State social workers in Hilo oversee so many cases of abused and neglected children spread over a huge swath of Hawaii island that the situation has become a crisis, with workers unable to devote adequate time to cases even as the numbers continue to grow, according to social workers, foster parents, service providers and others familiar with the child welfare system there.

The crisis, they added, is putting already vulnerable children in harm’s way.

Required face-to-face monthly visits by case workers to check on their young wards in the East Hawaii Child Welfare Services region sometimes do not happen or are significantly delayed because of the caseloads, which by one measure are nearly three times greater than recommended national standards.

The problem is exacerbated because the workers cover the largest geographic region in the state, stretching from Honokaa to just before Ocean View, a land mass greater than all the other main Hawaiian islands combined. A home visit to the farthest reaches of that area could mean a nearly four-hour round-trip drive — possibly for just one case.

Shandon Cuba, 18, who spent several years in the foster care system with his three sisters, said he asked a Hilo case worker to check on his two youngest sisters staying with a foster family in Kau, nearly two hours away, but learned the girls weren’t visited for a year because agency workers lacked the time to do so.

“My 2- and 5-year-old sisters were being abused in that home, and when it was finally reported, that foster home got shut down,” Cuba wrote in testimony to the Legislature. “One year of abuse could have been easily avoided if the monthly visits happened.”

The home was shut down in 2016, Cuba told the Honolulu-Star Advertiser.

Another former foster youth, Melissa Mayo, 18, told the newspaper she had three wonderful, dedicated social workers in the five years she was in the child welfare system, but her niece, now 5, wasn’t as fortunate.

During one stretch, the girl wasn’t visited for six months, and she allegedly was abused in her foster home, according to Mayo. She said her niece was traumatized by the experience. “It’s tragic at any age,” Mayo said.

‘Begging for assistance’

Cuba, Mayo and others have provided sometimes gripping written testimony to the Legislature in support of House Bill 2277, which would start a pilot program at the East Hawaii CWS office, creating 23 new positions and limiting the number of children each social worker can oversee to 20. Some now have more than twice that number.

The House approved HB 2277 with no opposing votes, and the measure, which calls the East Hawaii situation a crisis, is now before the Senate. It noted that in 2015 the rate of confirmed child abuse cases in East Hawaii — 213 per 100,000 residents — was nearly three times the rate on Oahu.

The legislation has received widespread community support, including from Mayor Harry Kim, whose office described the child welfare caseload in East Hawaii as shocking and disturbing.

“It is no wonder that the community is begging for your assistance,” Kim’s managing director, Wil Okabe, told legislators in written testimony.

Officials with Friends of the Children’s Justice Center of East Hawaii even raised questions about whether the overburdened system contributed to the horrific starvation death last year of a 9-year-old Hilo girl who had been on the agency’s radar.

“Did the lack of CWS worker positions contribute to her dangerous situation falling through the cracks and ultimately contribute to her death?” wrote Stephanie Oshiro, the organization’s president, and Robin Benedict, the program coordinator, in their legislative testimony.

The organization did not respond to a request for comment.

Crisis in the making

CWS officials said they couldn’t comment on individual cases because of confidentiality rules. But they agreed the East Hawaii situation is a crisis, one that has developed in recent years.

Roselyn Viernes, administrator for the office, told the Honolulu Star-Advertiser the high number of children each social worker oversees is not ideal and that the office still has not regained all the positions lost during major statewide budget cuts in 2009 and 2010. But the high numbers and lost positions are not unique to East Hawaii, Viernes and other officials said.

Even though the number of foster children in East Hawaii has surged 55 percent since fiscal year 2014, totaling 514 last year, the number of positions for social workers who conduct monthly visits has not increased, according to the Department of Human Services, which oversees CWS.

The East Hawaii office currently has 17 such positions, but four are vacant, Viernes said. The staff there historically has been among the most stable in the CWS system.

Some challenges the East Hawaii social workers face are unique to that region or are more pronounced there.

Many families in the child welfare system live “off the grid” in tents or other quarters, often in remote rural areas with no addresses and no cell phone service, CWS officials said.

Some are squatters, occupying land that is not theirs. “That is very common,” said Elladine Olevao, who is temporarily overseeing CWS as branch administrator.

Adding to the challenges, some families live in areas accessible only with four-wheel-drive vehicles. One client lived in a tree.

“Sometimes you can’t find them, but we’ve got to make the effort,” Viernes said.

Throw in the prevalence of mental health and substance abuse issues, including the need sometimes to fly children to Oahu for residential treatment services, a practice common to all the neighbor islands, and the job demands intensify.

Taking on more territory

The demands became even tougher in 2012 when the East Hawaii office was given responsibility for a big chunk of the Kau district, significantly expanding its territory, after the Kau courthouse closed. No additional resources were provided to the East Hawaii office to handle the extra territory, which previously was overseen by the Kona office.

In addition to supporting the pilot project legislation, DHS says it is taking steps to address the crisis.

The department is considering moving vacant positions from other regions to help bolster the East Hawaii office.

It also just started a project in partnership with Casey Family Programs, a national foundation, to identify geographic areas that have high concentrations of abused and neglected children in East Hawaii. Once those “hot spots” are identified, feedback will be sought to tailor services to meet the specific needs of those communities.

The goal is to lower caseloads and prevent those families from coming back into the system, Viernes said. “We have a very supportive community,” she added.

To address the problem related to monthly visits, the East Hawaii office is trying to schedule them more efficiently, making sure, for instance, that if a social worker goes to Kau, he or she tries to handle other Kau cases on that trip, according to CWS.

“We recognize that there may be gaps in workers not visiting kids,” DHS spokeswoman Keopu Reelitz said. “We are working together to address these concerns.”

Dedicated to the job

Many of the East Hawaii social workers are described as dedicated, passionate people striving to make a difference in the lives of abused or neglected children, often working nights and on weekends without compensation to try to keep up with the demands of the job.

What keeps them going under such trying conditions?

“I’ve made a difference in families’ lives, and I like seeing that,” Viernes said. “I know my co-workers do, too.”

The relationship between the social worker and the abused child is considered critical to the child’s well being. Often, that relationship may be the only stable one in the child’s life.

That’s why federal regulations require social workers to have face-to-face visits once a month.

Yet current and former CWS workers in East Hawaii say such a requirement can be almost impossible to meet without cutting corners in other parts of the job, given the heavy workloads.

Some say they ended up prioritizing which children they visit in a given month or put off completing required paperwork to meet court deadlines.

The number of fines the Hawaii island courts have imposed on DHS for failure to file timely reports has increased within the past two years, a Judiciary spokeswoman said. The fines ranged from $200 to $1,000.

‘Putting out fires’

The Child Welfare League of America, a national advocacy nonprofit, recommends that social workers have no more than 15 foster children to oversee at any given time.

But East Hawaii CWS workers frequently have at least 40, and when the children who are not in the foster system but have CWS supervision are included, the total can top 50, according to current and former workers.

“You’re just putting out fires and putting Band-Aids on,” said Sharon Dillard, who recently resigned from the East Hawaii CWS office partly because the stress of the job was affecting her health. “There’s no real social work going on, where you feel like you’re actually making a difference.”

Dillard, who has been a social worker since 1998 and has held jobs on the mainland and in Hawaii, worked in the East Hawaii office for the past three and a half years. She said she always had more than 40 foster children assigned to her.

“I have never had that kind of workload ever,” Dillard said. “Or that kind of pressure or stress. Nothing compares to it.”

Kalani Motta, a CWS social worker with 25 years’ experience on the Big Island, said he currently has 48 children assigned to him in East Hawaii, including 40 in foster care.

“I would like to do good social work,” Motta told the Star-Advertiser. “Mostly people now are putting out fires, just trying to prevent disaster.”

Asked whether kids are being put in harm’s way because of the heavy workloads, Motta said: “It’s not a matter of if but when. Everybody is just overwhelmed and overloaded.”

Michelle Starosky, another CWS social worker who joined the East Hawaii office about eight years ago, was one of those who felt overwhelmed.

She went on medical leave at the end of January to deal with ovarian cancer. She believes the stress of her job contributed to her medical problems.

Starosky told the Star-Advertiser she tried to keep up with her monthly visits but it was impossible with all the demands of the job. At the time she went on leave, she had about 40 children assigned to her — work that had to be picked up by her co-workers.

“To do a good job, I would need half the caseload,” Starosky said.

An overwhelmed system

Joseph O’Connell, an East Hawaii foster parent and service provider who has been pushing the pilot-project legislation, said his foster child last year went six months without being visited by a social worker. He saw that as yet another sign of an overburdened system.

“It’s absolutely crisis mode,” O’Connell said.

The problem with the monthly visits is not new, either in East Hawaii or the CWS system statewide.

Federal regulators in three major evaluations dating to 2003 have cited the state’s difficulties in meeting the required face-to-face visits. In their most recent evaluation of CWS last year, regulators mentioned the system’s insufficient quality and frequency of caseworker visits with parents.

Billie-Ann Bruce, 21, who aged out of the East Hawaii system three years ago, said in her written testimony to legislators that she saw her social worker only about four times in her final four years in foster care.

“I could never get in contact with my social worker,” Bruce wrote. “I would call for weeks and nothing. I believe a lot of trauma could have been saved if there was more time and energy to give each child.”