Explaining SIP Meeting

Explaining Tomorrow’s Social Services SIP meeting 030911

The Social Services branch of Sierra County Health and Human Services will have a meeting tomorrow.  The press release describes very well what is required of the meeting.  You can read it HERE.

In brief, in 2004, in response to actions taken by the federal government regarding child welfare services, the legislature passed AB636, Child Welfare System Improvement and Accountability Act.  The act mandated an “outcome based” approach to monitoring CWS services in the counties, instead of the system of “audits” which was previously used.  AB636 is part of an effort to improve CWS in California.  Indeed, the entire review is the California Child and Family Services Review. Read more HERE.

It’s important to note that Juvenile Probation has requirements similar to that of CWS, and they are also being reviewed as part of this process.

In 1989 the feds made money available, and then mandated a data gathering system for CWS in all states.  In California, the Child Welfare System/Case Management System (CWS/CMS) computer based system was implemented.  

The CWS/CMS system records everything about any action taken by CWS.  Follow this link to get an idea what the system is and how it works; the link describes how to make a “contact” and gives one an idea of what the software is like, and how it funnels social worker choices.  This page is one of hundreds of pages in the system: here.  Note that the training refers to one thing, a contact and associated contact, which means that the social worker called, wrote a letter, or visited in person someone connected with the referral (a file created when there is a report) or case (an action taken by the agency wherein risks to the children are reduced through the use of a “case plan”.)  Ideally, everything a parent or child says to the social worker, and everything the social worker says to them, is recorded.  There would be dozens to hundreds of these in a case, and they might include calls to service providers, foster parents, teachers or even the children or parents.  Note all the “fields” created by the contact.  Multiply that by all the pages and notebooks in the CWS/CMS system and you begin to realize three things about the CWS/CMS system:

1. Everything that happens in regards to the family should be in it, down to the last detail.

2. The system and the data it contains about a family is all that can be known about them, and a corollary is that those who work in CWS, the court, all service providers, come to take the data in CWS/CMS as TRUTH, or at least the only truth that matters.

3. It is possible to review the entire database of an agency, every interaction with every family.  In the first instance, the data in the application reveals everything about the family; in the second instance it reveals everything about the agency, and finally the feds use it to learn everything they care about on the state.
Using this data, the feds did a review of the states in the early 2000s.  They reviewed the data for many different “outcomes”, which eventually became those below:

Child Maltreatment Allegation & Substantiation Rates *New Feature - Multi Report*
S1.1 No recurrence of maltreatment
S2.1 No maltreatment in foster care
C1.1 Reunification within 12 months (exit cohort)
C1.2 Median time to reunification (exit cohort)
C1.3 Reunification within 12 months (entry cohort)
C1.4 Reentry following reunification (exit cohort)
C2.1 Adoption within 24 months (exit cohort)
C2.2 Median time to adoption (exit cohort)
C2.3 Adoption within 12 months (17 months in care)
C2.4 Legally free within 6 months (17 months in care)
C2.5 Adoption within 12 months (legally free)
C3.1 Exits to permanency (24 months in care)
C3.2 Exits to permanency (legally free at exit)
C3.3 In care 3 years or longer (emancipated or age 18 in care)
C4.1,2,3 Placement stability ew
2B Child abuse and neglect referrals by time-to-investigation
2C Timely caseworker visits with children
4A Siblings [static]
4B Least Restrictive (Entries First Placement)
4B Least Restrictive (PIT Placement)
4E (1&2) ICWA placement preferences—ICWA eligible/American Indian ethnicity
5B (1&2) Timely Health/Dental Exams
5F Authorized for Psychotropic Medications
6B Individualized Education Plan (IEP)
8A Exit Outcomes for Youth Aging Out of Foster Care

These measures reflect how the county is doing at preventing, for example, new allegations of abuse against a child.  Note, the official language talks about “re-abuse of a child” which means a report of new abuse is found “substantiated” which might mean someone laid the kid’s head open to the bone with a broom handle for the second time, or it might mean mom got busted for leaving the kid home alone (neglect) and so she left him with her mom and her mom’s boyfriend played doctor with the kid.  Either way, the agency let something bad happen to the kid again.

It should be said that in counties with sufficient trained staff, an analyst is assigned to catch problems before they go to the main database and in some instances “compensate” and make the county look better on the outcome measure.  However, CWS/CMS contains a time stamp on all actions, so close scrutiny would reveal the doctoring.  It isn’t likely to happen.  It doesn’t seem likely that Sierra County has such staff.  The analyst can also identify mandated reporters who “over-report” and the agency can retrain the reporter.  Finally, the county can “jiggle” the requirements for “evaluated out” referrals, sending more referrals to “differential response” by having a Community Resources worker instead of a CWS investigator, and control caseload and thereby have an indirect control on the data going to the state.

Even so, CWS/CMS is a powerful tool for controlling county CWS agencies.  

Below is Sierra County’s stats for referrals, by year, with referral disposition.  Note that “substantiated” means the referral was found to be true; “inconclusive” means no determination could be made; “unfounded” means the allegation was not true, and “assessment only” means the referral was “evaluated out of the system”.  There are dramatic changes in the number of referrals taken from year to year, but these changes could result from mandated reporter training, or better data input, or they could even represent increased stress in the county, with more child abuse and neglect.  Only in some instances were there actually increases in child neglect or abuse, there are many other features which could change the numbers.

Go review the county’s data yourself, here

The numbers and the data that could be generated prompted the state to require counties to improve areas where they’ve not done as well as the benchmarks for the outcomes.  

AB636 mandated 4 parts:

Quarterly Data Reports.  If the county has analyst staff, the QDR is not a surprise.

Peer Quality Case Review. This is perhaps the most important element of the AB636 review.  It is intended to look at things about the system in the county that the numbers can’t reveal.  Someone at the state level realized there was more to helping families than hard data could show.  View the tool for the PQCR HERE.  

The QDR and the PQCR provide data to the county about where the agency might be failing.  This is produced in the Self-Assessment, which is reported to the State.  The Self-Assessment functions as a kind of “gap analysis” to determine what needs to be improved. Review the SA process HERE

The Self Improvement Plan (more correctly a system improvement plan) outlines for the state how the county intends to improve areas which are weak.

The meeting is to discuss the SIP, to focus on identified goals, and to enlist community partners.  The SIP has to be approved by the Board of Supervisors.  

Anyone interested should attend this meeting, but take the time to understand the SIP process, first.

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