District of Columbia: Issues Associated with the Child and Family Services Agency's Performance and Policies
Released: 2003-04-02T00:00:00

Letter

Background

CFSA is responsible for protecting thousands of foster care children who have been at risk of abuse and neglect and ensuring that critical services are provided for them and their families. However, many children in CFSA’s care languished for extended periods of time due to managerial shortcomings and long-standing organizational divisiveness. As a result of these deficiencies, the U. S. District Court for the District of Columbia issued a remedial order in 1991 to improve the performance of the agency. In 1995, lacking sufficient evidence of program improvement, the agency was removed from the District’s Department of Human Services and placed in general receivership. Under a modified final order (MFO) established by the court, CFSA was directed to comply with more than 100 policy and procedural requirements. The efforts CFSA made during the receivership to improve its performance included establishing an automated system, FACES, to manage its caseload. The U.S. District Court ended the receivership in 2000, established a probationary period, and identified performance standards CFSA had to meet in order to end the probationary period. The court appointed the Center for the Study of Social Policy as an independent monitor to assess CFSA’s performance and gave them the discretion to modify the performance standards. However, in the summer of 2002, abuses of two children placed in group homes were reported, indicating that CFSA’s operations and policies, especially those regarding foster care cases, may still need improvement.

Additionally, several federal laws, local laws, and regulations established goals and processes under which CFSA must operate. ASFA, with its goal to place children in permanent homes in a timelier manner, placed new responsibilities on all child welfare agencies nationwide. AFSA introduced new time periods for moving children toward permanent, stable care arrangements and established penalties for noncompliance. For example, it requires states to hold a permanency planning hearing— during which the court determines the future plans for a child, such as whether the state should continue to pursue reunification with the child’s family or some other permanency goal—not later than 12 months after the child enters foster care. The D.C. Family Court Act of 2001, established the District’s Family Court and placed several requirements on the District’s Mayor and various District agencies, including CFSA and the Office of Corporation Counsel (OCC). The Family Court Act requires the Mayor, in consultation with the Chief Judge of the Superior Court, to ensure that D.C. government offices that provide social services and other related services to individuals served by the Family Court, including CFSA, provide referrals to such services on site at the Family Court.

CFSA operates in a complex child welfare system. The agency relies on services provided by other District government agencies. For example, both the Fire Department and the Health Department inspect facilities where children are placed, and D.C. Public Schools prepare individual education plans for children in care. In addition, CFSA works with agencies in Maryland, Virginia, and other states to arrange the placement of District children in those states and also works with private agencies to place children in foster and adoptive homes.

The management of foster care cases involves several critical steps. Typically, these cases begin with an allegation of abuse or neglect reported to the CFSA child abuse hot line. CFSA staff are required to investigate the allegation through direct contact with the reported victim. If required, the child may be removed from his or her home, necessitating various court proceedings handled by the District’s Family Court. CFSA case workers are responsible for managing foster care cases by developing case plans, visiting the children, participating in administrative hearings, attending court hearings, and working with other District government agencies. CFSA case workers are also responsible for documenting the steps taken and decisions made related to a child’s safety, well being, and proper placement. In addition, CFSA is responsible for licensing and monitoring organizations with which it contracts, including group homes that house foster care children.

HHS is responsible for setting standards and monitoring the nation’s child welfare programs. The monitoring efforts include periodic reviews of the operations, known as Child and Family Services Reviews, and of the automated systems, known as Statewide Automated Child Welfare Information System (SACWIS) Reviews, in the states and the District of Columbia. HHS last reviewed CFSA’s child welfare information system in 2000 and its overall program in 2001.

CFSA Undertook Actions to Address Most ASFA Requirements Reviewed and Met Half of the Selected Performance Criteria

CFSA took actions to address six of the nine ASFA requirements and met or exceeded four of the eight performance criteria we included in our study. Although ASFA includes other requirements, we only included those directly related to the safety and well-being of children. The performance criteria were among those performance standards that CFSA had to meet in order to end the probationary period following the general receivership. We selected those that, in our judgment, most directly relate to the safety and permanent placement of children in foster care. For example, CFSA signed a border agreement to achieve timelier placement of District children in Maryland, which addresses the ASFA requirement to use cross-jurisdictional resources to facilitate timely adoptive or permanent placements for waiting children. However, CFSA did not meet three requirements involving (1) proceedings to terminate the rights of parents whose children are in foster care, (2) annual hearings to review permanency goals for children and (3) notice of reviews and hearings. Table 1 summarizes the ASFA requirements directly related to the safety and well-being of children and identifies whether CFSA met them.

We analyzed automated data related to eight selected performance criteria and found that CFSA met or exceeded four of them. For example, one of the criteria requires sixty percent of children in foster care to be placed with one or more of their siblings; we found that as of November 30, 2002, 63 percent of children were placed with one or more siblings. The areas in which CFSA’s performance fell short included criteria related to (1) social worker visitation with children in foster care, (2) placement of children in foster homes with valid licenses, and (3) progress toward permanency for children in foster care and (4) parental visits with children in foster care who had a goal of returning home. For example, none of the 144 children placed in foster care during the 2-month period prior to November 30, 2002, received required weekly visits by a CFSA caseworker. In addition, 52 of 183 foster care children (32 percent), for whom CFSA had not met the progress towards permanency goal, had been in foster care without returning home for 36 months or more. Twenty-two of these children had been in foster care 5 or more years without returning home. A complete list of the performance criteria and our analysis is shown in appendix I.

CFSA has written plans to address two of the three unmet ASFA requirements and three of the four unmet performance criteria we selected for our study. One of CFSA’s plans includes actions to address one criterion for which the agency fell short—parental visits. This plan, the Interim Implementation Plan, includes measures that were developed to show the agency’s plans for meeting the requirements of the MFO issued by the court. The plan states that, for new contracts, CFSA will require its contactors to identify sites in the community for parental visits to help facilitate visits between parents and their children. However, CFSA does not have written plans that address other unmet criteria, such as reducing the number of children in foster care who, for 18 months or more, have had a permanency goal to return home. CFSA has also not implemented the ASFA requirement to provide foster parents, relative caregivers, and pre-adoptive parents the opportunity to be heard in any review or hearing held with respect to the child. Without complete plans for improving on all measures, CFSA’s ability to comply with the ASFA requirements and meet the selected performance criteria may be difficult. Furthermore, unless these requirements and criteria are met the child’s safety may be jeopardized, the time a child spends in foster care may be prolonged, or the best decisions regarding a child’s future well-being may not be reached.

Agency officials cited external demands, including court-imposed requirements, staffing shortages, and high caseloads, as factors that hindered CFSA’s ability to fully meet the ASFA requirements and the selected performance criteria. For example, program managers and supervisors said that the new court-imposed mediation process intended to address family issues without formal court hearings places considerable demands on caseworkers’ time. The time spent in court for mediation proceedings, which can be as much as 1 day, reduces the time available for caseworkers to respond to other case management duties, such as visiting with children in foster care. Furthermore, managers and supervisors reported that staffing shortages have contributed to delays in performing critical case management activities, such as filing for the termination of parental rights. Staffing shortages are not a unique problem to CFSA. We recently reported that caseworkers in other states said that staffing shortages and high caseloads had detrimental effects on their abilities to make well-supported and timely decisions regarding children’s safety. We also reported that as a result of these shortages, caseworkers have less time to establish relationships with children and their families, conduct frequent and meaningful home visits, and make thoughtful and well- supported decisions regarding safe and stable permanent placements.

CFSA Has Established Many Foster Care Policies but Lacks Others, and the Extent of Implementation and Documentation Varies

CSFA has established many foster care policies but, caseworkers did not consistently implement the six we examined. In addition, CFSA’s automated system lacked data on policy implementation for 70 percent of its foster care cases. When CFSA’s caseworkers are not consistently implementing the policies essential steps are not always being taken for all children in a timely manner. As a result, children may be subject to continued abuse and neglect or efforts to achieve permanent and safe placements may be delayed. Furthermore, without information on all cases, caseworkers do not have a readily available summary of the child’s history needed to make future decisions and managers do not have information needed to assess and improve program operations.

CSFA Has Established Many Foster Care Policies but Caseworkers Did Not Consistently Implement Them

While we previously reported in 2000 that CFSA lacked some important child protection and foster care placement policies, CFSA has now established many such policies and most are comparable to those recommended by organizations that develop standards applicable to child welfare programs. For example, CFSA has policies for investigating allegations of child abuse, developing case plans, and establishing permanency goals for foster children. In addition, one policy is more rigorous than suggested standards. Specifically, CFSA’s policy requires an initial face-to-face meeting with children within 24 hours of reported abuse or neglect, while the suggested standard is 48 hours or longer in cases that are not high risk. However, CFSA still lacks some that are recommended, namely (1) written time frames for arranging needed services for children and families (e.g., tutoring and drug treatment for family members); (2) limits on the number of cases assigned to a caseworker, based on case complexity and worker experience; and (3) procedures for providing advance notice to each person involved in a case about the benefits and risks of services planned for a child and alternatives to those services.

CFSA did not consistently implement the six policies we examined. We selected policies that covered the range of activities involved in a foster care case, but did not duplicate those examined in our review of the AFSA requirements or the selected performance criteria. For three of the six policies, data in FACES on all foster care cases indicate that the extent to which caseworkers implemented them varied considerably. Table 2 summarizes these three policies and the percentage of cases for which the data indicated the policy was implemented.

In some cases, it took CFSA caseworkers considerably longer than the required time to initiate an investigation or complete safety and risk assessments. In 93 cases, CFSA caseworkers took more than 10 days to initiate the investigation and in 78 cases, it took caseworkers longer than 100 days to complete a risk assessment, more than three times longer than the 30-day requirement.

For the other three policies, we reviewed case files and examined related data from FACES for 30 cases, because officials told us that the information related to these policies was not routinely recorded in FACES. One policy requires caseworkers to complete a case plan within 30 days of a child’s entry into foster care. Our analysis and file review found that case plans were not routinely completed within 30 days. Another policy requires conducting administrative review hearings every six months. These reviews ensure that key stakeholders are involved in permanency planning for the child. We found that administrative review hearings were rescheduled for a variety of reasons, such as the caseworker had to appear at a hearing for another case or the attorney was not available. The third policy requires caseworkers to identify and arrange for services for children and their families. It was difficult to determine whether services recommended by caseworkers were approved by supervisors or if needed services were provided. Managers said that sometimes services are arranged by telephone and the results not entered into FACES.

Officials said that several factors affected the implementation of some of the policies we reviewed. Agency officials explained that, in part, the data on implementation of the initial investigations and safety assessment reflected that the District’s Metropolitan Police Department was responsible for the initial investigation of child abuse cases until October 2001 and that data was not entered into FACES. CFSA now has responsibility for both child abuse and neglect investigations. Further, program managers and supervisors said that several factors contribute to the time frames required to initiate face-to-face investigations, including difficulty in finding the child’s correct home address, contacting the child if the family tries to hide the child from investigators, and even obtaining vehicles to get to the location. Caseworkers’ supervisors and managers explained that generally, the policies were not always implemented because of limited staff and competing demands and the policies were not documented because some caseworkers did not find FACES to be user friendly.

CFSA officials said they recently made changes to help improve the implementation of some of the policies we reviewed. CFSA has focused on reducing its backlog of investigations and reduced the number of investigations open more than 30 days from 807 in May 2001 to 263 in May 2002. CFSA officials said that they anticipate a reduction in the number of administrative review hearings that are rescheduled. The responsibility for notifying administrative review hearing participants when a hearing is scheduled was transferred from caseworkers to the staff in the administrative review unit, and notification will be automatically generated well in advance of the hearings. Additionally, another official said that CFSA has begun testing a process to ensure that all needed services are in place within 45 days.

However, without consistently implementing policies for timely investigations and safety and risk assessments, a child may be subject to continued abuse and neglect. Delaying case plans and rescheduling administrative review hearings delay efforts to place children in permanent homes or reunite them with their families. Further, without knowing whether children or families received needed services, CFSA cannot determine whether steps have been taken to resolve problems or improve conditions, which also delays moving children toward their permanency goals.

In addition to its policies for managing cases, CFSA has policies for licensing and monitoring group homes, plans for training staff in group homes, and a goal to reduce the number of young children in group homes. CFSA’s policies for group homes are based primarily on District regulations that went into effect July 1, 2002. According to a CFSA official, the agency was precluded from placing children in an unlicensed group home as of January 1, 2003. As of March 2003, all CFSA group homes were licensed, except one, and CFSA was in the process of removing children from that home. In the future, CFSA plans to use requirements for licensing group homes as well as contractual provisions as criteria for monitoring them. CFSA also plans to provide training to group home staff to make it clear that, as District regulations require, any staff member who observes or receives information indicating that a child in the group home has been abused must report it. Further, CFSA has a goal to reduce the number of children under 13 who are placed in group homes. CFSA has reduced the number of children under 13 in group homes from 128 in August 2002, to 70 as of February 2003; and, has plans to reduce that number even further by requiring providers of group home care to link with agencies that seek foster care and adoptive families.

CFSA’s Automated System Lacked Data on Many Foster Care Cases

While CFSA’s policies with regard to is automated child welfare information system --FACES—were not among the six policies we initially selected for examination, in our efforts to assess CFSA’s implementation of the selected foster care policies, we determined that FACES lacked such data for about 70 percent of its active foster care cases. Of the population of foster care cases at least 6 months old as of November 30, 2002—2,510 cases—data on the initial investigation and safety and risk assessment policies were not available for 1,763 of them. CFSA officials explained that all of these cases predated FACES and the previous system was used primarily to capture information for accounting and payroll purposes, not for case management. Top agency managers said that CFSA does not currently plan to make it an agency priority to include data in FACES for these pre-FACES cases. Additionally, FACES reports showed that data was not available on many of the more recent foster care cases. For example, complete data on the initiation of investigations and safety assessments were not available for about half of the 943 cases that entered the foster care system after FACES came on line. Officials explained that their plans are to focus on improving a few data elements at a time for current and future actions.

Complete and accurate data is an important aspect of effective child welfare systems. HHS requires all states and D.C. to have an automated child welfare information system. These systems, known as Statewide Automated Child Welfare Information Systems (SACWIS), must be able to record key child welfare functions, such as intake management, case management, and resource management. However, it its review of FACES, HHS found the system to be in noncompliance with several requirements, including the requirements to prepare and document service/case plans and to conduct and record the results of case reviews. In addition to the standards and requirements established by HHS for all child welfare systems, the MFO requirements stress the importance of an automated system for CFSA. Many of the requirements the MFO imposed on CFSA direct CFSA to produce management data. For example, the MFO requires that CFSA be able to produce management data showing (1) how many children who need medical reports received them within 48 hours after the report of neglect or abuse was supported, (2) the caseload figures by worker for all workers conducting investigations of reports of abuse or neglect, and (3) the number of supervisors with at least 3 years of social work experience in child welfare.

It is very important to have accurate and timely automated case management data for all cases. An expert from a child welfare organization stated that there is a great need to transfer information from old case records to new automated systems in a systematic way. Without such a transfer, paper records with important information may be lost. She said that records of older teens have been lost, and, with them, valuable information such as the identity of the child’s father, has also been lost. Without data in FACES, if caseworkers need missing data they will have to look for paper records in the case files, some of which are voluminous. This file review effort is much more time consuming than reviewing an automated report and requires more time for caseworkers to become familiar with cases when cases are transferred to new caseworkers. Complete, accurate, and timely case management data enables caseworkers to quickly learn about new cases, supervisors to know the extent that caseworkers are completing their tasks, and managers to know whether any aspects of the agency’s operations are in need of improvement.

CFSA Has Enhanced Its Working Relationship With the D.C. Family Court by Working Collaboratively, But Hindrances Remain

CFSA has enhanced its working relationship with the Family Court through its commitment to promoting improved communication and by expanding its legal support services for court activities. CFSA participates in various planning committees with the Family Court, such as the Implementation Planning Committee, and assists in providing service referrals on site at the Family Court. Since 2002, attorneys from the OCC have been located at CFSA and work closely with caseworkers. This co- location has improved the working relationship between CFSA and the Family Court because CFSA caseworkers and the attorneys are better prepared for court appearances. Additionally, training sessions have been held that included CFSA caseworkers, OCC attorneys, and Family Court judges. Furthermore, frequent dialogue between top management at CFSA and the Family Court and top management support have been key factors in improving these relationships.

However, CFSA officials and Family Court judges noted several hindrances that constrain their working relationships. These hindrances include scheduling conflicts between the court and CFSA, an insufficient number of caseworkers, caseworkers who are unfamiliar with cases that have been transferred to them, and the unclear roles and responsibilities of CFSA caseworkers, attorneys, and judges. For example, CFSA officials said that Family Court judges often override caseworker recommendations that affect children and families. Family Court judges told us that they believe caseworkers do not always recommend appropriate services for children and their families. As a result of these conflicting perspectives, court officials said that appropriate decisions affecting children and families might not be reached in a timely manner.

Conclusions

While CFSA has met several procedural ASFA requirements and other performance criteria, developed essential policies, and enhanced its working relationship with the Family Court, it needs to make further improvement in order to ensure the protection and proper and timely placement of all of the District’s children. To improve outcomes for foster care children, CFSA needs a comprehensive set of policies; effective implementation of all policies; complete, accurate, and timely automated data on which to base its program management; and an effective working relationship with the D.C. Family Court. However, gaps in its foster care policies, inconsistent policy implementation, and incomplete automated data may hinder CFSA’s ability to protect and improve the outcomes for the District’s children. We expect to have recommendations in our final report that will address these issues and strengthen CFSA’s operations.

Mr. Chairman, this concludes my prepared statement. I will be happy to respond to any questions that you or other Subcommittee Members may have.

GAO Contact and Acknowledgments

For further contacts regarding this testimony, please call Cornelia M. Ashby at (202) 512-8403. Individuals making key contributions to this testimony included Carolyn M. Taylor, Mark Ward, Sheila Nicholson, Vernette Shaw, and James Rebbe.

Appendix I: GAO’s Analysis of Selected Performance Criteria

GAO Analysis As of September 30, 2002, 46 percent of foster care cases had current case plans.

As of November 30, 2002, 1 percent of children with a return home goal had parental visits at least every 2 weeks.

Twenty-five percent of children in foster care have weekly visits with caseworkers in their first 8 weeks of care; 35 percent of all children in foster care have at least monthly visits with a social worker.

As of November 30, 2002, no children had weekly visits; 0.3 percent had at least monthly visits with a social worker.

4. Appropriate legal status for children in foster care No child in emergency care (legal status) for more than 90 days. 5. Current and valid foster home licenses Seventy-five percent of children are placed in foster home with valid licenses. 6. Progress toward permanency No more than 10 percent of children in foster care have a permanency goal of return home for more than 18 months. 7. Foster care placement with siblings Sixty percent of children in foster care are placed with one or more of their siblings. 8. Placement stability No more than 25 percent of children in foster care as of May 31, 2002, have had three or more placements.

As of November 30, 2002, no children in emergency care more than 90 days.

As of November 30, 2002, 47 percent of children were in foster homes with valid licenses. As of November 30, 2002, 30 percent of children had a permanency goal of return home for more than 18 months. As of November 30, 2002, 63 percent of children were placed with one or more siblings. As of November 30, 2002, 21 percent of children in care since August 1, 2001, had three or more placements.