searching the premises for signs of unsafe or unhealthy conditions. All of these activities could well cause a transmission of the coronavirus, given its high contagion level.
But they are also unavoidable, Green said. “When we’re assessing for abuse and neglect, we have to do that visit,” he said. “We have to make sure that we’re interacting with them and assessing these things face to face.”
On Tuesday, Department of Children and Family Services (DCFS) Director Bobby Cagle said that, to his knowledge, no one at the agency had tested positive for coronavirus.
But prevention of infection appears to be wanting. One caseworker required to conduct regular check-ins with families on her caseload told The Imprint she first heard from her supervisor only two days ago that the department would provide some masks and gloves — nearly a week after county and city leadership started taking extreme measures to limit social contact, like shutting down school districts. A 7-month-old drug-exposed baby was visited Thursday by an unprotected social worker, for example, she said.
The stepped-up efforts to protect workers, children and families in Los Angeles comes weeks after coronavirus began spreading through the county, during which time caseworkers continued to visit families in their homes. If the county follows federal guidance, it remains unclear how and whether the impoverished families typically investigated by social workers would obtain the WiFi bandwidth and technological capability to participate in video conferencing.
DCFS oversees the country’s largest county-run child protective agency, with more than 34,000 open cases of children in out-of-home foster care and families being monitored by the department. Social workers in Los Angeles carry caseloads averaging 20 to 25 children, according to the county’s Office of Child Protection, and they are required to visit each child at home between once and twice a month, depending on the status of the case.
Often, foster youth are living in homes with other children whose cases are handled by different social workers, meaning that each foster home could be visited by several different caseworkers each month.
“I’m afraid of getting those kids sick,” said the Los Angeles social worker who asked to remain unnamed due to fears for her job security.
“The kids we come in contact with — a lot of them are drug exposed, have poor diets, they’re not on multivitamins,” the social worker said, expressing concern that given their circumstances and medical history, some of the children may be at heightened risk from infection.
Every sector of society has been upended by the rapidly growing pandemic, and organizations from school districts to restaurants and law firms have had to act quickly to gauge risk, while protecting staff. One day before the new federal directive was issued this week, Cagle said in an interview that Los Angeles caseworkers had been directed to continue entering homes while they waited on federal guidance.
Cagle said his department is working to balance “the need to protect the public’s health, along with the need to make contact with the kids to ensure safety.”
Meanwhile, the department has developed a short screening questionnaire to identify potential coronavirus risk, asking whether anyone in the home has tested positive, has shown symptoms, or had recently visited a highly impacted country like China or Italy. Social workers have been directed to call with these questions in advance of scheduled visits. For unannounced emergency visits, they are supposed to go through the questionnaire at the door before entering the home. If there is a positive response to any of the questions, they are being directed to call their supervisors for further guidance.
If caregivers express concern about possible exposure from social workers entering the home, Cagle said, investigations and check-ins with the children can occur outside the front door. When social workers determine that the homes need to be inspected to determine children’s safety and the caregiver denied access, the department will go to the courts for a warrant.
Concern over social worker visits and virus spread is not limited to Los Angeles — Washington City Paper reported Wednesday that D.C.’s child protection agency does not have a sufficient supply of masks, gloves and hand sanitizer to provide to the social workers conducting investigations there. The department has ordered more but is experiencing the same shipping delays that have caused a nationwide shortage of such supplies.
Coronavirus has an incubation period of 2-14 days during which time a person may be contagious without knowing they are infected — symptoms are often very mild during these early stages of infection, according to the World Health Organization.
According to Eurosurveillance, a European scientific journal chronicling the epidemiology of communicable diseases,17.9 percent of coronavirus cases aboard the Diamond Princess cruise ship that suffered an outbreak were asymptomatic, meaning they exhibited no identifiable signs of infection. But researchers are still examining the extent to which people without symptoms can still transmit the disease.
“There’s a lot of uncertainties, but it hasn’t stopped social workers from doing their jobs,” social worker Green said. “It’s kind of part of our DNA.”