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Call to help may bring a dangerous wait

Last winter registered nurse Peigi Huseby helped a young patient at her Kaiser Permanente Cascade Park Medical Office. The minor was suicidal and Huseby found out it was due to physical and sexual abuse from family members.

As a mandatory reporter Huseby is designated by law to report cases of suspected child abuse and neglect. So she placed a call to the End Harm Line, Washington’s hotline dedicated to suspected abuse or neglect of vulnerable children. Instead of being connected quickly to someone ready to take a report, Huseby sat on hold for 43 minutes.

Huseby has grown used to waiting long periods of time to report child abuse through the End Harm Line, which is run by the Department of Children, Youth and Families. Huseby, who isn’t advocating on behalf of Kaiser Permanente, has taken her concerns to those who run the End Harm Line, the attorney general’s office, local politicians and state legislators. She spoke to The Columbian in March about the issue, but said she’s seen no substantive changes since then.

Huseby is sure the wait times are leading to missed reports of child abuse, and leaving kids in harm’s way. She’s afraid the problem will go unfixed, and that Washington will continue to put child abuse on hold.

“People are not just going to call back because they are mandatory reporters,” Huseby said. “You’re missing a lot of calls because of this, and hoping is hope, but it doesn’t cut it when it comes to kids and their lives.”

DCYF agrees with that assessment and will be asking the Legislature next session for more funding to expand its services. “DCYF cannot effectively receive and process all calls of concern related to child abuse and neglect,” the agency told the Legislature in its 2019-21 budget request. “More specifically, the abandoned calls may result in leaving a child at risk of harm.”

Anthony Schlecht, a nurse manager in the emergency department at PeaceHealth Southwest Medical Center, said the problem can also lead to delays in patient care.

“If you’ve worked triage it’s really stressful because you’ve got a steady line of people and now you’re trying to make these phone calls on the side,” he said.

His co-worker Wendy Harrison, a registered nurse in the emergency department, said, “Kids can get worse medically. We’re not here to treat them, because we’re sitting on hold. There’s a lot that can go wrong.”

Thousands of pages of emails, documents, formal complaints and hotline data, obtained through multiple public records requests by The Columbian, back up those worries. During peak call hours, wait times can last more than 30 minutes, sometimes more than an hour. More than 30 percent of calls can be abandoned. A 2018 decision package from DCYF said that as many as 1,700 calls can be abandoned per month.

DCYF spokeswoman Stephanie Frazier, in a telephone interview, said that DCYF believes the majority of callers who hang up do call back, but there isn’t specific data to track that.

The hotline receives close to 125,000 calls per year, according to Frazier, and DCYF statistics show call volume increased by 4,000 calls per year between 2012 and 2018.

Frazier said the End Harm Line has about 105 full-time equivalent employees, with 65 spread across regional offices, which handle calls during agency business hours, and about 41 in central intake, which handles calls during business hours and nonbusiness hours such as evenings, weekends and holidays.

In July, DCYF received funding for four new End Harm Line intake positions, which were divided between central intake and the six regions the End Harm Line is split across in Washington, according to Frazier. That is 14 employees short of the request DCYF made to the Legislature in its 2018 supplemental budget decision package.

Searching for solutions

State Rep. Chris Corry, R-Yakima, whose district includes a small part of eastern Clark County, told The Columbian in March he didn’t think “throwing money” at the problem was necessarily the best solution. But Huseby feels like legislators are trying to make DCYF create work-arounds, while shorting them on funding and staff.

As an alternative to adding staff, DCYF is going to ask the Legislature next year for $281,000 to create an online portal that would allow mandatory reporters to submit reports on a website, and not have to wait on hold. An intake worker would then call them back if necessary. The Washington State Department of Social and Health Services uses a web portal for Adult Protective Services, and 30 percent of all APS referrals are now made through the portal, according to DCYF.

DCYF is also planning to create a callback system that would allow callers to hang up the phone, keep their place in the queue and receive a call back when they reach the front of the line.

“In being able to have all those resources as solutions to the wait time, it certainly could have a significant impact,” Frazier said. “We want to make systemic changes.”

State Sen. Annette Cleveland, D-Vancouver, said The Columbian’s story in March brought the issue to her attention, and that she’s been examining it since. Cleveland, who serves on the Senate’s Human Services, Reentry and Rehabilitation Committee, which oversees DCYF, explained that, “often times we ask our agencies to do a lot with limited resources,” but that this problem warrants additional resources. She hopes the problem hasn’t led to neglect of children and future abuse.

Cleveland said the Legislature has provided funding for 64 full-time employees for DCYF in 2020 and 117 in 2021. She also explained the Human Services, Reentry and Rehabilitation Committee will continue to monitor the hotline, and if it needs more resources.

“We certainly don’t want that to happen,” she said. “We don’t want these reports to go by the wayside.”

Insufficient staff

As a mandatory reporter who calls the hotline, Huseby is skeptical of fixes that don’t include increasing staff. She believes the callback system is flawed because many mandatory reporters won’t be available to answer their phone at any given moment, and she sees similar flaws with the portal, including the fact that more staff will probably be needed to sift through the portal entries. She still thinks these potential solutions will have delays in responding to child abuse.

In July 2018, the End Harm Line was moved from the Department of Social and Health Services to the newly created DCYF. With the change came a revised regional structure that took the hotline from three regional intake centers to six. Each region now has its own intake phone number. The changes also came with a hope that placing the hotline within an agency dedicated to child welfare would give it more attention and resources.

But it hasn’t worked that way yet. Despite all her lobbying to change the system, Huseby said she believes legislators still don’t care enough about the problem.

“It all comes down to not enough funding, not enough staff, and that starts with leadership on the state level in terms of what they are willing to give, how much they are willing to fund it,” Huseby said.

The hotline issue underlines another problem: rising reports of child abuse. According to data provided by the state, reports of child abuse and neglect increased by 31 percent from 2010 to 2017. In internal emails, an administrator complained about the number of calls in 2018, saying it eclipsed anything seen in the last five years.

An area administrator, who works in central intake, fielded an email from a disgruntled caller in October 2018. The administrator explained inadequate staffing is the root problem.

“Our staffing levels are often not sufficient to handle call volumes,” he responded in the email. “We have made serious and detailed proposals for increased staffing, which have unfortunately not come into fruition.”

In Region Six — Clark, Cowlitz, Skamania, Lewis, Wahkiakum, Pacific, Thurston, Grays Harbor, Mason, Jefferson and Clallam counties — 26 percent of calls were abandoned in September and 32 percent of calls were abandoned in October. For those two months 1,137 total calls were abandoned. DCYF data indicates that 26 percent of calls were abandoned during May at the central intake office, which is the largest.

Internal emails show DCYF staff’s frustration with the Legislature’s inaction to help solve the problem. An area intake administrator for the hotline, based out of Tacoma, wrote in an email: “I still dream of a day where (headquarters) and Legislature provide us adequate resources to actually do the job.”

Tired of waiting

Formal End Harm Line complaints from 2019 show problems persist after the agency change. Callers still expressed frustration with wait times, and feared that child abuse was going unreported.

One caller complained about making a call for the third time in a day. Another caller, who works for a social services agency, waited 88 minutes to be connected. A middle school nurse waited 90 minutes.

Carl Smith, who works for Evergreen Public Schools, called to make two reports, and was told that he could only make one report at a time and would have to call back again to submit the second report. The reasoning is that making multiple reports on one phone call can tie up the system for too long, according to internal emails.

A September complaint about the End Harm Line from a concerned foster parent said her foster daughter was molested during an overnight visit. The foster parent had to wait 27 to 42 minutes on four different calls, and said she was disconnected multiple times.

“We are in crisis as a family and again with zero support from the state,” the complaint reads. “I do not know what to do, and now I am stuck on hold … instead of being able to comfort my foster daughter. … She has another visit happening on Tuesday and this needs to be addressed ASAP before that visit happens to protect her.”

A high school counselor in Thurston County wrote a complaint to state Rep. Beth Doglio, D-Olympia, in June about the End Harm Line while waiting on hold. The counselor complained of regularly waiting 45 to 60 minutes on hold. The complaint stated many mandatory reporters are educators and health care providers, who can’t afford to be on hold for an hour.

“How many reports go unheard because people were not able to wait for the better part of an hour before having their call answered?” the complaint asked. “How much harm has continued because reports never get made?”

Another complaint to Doglio’s office, from late October, was written while a public education employee waited on hold for longer than an hour. That person was attempting make a report about a student who had been choked by a parent the previous night, and didn’t feel safe to go home. The employee was on hold so long they had to ask a colleague to come and take their spot so they could use the restroom.

“Few providers will be so persistent in making these reports,” the complaint read. “Most will have to hang up the phone and go on with their daily duties. … This current situation puts abused children in further danger and is a sad statement about our state’s values.”

An urgent matter

Huseby, who volunteers as a court appointed special advocate for abused and neglected children, has seen the impact of child abuse and how that abuse becomes trauma that sticks. She said child abuse lingers long after it’s over. Children who are abused have higher rates of incarceration, and generally need more medical or mental health care as they age. Huseby looks at fixing the End Harm Line first as a moral imperative, but also as an investment in the future.

“You are not a legislator only for adults, and adults who can vote,” Huseby said. “You’re a legislator for everybody and probably most important for those who are disenfranchised. Ethically and financially it’s the right thing to do. Either pay now or pay later.”



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