Texas Department of Family and Protective Services (DFPS

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.
• Review the process by which the Department of Family and
Protective Services collects and uses data to evaluate
agency performance and improve outcomes for children in
the Child Protective Services system.
• Make recommendations to ensure the process effectively
uses data to strategically improve caseworker
performance, and identify and improve upon deficiencies
within the system and improve overall outcomes for
children and reduce child fatalities.
2
Presentation Overview
• Child Fatalities
o
o
o
o
FY 2013 data
Child fatality audit
Plan to address child safety
Prevention efforts
• Data Use
o Current data resources and tools
o Current uses of data
o Plans to improve use of data
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Part One
Child Fatalities
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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
o 16,676 in foster care
o 10,059 in kinship care
o 1,189 in other settings
5
Confirmed Abuse/Neglect Fatalities in the
General Population in FY 2013
1100
500
1000
900
994
1,016 1,024
973
Reported Child Fatalities
400
882
Abuse/Neglect Fatalities
804
280
800
700
223 213
300
227
231
212
200
600
156
500
Abuse/Neglect Fatalities
Reported Child Fatalities
1,024
100
2007 2008 2009 2010 2011 2012 2013
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Child Fatalities in the
General Population in FY 2013
In FY 2013, CPS
completed 160,240
investigations of
abuse or neglect
804
Reported Child Fatalities Statewide
(Includes CCL, CPS, RCCL)
648
156
Fatalities unsubstantiated as
child abuse or neglect
Confirmed child abuse or
neglect related fatalities
84
72
No prior CPS history
Prior CPS history
49
23
No CPS case at time of death
Open CPS case at time of death
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Child Fatalities in the
General Population
Child Fatalities in Texas
FY 2013
Total - 156
Abuse fatalities include:
▪ Blunt Force Trauma
Abuse
▪ Stabbing
41% (64)
▪ Suffocation
Neglect
59% (92)
Neglect fatalities
include:
▪ Drowning
▪ Unsafe Sleep
▪ Medical Neglect
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General Population
– Safety Factors
• In child fatality cases, factors that presented safety
threats to the child included:
o
o
o
o
o
o
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
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Child Fatalities in Conservatorship
in FY 2013
50000
20
Children in Conservatorship
44,928
44,780
45000
45,694
45,159
42,890
40,840
15
40000
10
Children in Conservatorship
35000
10
Abuse/Neglect Fatalities in Conservatorship
30000
5
4
3
25000
5
1
0
2
20000
Abuse Neglect Fatalities in
Conservatorship
47,104
0
2007
2008
2009
2010
2011
2012
2013
10
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
o DFPS Conservatorship includes both foster care and
kinship homes
o 7 child fatalities occurred in foster care
o 3 child fatalities occurred in kinship care
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Child Fatalities in Conservatorship
– Foster Care
• In FY 2013, there were 7 abuse or neglect related
fatalities in foster care placements:
o Physical abuse by caregiver – 1 child
o Unsafe sleep – 2 children
o Drowning – 2 children
o Suicide – 1 child
o Neglect/seizure-related – 1 child
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Child Fatalities in Conservatorship
– Kinship Care
• In FY 2013, there were 3 abuse or neglect related
fatalities in unverified kinship care placements:
o Drowning – 1 child
o Gun-related accident – 1 child
o Neglectful supervision – 1 child (kinship caregiver left the
child in the care of the biological parents who then
abused the child)
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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
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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:
o
o
o
o
o
Child fatality review process
Kinship Care
Foster Care
DFPS training and casework practices
Regulation of contracted providers
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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:
o Restructured the child fatality review process and clarified the role of
external reviewers to ensure thorough review of fatality investigations
o 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
o Implemented centralized, comprehensive data collection that allows for
real time analysis of fatalities
o Established an ongoing process to analyze issues and trends identified
during child fatality reviews in an effort to prevent child fatalities.
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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:
o Updated the manual provided to all kinship caregivers to include more
information on ensuring child safety.
o Reviewed kinship policies, procedures, and rules to ensure that they
are up-to-date and that safety is emphasized.
o Strengthen ongoing assessment of child safety risks during home visits.
o Is conducting an additional safety check on all children aged 3 and
under who are in kinship placements.
o 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.
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Child Safety Plan
– Foster Care
o 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:
o 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)
o Conducted child safety forums with providers across the state
(completed December 2013)
o Strengthening minimum standards related to the screening of foster
parents (See slides 20-21)
o Conducting a contract monitoring audit to assess the process for
evaluating residential provider performance, with a focus on child
safety and quality of care
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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:
o Conducted a statewide training on safety for all CPS foster/adopt
staff (November 2013)
o 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)
o 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)
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Child Safety Plan
– Strengthening Minimum Standards
• At the April 2014 DFPS Council meeting, DFPS is proposing
changes focused on enhancing safety in foster care:
o Require child placing agencies (CPAs) to implement a plan to
evaluate the accuracy of foster home screenings and the quality
of supervisory visits.
o 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
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Child Safety Plan
– Strengthening Minimum Standards
• Proposed Changes, Continued o 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:
o Stressors in the home
o Appropriateness of supplementary caregivers for the children
o Changes to the household
o Changes to household makeup
o Require CPAs to improve processes for identifying safety risk
factors prior to children being placed in the home.
o Once the homes are verified, CPAs will be required to conduct
more thorough visits and continually identify and address risk
factors in the home.
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Abuse/Neglect Prevention Efforts
• Public awareness campaigns to educate about safety
o Help and Hope – connecting families with community
resources
o Room to Breathe – promoting safe sleep for infants
o Watch Kids Around Water - drowning prevention
o Look Before You Lock - preventing deaths in hot cars
• DFPS safety webpage
o Section of DFPS website dedicated solely to safety
information
o ChildSafety@dfps.state.tx.us – email box for safety
questions or concerns
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Targeted Prevention Efforts
• Project HIP
o Targets certain high risk families who have had a recent
new birth
• Project HOPES
o Community-based programs focusing on high risk families
with children age 0-5
• STAR
o Community providers in every Texas county who provide
family crisis counseling and emergency respite care
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Part Two
Data Use
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Primary Data Source Systems
• IMPACT
o Comprehensive abuse/neglect case management system
o Addresses the full range of protective services, including intake,
investigations, family-based safety services, foster care, and adoption
o The infrastructure is 17 years old and resources required for system
maintenance are expensive and increasingly hard to find
o Usability has decreased over time, particularly compared to current web
applications
•
Data Warehouse
o
o
o
o
o
o
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
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Using Data Strategically –
Foster Care Redesign
•
Foster Care Redesign is an outcome-based model in which:
o Data reported by Single Source Continuum Contractors and
DFPS data are used to evaluate contractor performance
o 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
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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
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Plan to Improve
Data Collection and Access
• IMPACT Modernization
o 83rd Legislature provided initial funding for IMPACT modernization
o Project includes implementation of Business Intelligence tool
o Will streamline caseworker documentation and improve usability
of data, access, and data-driven decision making
o 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)
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Long-term Vision for Data Use
•
Using Predictive Analysis to Support Decision Making
o 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
o DFPS is exploring opportunities in critical business areas to
use Predictive Analytics to make better decisions, more
quickly, and with less expense
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