Child and Family Services - March 12, 2003

Minutes

Children Services Committee Meeting

March 12, 2003

• Attachment: PIP Chart

• Review Agenda, Approve Minutes and Set New Agenda Items

Present: John Shore, Brenda Jackson,

Conclusion: Approved minutes of February meeting.

Action Items:

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Person Responsible:

Deadline:

• Update on Multiple Response

Discussion: Guilford County reported that had implemented MRS countywide. Franklin County is accepting more and more neglect allegations with MRS. They are starting to hear from stakeholders about concerns in confronting families (schools, etc.). Buncombe County is moving agency wide on April 1. They are contracting for additional facilitation. They have concerns about how respond to allegations from CPS Watch which is in active in county – particularly if a drop in substantiations occurs in MRS. Linda Cole indicated they have organization in Forsyth which looks at substantiation rate as an indicator – we need to think about how report. JoAnn Lamm gave an update on special provision language. It would indicate 33 “evaluation counties” but if a county requested in and the State had the resources to support it, then it could come in. Language would be added to allow legislation to be entered into the short session to go statewide. A question was raised as to where we stood on evaluation. JoAnn indicated that they have talked to Duke University. They have also gotten surveys back from workers but not families. What additional training will be made available outside from the 4-part training? That will depend of the needs of the counties but will provide the same level of support provided to the pilot counties.

Conclusion: An update will be given next month.

Action Items:

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Person Responsible:

Deadline:

• Structured Intake

Discussion: The Structured Intake product is part of the work plan for committee and grew out of Federal Program Improvement Plan. The goal was to get consistency and to make better screening decisions. Survey of some counties addressed the impact on staffing, impact on screening, strengths and concerns (attached). One concern was the length of the intake form. The old form had 21 questions vs. 25 in new form. If the intake process had already answered questions in the narrative, then you don’t have to repeat questions included to insure that specific topics are covered. Mecklenburg County felt initially that they would have to double staff – there has been no increase in staffing. Upon doing it, the Mecklenburg staff love it. They are screening in some cases that would have rejected before but also screening out some that would have accepted before – it is balancing out. Some counties had to manage differently such as having a backup system. It was reported that the value of additional information far outweighs any additional time required. It has been a very valuable tool for staff that don’t regularly do intake. Intake staff reported that it really helps in documenting why intake decision was made.

Conclusion: Adopted effective June 1 with 1-day training to be provided before.

Action Items:

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Person Responsible:

Deadline:

• Dissemination of Updated Family Case Plan and preliminary discussion

Discussion: The work group working on this item still has some work to do before it is ready for presentation to the committee.

Conclusion:

Action Items:

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Person Responsible:

Deadline:

• Potential Impact of HIPPA on Child Welfare

Discussion: It was reported that the State Attorney General would not be providing guidance to counties on dealing with HIPPA in child welfare. The impact will vary from county-to-county due to differing status under HIPPA. The privacy regulations take place April 14 for some agencies.

Conclusion:

Action Items:

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Person Responsible:

Deadline:

• Program Improvement Plan

Discussion: JoAnn shared where NC stood in achieving benchmarks compared with national standards. See attachment # 2 (due to format is in a separate file).

Conclusion:

Action Items:

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Person Responsible:

Deadline:

• Legislation

Discussion: JoAnn brought to the Committee’s attention two bills affecting Children’s Services which has been introduced in the legislature. HB 152 requires cooperation regarding giving children medication and placement of child that would increase risk of SIDS in childcare centers. We need to work with DCD to clarify roles. Need as future agenda item. HB 402 requires that a social worker must have permission of homeowner or presence of law enforcement to enter a household.

Conclusion:

Action Items:

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Person Responsible:

Deadline:

Attachment # 1 - Survey of Counties Working with Structured Intake Form

	Impact on Staffing	Impact on Screening	Strengths	Concerns
Alamance	Are concerned about need for additional staff	Have not used the new Intake Report
Buncombe	15-20 minutes longer on each report for about a week or so and once they became familiar it didn’t take that much longer. Does not believe the policy requires additional staff.	When issues arise with any reporter, a professional or family member/neighbor, who has a time constraint, workers talk with the reporter about the importance of talking with them about the family and ask if there is a more convenient time to talk.	Intake staff did a good job with the old report, however the information obtained with the new document is more thorough. The new Intake Report is invaluable in training new workers from pre-service because it is so thorough. The Intake Report gives us so much information; it informs your screening. Using this report and policy fits in with MRS. Investigators are able to think about what type of referrals might be necessary.	When the new policy was shared with staff, they gave the supervisor all kinds of grief. When we discussed how to format and include the information we were accustomed to including, and made it “look” the way we wanted, they were fine, and now have no problems with it.
Cabarrus		Have not been using the new Intake Report.

Impact on Staffing

Impact on Screening

Strengths

Concerns

Alamance

Are concerned about need for additional staff

Have not used the new Intake Report

Buncombe

15-20 minutes longer on each report for about a week or so and once they became familiar it didn’t take that much longer.

Does not believe the policy requires additional staff.

When issues arise with any reporter, a professional or family member/neighbor, who has a time constraint, workers talk with the reporter about the importance of talking with them about the family and ask if there is a more convenient time to talk.

Intake staff did a good job with the old report, however the information obtained with the new document is more thorough.

The new Intake Report is invaluable in training new workers from pre-service because it is so thorough.

The Intake Report gives us so much information; it informs your screening. Using this report and policy fits in with MRS.

Investigators are able to think about what type of referrals might be necessary.

When the new policy was shared with staff, they gave the supervisor all kinds of grief.

When we discussed how to format and include the information we were accustomed to including, and made it “look” the way we wanted, they were fine, and now have no problems with it.

Cabarrus

Have not been using the new Intake Report.

Catawba

New intake report does take longer, but not more than 10 minutes or so. Of course if you have 10-11 calls a day, this adds up to 2 hours of extra time. We think the more it’s used, the quicker it will go, and the time issue will be less an issue.

Have not implemented fully due to computer issues. Are using a large flip chart to cause the worker to ask the allegation –specific questions. Well-being questions not implemented fully, having to do with length of time and comfort level of workers, who have 70+ yr. of exp.

Are getting 100% better information than before.

Intake talk time is more meaningful- the information gathered is more comprehensive and is obviously the result of more focused questions.

Have a CPS Modular System that requires programming changes.

Programmers are going to give us an estimated cost but we know it will be high because our Intake form is so integrated into the data base and documentation components.

Cleveland		Have not been using the Intake Report.		This is a One Case/Cox System County.
	Impact on Staffing	Impact on Screening	Strengths	Concerns
Gaston	Do not find that it impacts need for additional staff, did take longer when first implemented, but does not at this point.	Does not believe it has increased screen-ins.	Intake staff are able to get thorough information, very helpful with new staff or staff who do not do Intake on a regular basis, (evening workers) It saves time, as she had to call reporters back for more information in the past. With new workers, it makes screening decisions easier.	Initially met with resistance from workers.
Harnett	Believes it may have an impact on staffing. When the SW first started using the new report, it took 45 min to an hour, now it takes 30-45 min.	Have recently been using the old report form, as the SW trained on the new report is out and screening decisions are not as clear as when we were using the new report. Have not noticed an increase in reports.	Professional reporters appreciate the time spent with them at Intake. Makes decision about whether to accept a case clear. Investigators say there is much more information, especially regarding DV.	Anonymous reporters have become aggravated at length of interview. For an experienced SW, the questions can be redundant. Formatting can be improved.
Johnston	Has increased Intake time slightly, does not believe this will require additional staff.		We are getting a lot more information. The strengths questions stop reporters and make them think, One reporter, said, “Wow, I can’t believe you’re asking me that.”

	Impact on Staffing	Impact on Screening	Strengths	Concerns
Mecklenburg	Indicates it may take about 10 minutes longer, however they have not experienced a need for additional staff. We have a person out on medical leave and we are still not feeling a need for additional staff.	Has changed screening somewhat, screened a few more in.	They are getting better information, and are more consistent. This approach educates the reporter about MRS and ties in with the strengths-based MRS philosophy. Reporters are saying they feel more respected and listened to.	Staff resisted initially.

Impact on Staffing

Impact on Screening

Strengths

Concerns

Mecklenburg

Indicates it may take about 10 minutes longer, however they have not experienced a need for additional staff. We have a person out on medical leave and we are still not feeling a need for additional staff.

Has changed screening somewhat, screened a few more in.

They are getting better information, and are more consistent.

This approach educates the reporter about MRS and ties in with the strengths-based MRS philosophy.

Reporters are saying they feel more respected and listened to.

Staff resisted initially.

Onslow	Supervisor states that she has completed Report Form personally a couple of times and it does take longer and feels it could impact staffing.	Have not been using the Intake Report on a consistent basis.		Use the One Case/Cox system that impacts ability to implement fully. Professional community is somewhat intolerant of being questioned.
Stokes	Have not changed things a great deal; no real increase in length of time completing report.		The design of the report helps us focus on the real issues. We are getting good information.
Union		Have not been using the new Intake Report	Believes the information obtained will be more thorough. Does not see this policy as different from what you should have been doing all along.	Use the One Case/Cox system and this has prevented them from formatting on the computer.

Onslow

Supervisor states that she has completed Report Form personally a couple of times and it does take longer and feels it could impact staffing.

Have not been using the Intake Report on a consistent basis.

Use the One Case/Cox system that impacts ability to implement fully.

Professional community is somewhat intolerant of being questioned.

Stokes

Have not changed things a great deal; no real increase in length of time completing report.

The design of the report helps us focus on the real issues.

We are getting good information.

Union

Have not been using the new Intake Report

Believes the information obtained will be more thorough.

Does not see this policy as different from what you should have been doing all along.

Use the One Case/Cox system and this has prevented them from formatting on the computer.

	Impact on Staffing	Impact on Screening	Strengths	Concerns
Wilson	Old report form, minimum of 15 minutes on the phone with reporter, sometimes longer depending on nature of the report. Initial completion of new report form 30 to 45 minutes, sometimes longer. Currently app. 30 minutes to complete, as with old intake can take longer depending on situation. When call volumes are high, we have had to back up the intake worker. I do not think this would necessitate an additional staff person for our agency, but for some counties this might be an issue.	Because of the program improvement plan this is difficult to say. We have accepted more reports since piloting this form; it is difficult to determine the variable. Statewide the number of accepted reports has risen.	More information is gathered on the new form, therefore it is expected that a better screening is received resulting in more acceptable reports. There is a structure to the intake process. When used correctly it gives enough information to accurately screen a report. Thoroughly breaks down every issue that might be a risk factor to children. It also gathers specific information that might have been missed in the last Intake form.	Have not used the screening decision flow charts, which is expected to increase reports. Frustration of reporters sometimes due to length of the report and type of questions asked. Sometimes calls get backed up or additional staff manpower is needed to take referrals causing work delays. The report itself is not user friendly; need to work with automation to find some shortcuts to manage this issue. Much more paper involved for copying and storing the document. With the roll out of MRS, the increase in number of CPS reports and the use of the new form, Structured Intake should be monitored to determine the impact on Intake and the manpower needed to ensure accuracy and timeliness in child protection.

Impact on Staffing

Impact on Screening

Strengths

Concerns

Wilson

Old report form, minimum of 15 minutes on the phone with reporter, sometimes longer depending on nature of the report. Initial completion of new report form 30 to 45 minutes, sometimes longer. Currently app. 30 minutes to complete, as with old intake can take longer depending on situation.

When call volumes are high, we have had to back up the intake worker. I do not think this would necessitate an additional staff person for our agency, but for some counties this might be an issue.

Because of the program improvement plan this is difficult to say. We have accepted more reports since piloting this form; it is difficult to determine the variable. Statewide the number of accepted reports has risen.

More information is gathered on the new form, therefore it is expected that a better screening is received resulting in more acceptable reports.

There is a structure to the intake process. When used correctly it gives enough information to accurately screen a report. Thoroughly breaks down every issue that might be a risk factor to children. It also gathers specific information that might have been missed in the last Intake form.

Have not used the screening decision flow charts, which is expected to increase reports.

Frustration of reporters sometimes due to length of the report and type of questions asked.

Sometimes calls get backed up or additional staff manpower is needed to take referrals causing work delays.

The report itself is not user friendly; need to work with automation to find some shortcuts to manage this issue.

Much more paper involved for copying and storing the document.

With the roll out of MRS, the increase in number of CPS reports and the use of the new form, Structured Intake should be monitored to determine the impact on Intake and the manpower needed to ensure accuracy and timeliness in child protection.