Thomas Scott Olsen, a 29-year-old paraplegic who was already skinny at 6 feet, 112 pounds in September, lost more than half his body weight before his ulcerated, flea-bitten body was hauled away by coroner's deputies Dec. 7.

His sister, Kimberly Loebig, who'd accepted the duty of feeding and caring for him, called police, but only after spending nearly four hours cleaning the room where she kept him.

		Related article Volunteer advocates are little help, study finds

Loebig has been ordered to stand trial in Olsen's death, but his steep decline raises the question of why no one noticed before it was too late.

It turns out that Allegheny County's Office of Children, Youth and Families had reason to make monthly visits to the home in Shaler. Loebig's 10-year-old son had been made a ward of the state after getting into serious trouble at school.

It's not clear, however, whether the caseworker went to the house. She'd tell a judge later that she'd had trouble arranging visits.

Even if the worker did go, Olsen's health wasn't her official responsibility.

Still, social work experts say, under the best circumstances, caseworkers check on all family members. And the best circumstances, they say, would be those in which workers have manageable case loads and enough time to complete the required family visits and spend time with family members while there.

Late last year, Loebig's caseworker, Arlene Rice, was swamped. On the day Olsen died she had 36 cases.

With 36 cases, Rice was responsible for six more families than the maximum permitted by state regulations and 11 more than the 25 that CYF allows for that type of caseworker -- an intake worker who investigates reports of abuse and handles cases until they are moved to a different unit.

But even the CYF limit of 25 is too high, according to the Workload Assessment Study commissioned by Marc Cherna, who directs the county's Department of Human Services and oversees CYF. The study concluded that an intake worker should have no more than 16 cases.

High case loads and caseworker turnover were criticized in evaluations of CYF in 1995 and 2000. Both still remain high. Turnover is greater now than the 1999 rate of 15 percent, and Cherna typically has 50 fewer caseworkers than the authorized level of 296 .

CYF's turnover and case overload rates are among the worst in the unit where Rice works.

Turnover troubles

The turnover rate for CYF as a whole was 19 percent last year. Rice is assigned to a unit called Lexington Intake. The largest group of intake workers, it is notorious for high levels of dissatisfaction and turnover -- more than 50 percent from January 2003 through March 2004, the last date for which the Post-Gazette obtained statistics.

Over that 14-month period, half of the original 34 workers left. As they transferred or quit, CYS assigned another 26 to the unit, and 17 of them left as well. Some stayed only a few weeks, some a few months.

Only 17 remained the entire time. Six of them, including Loebig's caseworker, carried case loads averaging more than the state limit of 30. Her average over the 14-month period was 35. One of her co-workers averaged 42 cases, a result of periods when CYF gave him responsibility for more than 50 families, with more than 130 children.

The Workload Assessment Study conducted for CYF in 2002 by Hide Yamatani and Rafael Engel, professors in the University of Pittsburgh's School of Social Work, says it is a physical impossibility for a caseworker to perform all of the required duties for each family with that many cases.

As a result, caseworkers say, some tasks aren't done. Fear that incomplete work may lead to child injury or death prompts some caseworkers to quit. Those who remain pick up the families left behind, increasing case loads, stress and risk.

Mary Grealish, a social work consultant who teaches best practices for agencies nationwide, says the Loebig case bears similarities to a widely publicized case in New Jersey last fall that led to major reforms in the state's child welfare system.

Caseworkers were visiting Raymond and Vanessa Jackson in Collingswood, outside Camden, to see their foster children but never noticed that a 19-year-old the couple had adopted was close to death from starvation, weighing only 45 pounds when discovered rummaging through a neighbor's garbage.

"Seven people were going in and out. But they forgot case practices," said Grealish, president of Community Partners Inc. of McMurray, a consulting firm which provides training in human services.

Officially, the caseworkers may not be responsible for the health of adults, like the 19-year-old and Olsen. But, Grealish said, "I think it is part of basic practice to check on safety of all family members. That is not the law. But that is what I teach."

On every visit, she said, a caseworker should ask, "Who is in the household, and is everyone safe and is there an impending crisis?"

Richard Gelles, dean of the University of Pennsylvania School of Social Work, said there's a reason a caseworker doesn't see the 45-pound 19-year-old: It's not what the worker is there to see; nor is it what the worker was trained to find.

"The caseworker is not there to see everything. He is there to see something specific," Gelles said.

It might be reasonable to ask a caseworker to assess the entire household, Gelles said, if the caseworker is given the proper tools to determine risk.

Even with such tools, however, caseworkers will need reasonable case loads, said Dr. Leroy Pelton, former director of the School of Social Work at the University of Nevada at Las Vegas:

"There are some incompetent caseworkers," he said, "but when you are talking of case loads, you are talking about an administrative matter."

Cutting case loads

In early 2003, eight Lexington Intake workers typically had more than 30 cases. In March 2003, CYF administrators ruled that no intake worker was to have more than 25.

In response, Lexington workers closed inactive cases and transferred others. Within weeks, the number of caseworkers exceeding 30 cases was down to just two. But by mid-June that number was up again -- to nine. In addition, the number of caseworkers with more than 25 families never significantly declined despite the order.

Nearly a third of the caseworkers assigned to the Lexington unit had more than the CYF-mandated number of cases at any given time.

Every week or so, CYF supervisors received a report with this information. Those reports, copied for the Post-Gazette, frequently had been marked with lines under the names of workers with more than 30 cases.

Still, nothing happened until about two months ago when the Post-Gazette began questioning the numbers in light of the Workload Assessment Study and Olsen's death.

The most recent report shows not one Lexington worker with more than 30 cases. Still, 11 of the 28 have more than the CYF-set limit of 25.

To get below 30, Cherna said, he asked workers and supervisors to devise innovative methods to cut the cases. And, he contends, in some cases the high numbers can be explained by workers who simply fail to close the files on families no longer receiving services. It's not as though those children are at risk, he said.

Still, he wants lower case loads. He commissioned the Workload Assessment Study to give credence to his pleas for more caseworkers to reduce overload.

But at the same time, he has not hired the number of caseworkers he's authorized by the county to have -- 296. And he hasn't gotten close to the 310 that the state of Pennsylvania has agreed to fund.

Even though state and federal money pays 90 percent of a typical caseworker's $30,600 salary, Cherna says it will be difficult now to get the county to approve an increase to 310 when it's laying off workers due to budget problems.

He blames his inability to reach the approved staffing levels on state regulations that require him to hire through the civil service system. He says precious few people on the civil service list want to be caseworkers, and frequently those who give it a try aren't qualified and quickly quit.

The problem has dogged him since he came to Pittsburgh to direct CYF in 1996. "It is very frustrating that we have not been able to fix this problem," he said.

Gelles is not sympathetic. Turnover is reduced, he said, if agencies hire people who've earned master's degrees in social work, are over age 25, have worked before and have their own child.

Cherna can hire people with at least some of those attributes from the University of Pittsburgh School of Social Work, tracking down its graduates, and persuading them to take the civil service test, Gelles suggested.

Loebig's formal arraignment on charges of homicide in the death of her brother is scheduled for June 18. In addition to the 10-year-old, Loebig's daughter was made a ward of the state and placed in foster care when Loebig went to jail in March -- another youngster for overburdened intake workers to deal with.