CFSA Has Met Some Court-Ordered Requirements, but Is Not Likely to Meet All Requirements by December 2006

CFSA has met some court-ordered requirements, but the agency is not  likely to meet all of its requirements by December 2006, according to the  recent court-monitor’s report and our work. For example, despite a benchmark set at 90 percent, only 29  percent of children in foster care had received medical evaluations as of  April 2006, and data were not available for the percentage of children who  received dental evaluations. This raises questions about the agency’s  ability to meet the court-required benchmarks by December and to sustain  the improvements it has made. Several Factors Hinder CFSA’s Progress in Meeting Performance Requirements

Complex cases and shortages of health care providers and qualified foster  and adoptive homes hinder CFSA’s ability to meet court-ordered  requirements, according to CFSA officials, caseworkers, and the court  monitor. While caseworkers’ caseloads have been reduced because of  CFSA’s efforts to recruit and retain caseworkers, cases are complex, in  part because of the high proportion of teenagers and children with medical  or mental health needs. CFSA’s efforts to meet court-ordered time frames  is further complicated in a small number of cases by difficulty in  coordinating with the District’s Metropolitan Police Department. At the  same time, CFSA officials told us that there is a shortage of health care  providers to serve these children with health care needs, and the limited  number of qualified foster and adoptive homes hinders CFSA’s ability to  give children the most appropriate and timely placements. For  example, caseworkers told us that they cannot close out investigations  involving severe physical or sexual abuse without a report from the police  department. CFSA Uses Routine Reports and Qualitative Studies to Monitor Its Progress toward Meeting Court-Ordered Requirements, but Current Data May Not Provide an Accurate Picture

CFSA is generating a number of daily and monthly reports to show its  progress in meeting court-ordered requirements. CFSA Has Implemented Several Initiatives to Help Achieve Unmet Requirements, but It May Be Too Soon to Know if They Will Yield Long-term Results

In the last 2 years CFSA has implemented a number of initiatives to help  address hindrances in meeting court-ordered requirements. CFSA has  hired new staff and reorganized existing staff to focus resources in key  areas. In  addition, CFSA is beginning to take steps to hold its management staff as  well as private contractors accountable for helping the agency meet  specific performance requirements. Although CFSA has made some progress in improving the  placement process for children, it is too soon to determine whether these  efforts will yield long-term success. Recommendations for Executive Action

To improve CFSA’s ability to serve the District’s children and to help meet  court-ordered requirements, we recommend that the Mayor of the District  of Columbia:    direct CFSA to provide caseworkers with specialized training to help  them develop the skills needed to address the complexities of their  caseloads and    explore options for increasing the pool of providers for mental health,  medical, and dental services. We  also interviewed (1) CFSA managers to learn about the strategies the  agency has used to help guide its decisions on what data to gather and  how to use these data; (2) CFSA’s Chief Information Officer to learn about  CFSA’s automated child welfare information system, FACES, and its  capacity for informing CFSA managers on the agency’s progress in  meeting its performance requirements; and (3) the court-appointed  monitor, the Center for the Study of Social Policy (CSSP), to gain its  perspective on what CFSA has done and where it might improve in its  efforts to develop data needed to assess its performance. To gather information on the extent to which CFSA has implemented  initiatives or developed plans to achieve unmet requirements, we reviewed  the court monitor’s reports and identified key requirements related to  managing child welfare cases that had not been met as of December 2005. District of Columbia: Issues Associated with the Child and Family  Services Agency’s Performance and Polices.
Why GAO Did This Study

The District of Columbia's Child and Family Services Agency (CFSA) has a history of serious performance problems. A court case in 1989 set in motion sweeping efforts to improve the District's child welfare system. Since then, CFSA has worked to meet performance requirements ordered by the U.S. District Court. However, recent reports by the court monitor show that CFSA is not meeting performance requirements on many measures. To update Congress, we assessed (1) whether CFSA is likely to meet requirements by December 2006; (2) what factors, if any, hinder the agency from meeting requirements; (3) how CFSA is monitoring its progress; and (4) the extent to which CFSA has implemented initiatives to achieve unmet requirements. To conduct this work, we reviewed reports by CFSA and the court monitor and interviewed stakeholders, including the court monitor and CFSA managers, supervisors, and caseworkers.

What GAO Found

CFSA has made progress, but the agency is not likely to meet all of the court-ordered requirements by December 2006, based on the recent court monitor's report and our work. From December 2005 to April 2006, CFSA improved its performance and met some benchmarks. However, CFSA's performance on other requirements remains well below benchmarks, raising questions about the agency's ability to meet all of the court-ordered requirements by December and sustain the improvements it has made. For example, only 29 percent of children in foster care received medical evaluations within 30 days of placement in April 2006, despite a benchmark of at least 90 percent. Several factors--complex caseloads and shortages of health care providers and qualified foster and adoptive homes--hinder CFSA's ability to meet court-ordered requirements. CFSA's cases are complex, in part because of the high proportion of hard-to-place teenagers and children with medical or mental health needs in the District's child welfare system. Caseworkers reported that they do not have enough specialized training to help them develop the skills they need to address these caseload complexities. CFSA's effort to meet court-ordered time frames is complicated in a small number of cases--those involving severe physical or sexual abuse--by the difficulty of coordinating with the District's Metropolitan Police Department. At the same time, CFSA officials told us there is a shortage of health care providers to serve these children, and the limited number of qualified foster and adoptive homes hinders CFSA's ability to give children the most appropriate and timely placements. CFSA uses routine reports and qualitative studies to determine whether it is meeting requirements, but current data may not provide an accurate picture of the agency's progress. Implementing the agency's new Web-based case management system has been challenging and caseworkers reported that because of these implementation difficulties, they have not always entered complete and accurate data on their cases into the system. However, CFSA has recently taken a number of steps to resolve these issues, including, for example, issuing frequent system upgrades to address identified problems and developing enhanced system training for caseworkers. Within the past few years, CFSA has implemented several initiatives to address the challenges it faces and achieve remaining requirements, but it may be too soon to know if they will yield long-term results. CFSA has hired new staff and reorganized existing staff to focus on key areas. In addition, CFSA has implemented new practices, such as a tool to prioritize investigations based on risk. CFSA is also beginning to hold its management staff and private contractors accountable for helping the agency meet specific performance requirements. Many of these initiatives seem reasonable, but it is too soon to tell whether these efforts will help CFSA meet the remaining court-ordered requirements.