Senate Health and Human Services Committee Interim Charge Presentation. Judge John Specia, DFPS Commissioner February 20, 2014. Interim Charge. Review the Department of Family and Protective Services’ efforts to reduce child fatalities.
Presentation Overview Child Fatalities FY 2013 data Child fatality audit Plan to address child safety Prevention efforts Data Use Current data resources and tools Current uses of data Plans to improve use of data
Part One Child Fatalities
Child Protective Services–FY 2013 In Fiscal Year 2013 - 7,159,172 children lived in Texas 160,240 abuse/neglect investigations were completed by CPS 27,924 children were in the state’s conservatorship on August 31, 2013 16,676 in foster care 10,059 in kinship care 1,189 in other settings
Confirmed Abuse/Neglect Fatalities in the General Population in FY 2013
Child Fatalities in the General Population in FY 2013 In FY 2013, CPS completed 160,240 investigations of abuse or neglect
Child Fatalities in the General Population
General Population– Safety Factors In child fatality cases, factors that presented safety threats to the child included: Lack of protective capacity of the caregiver Repeat maltreatment to the child Access to a swimming pool Access to a firearm Inappropriate sleeping arrangements Children age three and under represent 80% of all child fatalities from abuse or neglect
Child Fatalities in Conservatorship in FY 2013
Child Fatalities in Conservatorship In FY 2013, 10 children in DFPS conservatorship died as the result of abuse or neglect by the child’s caregiver DFPS Conservatorship includes both foster care and kinship homes 7 child fatalities occurred in foster care 3 child fatalities occurred in kinship care
Child Fatalities in Conservatorship– Foster Care In FY 2013, there were 7 abuse or neglect related fatalities in foster care placements: Physical abuse by caregiver – 1 child Unsafe sleep – 2 children Drowning – 2 children Suicide – 1 child Neglect/seizure-related – 1 child
Child Fatalities in Conservatorship – Kinship Care In FY 2013, there were 3 abuse or neglect related fatalities in unverified kinship care placements: Drowning – 1 child Gun-related accident – 1 child Neglectful supervision – 1 child (kinship caregiver left the child in the care of the biological parents who then abused the child)
Audit of Child Fatality Review Process In FY 2013, DFPS Internal Audit was directed to conduct an audit of the existing child fatality review processes The audit found that DFPS needed to make efforts to identify lessons learned and ensure the agency has a clear and consistent response to each fatality In particular, it was noted that policy and procedures are maintained in multiple documents and not consistently presented in a logical flow, which requires staff to piece together information from various places to perform their job functions
Child Safety Plan DFPS developed a child safety action plan that includes implementation of the recommendations in the audit and changes proposed in response to specific child fatality cases, identified trends, or as a recommendation from a child safety forum with providers. Areas addressed in the child safety plan include: Child fatality review process Kinship Care Foster Care DFPS training and casework practices Regulation of contracted providers
Child Safety Plan– Reviews of Child Fatalities In response to the audit findings and recommendations, DFPS overhauled the child fatality process to be more consistent, transparent, and comprehensive: Restructured the child fatality review process and clarified the role of external reviewers to ensure thorough review of fatality investigations Streamlined and clarified internal fatality review policy and protocols to ensure consistent application across all regions. Consolidated all fatality related procedures into a separate manual Implemented centralized, comprehensive data collection that allows for real time analysis of fatalities Established an ongoing process to analyze issues and trends identified during child fatality reviews in an effort to prevent child fatalities.
Child Safety Plan– Kinship Care In FY 2013 there were 3 fatalities in kinship care, though there were none in FY 2012. Each of the 3 fatalities was related to improper supervision. To address concerns, DFPS: Updated the manual provided to all kinship caregivers to include more information on ensuring child safety. Reviewed kinship policies, procedures, and rules to ensure that they are up-to-date and that safety is emphasized. Strengthen ongoing assessment of child safety risks during home visits. Is conducting an additional safety check on all children aged 3 and under who are in kinship placements. Is updating the DFPS home assessment for kinship placements to ensure that caseworkers clearly identify risks during the family’s home study and take appropriate steps to address those identified risks.
Child Safety Plan – Foster Care With 90% of children in foster care placed with private providers, how DFPS regulates and monitors those providers is critical. DFPS is taking the following actions: In Region 7, conducted unannounced visits in foster/adopt homes with very young children and conducted a review of frequent visitors to ensure appropriate background checks had been completed (November 2013) Conducted child safety forums with providers across the state (completed December 2013) Strengthening minimum standards related to the screening of foster parents (See slides 20-21) Conducting a contract monitoring audit to assess the process for evaluating residential provider performance, with a focus on child safety and quality of care
Child Safety Plan– Strengthening DFPS Training In 46% of child fatalities, CPS had prior involvement with the family. In order to ensure CPS workers have the training to identify safety risks, DFPS is taking the following steps: Conducted a statewide training on safety for all CPS foster/adopt staff (November 2013) DFPS is also updating training for caseworkers on identifying and addressing safety concerns. Training will focus on better communication between CPA and CPS staff. (Spring 2014) Increase training for Human Services Technicians (HST), who often transport children to services, to enhance their abilities to recognize safety issues. Because HSTs are an additional set of eyes on children, they serve as another opportunity to observe and ensure that child’s safety. (Spring 2014)
Child Safety Plan– Strengthening Minimum Standards At the April 2014 DFPS Council meeting, DFPS is proposing changes focused on enhancing safety in foster care: Require child placing agencies (CPAs) to implement a plan to evaluate the accuracy of foster home screenings and the quality of supervisory visits. Require a more comprehensive foster home screening process by CPAs to include: additional law enforcement checks assessment of support systems required interviews with adult children additional reference interviews additional information on finances
Child Safety Plan– Strengthening Minimum Standards Proposed Changes, Continued - Require child placing agencies (CPAs) to make more unannounced visits to the foster home (2 per year). During the visits, the CPA will be required to look at: Stressors in the home Appropriateness of supplementary caregivers for the children Changes to the household Changes to household makeup Require CPAs to improve processes for identifying safety risk factors prior to children being placed in the home. Once the homes are verified, CPAs will be required to conduct more thorough visits and continually identify and address risk factors in the home.
Abuse/Neglect Prevention Efforts Public awareness campaigns to educate about safety Help and Hope – connecting families with community resources Room to Breathe – promoting safe sleep for infants Watch Kids Around Water - drowning prevention Look Before You Lock - preventing deaths in hot cars DFPS safety webpage Section of DFPS website dedicated solely to safety information ChildSafety@dfps.state.tx.us – email box for safety questions or concerns
Targeted Prevention Efforts Project HIP Targets certain high risk families who have had a recent new birth Project HOPES Community-based programs focusing on high risk families with children age 0-5 STAR Community providers in every Texas county who provide family crisis counseling and emergency respite care
Part Two Data Use
Primary Data Source Systems IMPACT Comprehensive abuse/neglect case management system Addresses the full range of protective services, including intake, investigations, family-based safety services, foster care, and adoption The infrastructure is 17 years old and resources required for system maintenance are expensive and increasingly hard to find Usability has decreased over time, particularly compared to current web applications Data Warehouse Subset of the information in IMPACT Official data source for non-financial agency reporting and data analysis Integrates data from multiple systems Makes data more manageable, accessible, and timely Enables management and workers to make more informed decisions Creates tangible reports that can be used as management tools
Using Data Strategically –Foster Care Redesign Foster Care Redesign is an outcome-based model in which: Data reported by Single Source Continuum Contractors and DFPS data are used to evaluate contractor performance DFPS is collaborating with leading research organizations to: Establish baselines (using legacy system data) and targets associated with selected measures (e.g., permanency, placement stability) to assess contractor performance Implement a continuous quality improvement process that will provide opportunities for the contractor to make ongoing adjustments to meet established performance outcomes
Using Data Strategically –CPS Performance Dashboard CPS has reviewed all available data to establish key measures related to safety, permanency and well-being Data will be combined with case reads to examine the quality of casework at critical points to understand how system is working and where to target resources to most effectively improve outcomes Supports a reasoned, planned approach to make necessary policy and process improvements Provides a method for tracking whether improvements are resulting in better outcomes Full implementation anticipated by May 2014
Plan to Improve Data Collection and Access IMPACT Modernization 83rd Legislature provided initial funding for IMPACT modernization Project includes implementation of Business Intelligence tool Will streamline caseworker documentation and improve usability of data, access, and data-driven decision making The following initial improvements will be available by the end of 2014: Business Intelligence to improve the usability of the system for caseworkers, prompting them to take case actions Online data book with data that can be accessed and manipulated by the public External access to Court Appointed Special Advocates (CASA)
Long-term Vision for Data Use Using Predictive Analysis to Support Decision Making The modernization of the IMPACT case management system lays the foundation for predictive analytics – modeling and data-mining that analyze current and historical facts to make predictions about future, or otherwise unknown, events DFPS is exploring opportunities in critical business areas to use Predictive Analytics to make better decisions, more quickly, and with less expense