Washington state child welfare agency sees surge in deaths, near deaths as budget shrinks

The leader of Washington’s child welfare agency said the department was forced to end its contract with a pediatric care facility in Kent due to reduced funding in the upcoming state budget, even as the number of children involved in welfare cases who died or nearly died has surged.

Between Jan. 1 and March 31, seven children whose cases were under review by the Washington State Department of Children, Youth and Families died and 20 children nearly died. The 27 “critical incidents” were triple the total the department recorded for the first three months of last year, DCYF Secretary Tana Senn said during a virtual news conference Friday.

More than half of the 27 incidents were related to opioids, including 13 of the 15 cases involving children under 3. During the same time last year, only six cases involved children that young, and five of those involved opioids, Senn said.

Senn reported the spike in children dying or nearly dying just days before the Pediatric Interim Care Center in Kent, which DCYF has funded through a contract, is set to close. Open since 1990, the facility provides 24-hour care to infants who are medically fragile and who have been exposed to drugs, according to its website.

On May 20, Gov. Bob Ferguson vetoed a section of the state’s budget that would have directed DCYF to fund such a facility.

“The Legislature significantly reduced the funding for this program and while this is important, I am vetoing this item because of the state’s significant fiscal challenges and funding cuts from the federal government,” Ferguson wrote in May to the state Senate.

Republicans criticize cuts

In a letter sent Friday to Senn and Ferguson, members of the House Republican caucus decried the Kent facility's closure and urged DCYF and the governor to reinstate the contract and work with state legislators to restore baseline funding." The letter also accused DCYF of "(cutting) off referrals" to the facility, leading it to be underutilized, and then citing that "underutilization" as a reason to end the contract.

In her news conference Friday, Senn said hospitals — not DCYF — are responsible for referring children to the Kent facility, and that the department ended its contract because it hasn't received enough funding from legislators to continue the contract.

Barbara Drennen, co-founder and executive director at the Pediatric Interim Care Center, said about 3,500 babies have been cared for at the facility in the 35 years it has been around, averaging around 100 to 150 babies a year. That number has dropped to around 20 babies annually, she said.

In the last couple of years, she said, DCYF has stopped referring babies to the facility, but she was unclear why. She explained that generally the hospital calls her facility to see if there is open bed space and if so, the hospital then calls DCYF.

"In the last couple years, when they would call DCYF it would stop right there, and we wouldn't get the placement," Drennen said.

The facility relies on funding from the Legislature and donations from community members, but does not receive any federal money. Drennen added that community members have offered to increase donations, but she is unsure that the facility will be able to fully operate without referrals.

She noted that some full-time employees at the facility have worked there since it opened, and others have worked there for decades. She has also had people come work for her who were themselves treated at the facility as babies, Drennen said. Staff at the facility work with mothers of the babies, and Drennen said the goal is to be able to reunite babies with their mothers.

The closure of the facility is “devastating,” Drennen said.

In an op-ed published by The Seattle Times on Friday, Rep. Travis Couture, R-Allyn, urged the governor and Senn to reinstate the contract between the state and Pediatric Interim Care Center, and said it would give lawmakers a chance “to regroup” and “to find solutions.”

Kortney Scroger, a spokesperson for DCYF, said in an email the agency appreciated the care provided by the Pediatric Interim Care Center, but noted the $16 billion shortfall in the state's budget and said the agency has to use its resources "as efficiently as possible." Scroger added that the funding to the facility was "not cost-effective."

Additionally, Scroger said the agency is relying on new evidence-based models because those demonstrate a better outcome for babies "when they 'room in' at hospitals under the care of a physician" or stay in transitional care homes with their mothers.

"While hospitals, of course, may choose to continue to refer children to the Kent PICC, they have been doing so much less frequently as demonstrated by the empty beds," Scroger said.

Scroger clarified that DCYF isn't shutting down the Pediatric Interim Care Center, and that the facility can continue to accept referrals from hospitals. She said the facility has informed DCYF on multiple occasions that there is "sufficient charitable funding to continue serving children."

Ferguson's office did not respond to a request for comment about the closure.

An ongoing trend

The number of accidental ingestions and overdoses among kids connected to DCYF has been on the rise for years.

In a report last July, the state's office of family and children's ombuds, an independent watchdog of the agency, raised concerns about an increasing number of drug-related deaths and near deaths, saying accidental ingestions and overdoses accounted for 16 deaths and 51 near deaths examined by the agency in 2023 — more than five times the number recorded in 2020.

Senn said there are many reasons behind why more children involved in DCYF cases are dying or nearly dying, including malnutrition and medical fragility, but cited opioids and "the entire (fentanyl) epidemic" as a major factor.

"It's clearly very connected to the epidemic of high-potency synthetic opioids," Senn said. "Reading the cases every time is heartbreaking. It hits you personally every time."

In addition to dealing with the opioid crisis, Senn said parents involved in DCYF cases are significantly more stressed now than they were during the COVID pandemic, when many were receiving financial aid and were staying at home where they could receive additional support from family members.

DCYF has taken some steps to respond to the spike in deaths and near deaths, Senn said, including conducting a "safe child consult" for every case involving opioid use and a child under 3. Those consults involve a thorough review of a child's case between a social worker, a DCYF supervisor and a quality control employee to "determine a next step" for a child, Senn said.

The consults typically happen after a case is referred to DCYF, and before the agency decides whether to send a child home or petition for out-of-home care.

According to Senn, DCYF is also increasing training for caseworkers around the most common causes of nonopioid fatalities or near fatalities, including malnutrition and medically complex cases. The department is also surveying employees who work directly with families to identify trends and get more information and ideas of how to improve services, and trying to identify "geographical hot spots where it can highlight services, Senn said.

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