While workforce shortages are plaguing nearly every field these days, the stakes are particularly high for Ohio's county children's services agencies.

The pandemic exacerbated turnover, as about 38% of Ohio child-protective services workers left their positions in 2020.

Matthew Tracy, ongoing social worker for Licking County Job and Family Services, explained much like first responders, caseworkers serve communities around the clock and are called to support families and keep children safe, often during traumatic moments.

"We're meeting them at their worst place, at their worst spot," Tracy pointed out. "It's very difficult to process at times."

Stephanie McDaniel, family services supervisor for Athens County Children's Services and a native of southern Ohio, enjoys giving back to her community, and while turnover increases stress, she explained her co-workers and the families she serves are what keep her motivated.

"My team's very tight, and having somebody to talk with is just really key," McDaniel emphasized. "Trying to remember why we are doing this. We want children to grow up in healthy and happy households. "

Research shows turnover is costly to taxpayers and can lead to children lingering in foster care.

Tracy argued if more workers can be hired and individual caseloads reduced, agencies could better serve the needs of children.

"Because we can actually spend more time with these families, you're going to have a lot better outcome of kids going home or getting home sooner, but also safely," Tracy contended.

McDaniel said caseworkers, just like parents, want what is best for the child.

"When we have a family that doesn't see us as scary or threatening, when they work alongside us, we have more success," McDaniel observed. "We want to build a network and a team around a family in order to help them be successful. "

She added their goal is to find permanency for children, whether through reunification with a parent or placement with a relative or other caregiver.

A grim reminder is out - that Arizona could be doing more to keep its youngest residents safe and healthy.

The state's 29th annual Child Fatality Report says a total of 863 Arizona children died last year - and almost half of those deaths were considered preventable.

They include fatalities from abuse and neglect, COVID-19, drowning, firearm injuries - as well as substance-related causes, and sudden unexpected infant deaths. And all increased last year compared to 2020.

Dr. Mary Rimsza - the medical director of the Child Fatality Review program of the Arizona Chapter of the American Academy of Pediatrics and chair of the review team - said it's unusual to see such a substantial increase, but this tragic information is useful.

"Frankly," said Rimsza, "a major purpose of us doing this report is to identify preventable deaths and to make recommendations on how future deaths can be prevented. That is our mission."

The report says Arizona's child mortality rate increased 4.7% from 2020 to 2021, and it's higher among boys than among girls.

In 2021, 31 children's deaths were attributed to COVID-19, compared to 12 in 2020.

Another category with an alarming increase was drowning - the rate jumped 108%. And in substance-related deaths, poisoning was the leading factor.

Of the 49 child poisoning fatalities Rimsza said 46 were opiate overdoses, and fentanyl was responsible for 44 of them.

"The deaths due to fentanyl and other opiate overdoses, most all the opiate deaths in children were due to fentanyl," said Rimsza. "It is a huge problem in our state. It is a very tragic event - oftentimes, it could be the first time a young person tried a drug."

Rimsza added that the message to Arizona families is that there are many steps families can take to prevent a tragedy - from ensuring safe sleep environments for infants, to making sure pool areas are supervised and well fenced, to storing firearms safely and securely.

The report contains a full list of recommendations.

In just two months, it should be easier for providers of children's services in Pennsylvania's child-welfare and foster-care system to get the liability insurance they need. Governor Tom Wolf signed a bill into law that outlines who takes responsibility when an incident or accident occurs in the child-welfare system.

Some counties' contracts require the private children's service provider to take full responsibility, even when they are not at fault.

Samea Kim, vice president for Legal & Public Affairs at the Pennsylvania Council of Children, Youth & Family Services said as a result, the private providers have had trouble getting affordable, quality liability coverage - and this should make it easier for them to do so.

"This bill would allow the agency to take ownership of something that may have come up, if it was within the scope of what they did. Otherwise, if it was something related to the county, then the county would be able to take responsibility for their own actions," Kim said.

Kim added under the current system, providers were making insurance payouts even in cases when they were not at fault, because the county contract requires the provider to take liability. The new law goes into effect February 1. There are nearly 15,000 children in Pennsylvania's child-welfare system.

Laura Maines, CEO of Every Child, Inc., a nonprofit adoption and foster care organization based in Pittsburgh, said groups like hers have faced limited liability insurance coverage options and high premium costs, driven in part by the contracts that require private providers to indemnify government agencies in any situation. So, they advocated for House Bill 2214.

"This is about fairness," Maines said. "This is about accountability. This is really about partnership and service continuity. And so, what [HB] 2214 does is it says if there is any language in a public foster care contract or child welfare contract that seeks to transfer 100% of the risk to the private agency, it's unenforceable."

Maines added professional liability insurance protects the agency if something happens to a child and there is a claim brought against their agency.

Backers of legislation awaiting Gov. Tom Wolf's signature said it would improve the odds of success for teens transitioning out of foster care.

More than 5,500 children in foster care in Pennsylvania are age 14 or older, and House Bill 1866 outlines the steps county child-welfare agencies must take to help them make a smooth transition to adulthood with support from caregivers or family members.

Kari King, president and CEO of Pennsylvania Partnerships for Children, said it is important to spell out the details.

"And it really tries to make much clearer what those county offices need to do to better support these youths," King explained. "Some of those provisions are working with the youth on what's called a permanency plan. So, really working with that child to say, you know, 'What are your goals? What do you want to see as kind of the outcome?' "

The bill passed in October with bipartisan support. After the governor signs the measure, it will take effect in 60 days. King added the bill was introduced by state Rep. Karen Boback, R-Luzerne County. It requires counties do more to improve their data collection and document family-finding efforts, increase teens' opportunities for permanency and help them maintain supportive adult connections.

King noted the end goal is to prevent homelessness when a young person ages out of the foster-care system. She emphasized they let policymakers know not having adequate planning and support services to ease the transition often means a poor outcome, which for some, has had lifelong effects.

"Something that we've really raised is that 37% report that they don't have stable housing, and 25% don't have either a GED or a high school diploma," King reported.

King added transition-age youth often struggle as a result of being in foster care, so it is important they have supportive connections, and child-welfare agencies document their own steps and provide the information to the young person in transition to adulthood.