Missouri’s director of social services is planning changes to how it investigates fentanyl-related deaths among children

A report on fentanyl-related deaths among children will lead to changes in the way child abuse investigators in Missouri handle the discovery of the dangerous drug, said Robert Knodell, director of the Department of Social Services.

“These are problems that we want to rip the Band-Aid off of, not try to run away from or paper over,” Knodell said. “Let’s have open, uncomfortable conversations so we can achieve better outcomes for Missouri’s children.”

Knodell convened a group of state government officials, health care workers, law enforcement officials and child welfare officials to investigate fentanyl deaths among children after a report was released last year showing that 20 children under 5 will die in 2022 died of overdoses over the years.

The group found that investigators either did not adequately investigate whether a parent was taking fentanyl or, in some cases, did not do enough to remove a child from the home after the mother and child tested positive for the drug at a hospital.

“I was shocked at the severity of these cases leading to the deaths,” said Jessica Seitz of the Missouri Network Against Child Abuse. “I can continually emphasize that the Department of Children is not the only party responsible for the safety of children in our state. Law enforcement, child welfare, and multiple disciplines are responsible for investigating child abuse. But these parties need to be engaged and included.”

Some of the recommendations include a more rigorous training program for investigators on how to recognize fentanyl and treat discovery of the drug as an imminent threat when law enforcement and juvenile officials are involved.

“This poses a great danger to the child,” Knodell said. “This needs to be responded to.”

The report comes amid several years of turmoil in the children’s department. Employee turnover, including in the St. Louis office, led to a large backlog of cases and burdened investigators with an unmanageable workload. New hires in St. Louis have increased over the past year, and children’s division chief Darrell Missey says cases that have been open for more than 45 days are beginning to be closed.

Missey said last year St. Louis’ staffing problems led to triage, where cases where a child was in immediate danger were put first, ahead of certain neglect cases. Knodell said fentanyl should be considered a “greater danger than perhaps other substances” “solely because of its deadly nature.”

“When you look at neglect situations, the risk of fentanyl is red-hot far from where I sit,” he said.

Brian Munoz/Brian Munoz/St. Louis Public Radio

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Salary increase

Child protection advocates have raised the alarm about investigators’ salaries.

Currently, investigators have a starting salary of around $43,000 per year. A 3.2% increase in this year’s budget will increase that amount to about $44,000. While lawmakers from both parties expressed interest in a larger wage increase, neither the House nor the Senate version went further.

The starting salary in Missouri is well below that of many other states. Starting salaries for child abuse investigators in Illinois are around $72,000.

“I hope that we continue to see an upward trend for the children’s team members in the future, and hopefully it is significant,” Knodell said.

State Rep. Keri Ingle, a Lee’s Summit Democrat who unsuccessfully sought a raise for children’s division employees, said she was disappointed that neither the Legislature nor the governor’s office pushed for bigger raises for investigators.

She noted that previous efforts by the Legislature to increase salaries fell victim to Gov. Mike Parson’s veto. Parson largely sought a raise for state employees, which is relatively standardized across the board.

“This is exactly what I expected,” Ingle said. “It is not currently the focus of the legislature. It should be, but it isn’t. And while we at DSS have heard concerns about the shortage of investigators and heard that pay is the main problem in recruiting and retaining investigators, it still hasn’t been an effective motivator to change people’s hearts and minds who create the budget.”

Speaking to reporters Thursday, Parson said, “We believe we have a good plan for our state workers.”

Sarah Kellogg of St. Louis Public Radio contributed to this report.

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