L.A. Supes Vote on Role of Public Health Nurses in Child Welfare

Today, the Los Angeles County Board of Supervisors unanimously approved a motion instructing a handful of agencies to report back in 30 days on whether or not to move 103 public health nurses employed by the Department of Children and Family Services (DCFS) to the Department of Public Health (DPH).

Last August, the county launched a pilot program that paired public health nurses with child-abuse investigators during investigations of maltreatment for children under the age of 2.

The motion, issued by Supervisors Sheila Kuehl and Hilda Solis, instructed the Office of Child Protection to work with the county’s Chief Executive Office, DCFS, DPH and “applicable unions” to report “on the feasibility, benefits and detriments, if any, and fiscal viability,” of moving the nurses who were involved with the pilot project.

The motion is the outgrowth of a June report on the role of public health nurses issued by the Office of Child Protection, a still-experimental office meant to coordinate all child-serving agencies towards better protecting children from abuse.

In the report, the office’s director, Michael Nash, recommended:

  • The consolidation of the nurses under DPH.
  • The elimination of the pilot project that paired public nurses with social workers on child abuse investigations.
  • Enhanced medical training for social workers.
  • A robust discussion about how this limited resource could be used more “efficiently and effectively.

While the motion being considered was narrowly tailored to the report’s recommendation regarding consolidation, Nash took the opportunity to plug his larger goals.

“This is the first step in creating a better system,” Nash said during the meeting. “What we need to do is have a comprehensive conversation about use of public health nurses in child welfare.”

Supervisors Mark Ridley-Thomas and Don Knabe, who had initially pushed back on Nash’s recommendation to eliminate the nurse-social worker pilot program, pointed out that any future move of DCFS nurses to DPH should not negatively affect the ongoing program.

“Would this impact the pilot in any way?” Knabe asked. “Is that your intent?”

DCFS Director Philip Browning, sitting alongside Nash, said it would not.

“We are going to continue the pilot until the board determines otherwise,” Browning said. “We have social workers and nurses tonight and today going out jointly to look at children and respond to referrals of abuse.”

Half a dozen public health nurses used the public comment period to voice their support for consolidation under DPH.

Virgin Waters, a public health nurse supervisor employed by DCFS as part of the nurse-social work pairing pilot, said that further discussions should include the issue of staffing. Waters said that while a recent expansion in the number of social workers had helped in reducing their caseloads, it had created new strains for nurses and supervisors like herself.

“There is an increase in the number of social workers that we consult with, but not enough staffing,” she said.

“I am in support of the merger of us going into DPH, and I hope you can look at the staffing issues.”

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Daniel Heimpel, Publisher, The Chronicle of Social Change
About Daniel Heimpel, Publisher, The Chronicle of Social Change 181 Articles
Daniel is the founder of Fostering Media Connections and the publisher of The Chronicle of Social Change. Reach him at dheimpel@fosteringmediaconnections.org.


  1. I hope that LA looks at the PHN caseloads and also hires some PHNs to oversee and monitor the use of psychotropic medications with children in foster care. LA county PHN’s testified this year in the legislature regarding caseloads and the need for staff to perform this role! Governor Jerry Brown and The Senate and Assembly Budget Committees have new approved funds that come with a 75% federal match for administrative nursing oversight! Hope to see those positions established in LA.

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