Texas Department of Family and Protective Services
Advisory Council Meeting
April 17, 2009
The Texas Department of Family and Protective Services (DFPS) Advisory Council met in Public Hearing Room 125-E of the John H. Winters Building, 701 West 51st Street, Austin, Texas. Council Members present were Chair Ommy Strauch, Debbie Epperson, Paul Furukawa, Richard Hoffman, Faith Johnson, Linda Bell Robinson, and Mamie Salazar-Harper.
Not present were Vice Chair Imogen Sherman Papadopoulos and Gigi Edwards Bryant.
Also present were Commissioner Anne Heiligenstein and agency staff.
Agenda Item 1 – Call to Order
Call to order by Chair Ommy Strauch at 9:04 am.
Agenda Item 2 – Reading, Correction and Approval of Minutes of January 9, 2009
Regular Meeting
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Dr. Furukawa moved adoption of the minutes as printed; Mr. Hoffman provided a second. The minutes needed no corrections and were approved as distributed.
Agenda Item 3 – Public Testimony
Mr. Johnny Norris Ferguson provided the following testimony regarding his involvement with the foster/adopt program. He and his wife applied to the program last June. They completed their training with Arrow Project. All but their home study was complete when they were informed by Arrow that they were not a match for adoption. When they further inquired with CPS as to why, they were told CPS could not give them the reason because their home study information was confidential and would have to be given to them by Arrow Project.
Mr. Ferguson talked to CPS and the Ferguson's information was requested from Arrow Project. The case was then assigned to Georgetown CPS, and the Ferguson’s were told they would need to start over completely since the information Arrow Project gathered from them did not result in an acceptable home study.
The Ferguson’s decided against starting over with a new home study since they had not been told why they did not pass the first one. They did not want to go through the process again only to be told again that they were not a match for adoption. The Ferguson’s never did find out why Arrow Project disqualified their home study; however, the last night of training, they did talk with Arrow staff about a problem that had come up with the children that they wanted to adopt. They had been accused of telling these children that they were going to adopt them. The Ferguson’s state they did not tell the children this. Two days after this discussion at the training, they received notification that they were not approved to adopt.
A couple of nights later, they were informed by the foster mother of the girls they were interested in adopting that the girls had been placed with the foster parents for adoption. The girls were given the opportunity to tell the Fergusons goodbye over the phone; however, Mr. Ferguson could hardly understand the youngest girl who was talking very quietly. Mr. Ferguson told the girl he would see her the next morning at 9:00 to tell her and her sister goodbye. Mr. Ferguson says the foster mother then became hostile and said, no, the children will be in school tomorrow, and hung up the phone. The Fergusons did not get to tell the girls goodbye the next day.
Mr. Ferguson says he tried to find out what was going on. He provided a handout with phone numbers of people he called who failed to call him back. He states that he is 100 percent for the children, and that he and his wife have a voluntary safe house for any child to come to after school. Mr. Ferguson believes something needs to be done to ensure that employees return phone calls. The Fergusons are also considering filing a lawsuit against Arrow Project since they do not know what else to do.
Commissioner Heiligenstein stated that she will ask CPS staff to look into Mr. Ferguson’s situation. He is entitled to a response and she assured him one would be provided.
Ms. Kathleen Nickels complimented the department on work with the legislature on bills involving the adoption and review process, specifically HB 2225. Ms. Nickels represents a network of attorneys, adoption agencies, and other organizations that work with CPS in Corsicana, and she came to speak before the Council because the situation in Corsicana is dire. Ms. Nickels stated, there are some signs of change, but everyone fears that not enough will happen. She asked the Council to help ensure momentum is maintained.
Ms. Nickels stated she has no qualifications, training, role, or authority; she came as an outsider to fight a case in Corsicana seven months ago and with nothing but determination, dumb luck, and divine intervention overcame many obstacles that other people are also facing. She would like to put this ordeal behind her, but she cannot leave behind people that are still stuck dealing with the same things that she dealt with. According to Ms. Nickels, two state investigators have been interviewing people in the Corsicana office. This has given people hope, but they remain skeptical that anything will be resolved. People fear that an internal report will be filed with little action being taken.
Her concern is that the investigators may only hold internal interviews. Ms. Nickels stated the investigators could find: falsification of records; caseworkers claiming to make visits they don’t actually make; the use the travel allowance to visit boyfriends; employees taking long lunches or faking names on the Angel Tree in order to get stuff to take home.
She reported that a grandparent, Joan Jenson who has a lot of resources and a big family, had to fight four and a half months to be allowed to care for her granddaughter who was taken at birth from her biological parents. Four months after Ms. Jenson received care of this granddaughter, CPS workers appeared without any warning or notification, to remove the girl from Ms. Jenson and place her with the final adoptive parents who had been selected. Because Ms. Jenson was not at home when the workers arrived, she was able meet with her attorney to sort things out without having to give her granddaughter to CPS. Caseworkers involved in Ms. Jenson’s case perjured themselves in court which, Ms. Nickels stated, is not an unusual occurrence in Corsicana. Ms. Jenson receives regular monthly visits from two caseworkers who show up without speaking and look very closely for things they could write her up on to show that she is not in compliance.
Ms. Nickels reported on another grandmother, Patty, who has been trying to adopt her three grandchildren, between the ages of 7 to 15, for two and a half years. Patty was not allowed to visit with the children for eight months and has had to beg for resources and financial assistance. Her adoption is continually delayed by management blunders according to Ms. Nickels.
The nearest contracted services for parents are in Waxahachie, a 45-minute drive from Corsicana. Parents who do not have transportation or job flexibility to travel to Waxahachie two or three times a week have a huge battle to fight.
Ms. Nickels wants to find out who the investigators are that were sent to Corsicana. She has a list of ten people the investigators need to interview. These 10 people are willing to talk and give their names; talking to them will uncover patterns of wasting taxpayer funds, demoralizing workers, and causing harm to children who are supposed to be protected. Ms. Nickels is not suggesting these are statewide problems, but they are problems in Corsicana.
Commissioner Heiligenstein requested that Ms. Nickels speak with Assistant Commissioner Audrey Deckinga about the concerns she has raised.
Agenda Item 4 - Agency Briefings
4.a. Committee on Licensing Standards Interim Report – Dan Adams, Kim Kofron, Sasha Rasco
Sasha Rasco looks forward to working in the capacity of Assistant Commissioner of Childcare Licensing; she will continue the legacy of bringing many rules to the Council for consideration. She thanked Commissioner Heiligenstein for the opportunity to lead and direct the childcare licensing program. Ms. Rasco has worked in licensing for over 10 years, worked previously in direct childcare, and now has two of her own children in childcare; so she remains professionally and personally committed to the protection of children, quality childcare, child welfare, and adoption industries in Texas.
Assistant Commissioner Rasco introduced the Committee on Licensing Standards to the Council and reported on Senate Bill 58, which created this governor appointed committee on licensing standards. The charges of the committee are to review the deaths of children in out-of-home care and patterns of licensing violations across the state regionally. The statute also requires the committee to review the details of administrative reviews conducted by the licensing program.
CCL regulates over 30,000 different childcare settings and agencies, so committee members were chosen to provide different perspectives on both the settings they regulate and the different consumers that participate in that regulation. The membership includes the following: one member who operates a residential child-care facility: Dan Adams, CEO of Cal Farley’s Boys Ranch; a member who operates a child-placing agency: Ann Stanley, senior director for Casey Family Programs in Austin; a member representing a daycare operation: Kim Kofron from the Children’s Courtyard, which has 60+ daycare facilities in Texas; one member who is parent or guardian of a child in care: Tivy Whitlock, who is from Universal City in the San Antonio area; a member who is an expert in child development: Dr. Karyn Purvis, from Texas Christian University, who is also the Chair of the Committee and is known particularly for her work in infant and toddler mental health; and finally, two committee members who work for the Department with regulated childcare operations: Ms. Rasco and Adriene Driggers, District Director in San Antonio.
Mr. Adams started as a house parent and has been in this business for 20+ years before working his way to his CEO position. He appreciates having been appointed to the committee which has a lot to bring to the table. Relative to the data the committee has been working on, Mr. Adams will defer to Sasha Rasco and Cheryl Nimmo and the people who pull together data for the committee to study.
Members of the Committee were appointed on September 24. Their initial meeting was on November 25, 2008, when members met to discuss committee responsibilities and be introduced by Diana Spiser and Sasha Rasco to their respective roles. One of their charges is to analyze the data on child deaths. The committee submitted their first report in December which stated they were on the job and attentive to their charges, but at this time there was no analysis yet to report.
The Committee met in Austin on January 7, 2009, by phone in February, and in person March 23 at Cal Farley’s Boys Ranch, 35 miles north of Amarillo, Texas. In the course of these meetings, they have touched generally on minimum standards deficiencies, voluntary and involuntary closures, corrective and adverse actions, investigation findings, and waivers and variances in administrative reviews. The committee has zeroed in on what is most urgent, which is child deaths. There seems to have been an inordinate number between ‘04 and ’08 in facilities that were unregulated, unregistered and illegally operated. 58 children died in those non-regulated facilities, and 76 percent of them were under one year old; 34 percent died of SIDS, and 33 percent of those died under circumstances that were considered not diagnosed as SIDS but as somehow sleeping condition related, which could be suffocation.
Ms. Kofron reported that the 60 Children’s Courtyard schools in Texas serve infants through pre-K for full daycare, plus a large after-school program. Licensing and minimum standards are very close to their hearts. The Committee saw the large number of deaths in the illegal unlicensed operations, and made the following recommendations in their interim report: for the legislature to support childcare licensing in the development of a public awareness campaign that will focus on making individuals aware of the risks of placing children in an illegal operation; childcare licensing should be supported in locating and requiring licensure of those illegal childcare operations; childcare licensing should review the training requirements for daycare operations and child placing agencies and foster parents on the causes and prevention of death in infants under one year, and determine if those requirements should be changed or strengthened; and there should be further childcare licensing review of deaths that occurred as a result of suffocation or sleeping arrangements to assess the implications of what that training policy should be.
At their meeting scheduled for June 24, the committee will explore ways to solicit public input, and a stakeholder meeting is tentatively set for September 9, 2009. The committee hopes to receive stakeholder comments and concerns and incorporate them into their analysis and recommendations to improve the protection of children. The Committee will continue to review data and analysis related to their charge, and will issue their findings in a report in December of 2009.
4.b. Rider 13 Report – Sally Tompkins, Director of Management Support
Ms. Tompkins pointed out that Rider 13 specifically charges the Agency to develop a human resources management plan to improve employee morale and retention. The plan must focus on reducing turnover through better management. 2007 was a year of high turnover with 21.2 percent overall. Last year, turnover had dropped to 19.4 percent, and year to date is at 15.1 percent. The highest turnover positions are still the CPS Specialist IIs; which are at 29.4 percent, down almost 9 percent from last year. Statewide intake workers are also high-turnover positions at 27.4 percent, down only one percent from last year.
The highest turnover numbers are in: Region 11 in Edinburg at 22.1 percent, and Region 7 in Austin at 19.2 percent. The lowest turnover positions are: RCCL workers at 10.2 percent and CCL workers at 14.8 percent. The lowest turnover regions are: Region 5 in Beaumont at 14.7 percent and Region 2 in Lubbock at 16.2 percent.
Turnover in CPS has decreased 7.7 percent from last year. APS turnover has increased 2 percent; APS leadership has observed that some workers are leaving for higher paying jobs at HHSC. APS employees are staying with the department longer; 73 percent of folks leaving APS last year were within their first three years of employment, as opposed to the previous year when 85 percent of vacating employees were within their first three years with the department. CCL turnover has decreased by 2 percent and RCCL is down almost 4 percent. Statewide Intake turnover has decreased a little over one percent.
Regarding turnover among all employees, first quarter turnover annualized, and then second quarter turnover annualized. Turnover has decreased in almost every position in the agency. APS, again, has gone up slightly, and Statewide Intake has fluctuated up and down, but there is still another half a year to go. Research on retention indicates what the problems are and what the department needs to work on. Three sources of information are: the State Auditors Office online exit survey, the Survey of Organizational Excellence (SOE), and regional focus groups. The top reasons DFPS staff cite for leaving are: working conditions; environment, safety and work-related stress, workload issues; issues with employees they supervise or issues with their supervisors; and pay and benefits. When they leave, 68 percent leave state government, 18 percent go on to work at other HHSC agencies, and 14 percent go to other state agencies. Six workgroups comprise the Workforce Support and Retention Initiative (WSRI); a lot of retention efforts occurring throughout the state have been pooled under WSRI so that efforts and success can be leveraged.
Last year’s efforts to recruit and retain staff included: attending 77 job fairs; placing over 65 newspaper ads; and conducting a pilot with CareerBuilder.com, an online job search function. Over 3700 potential applicants were referred to HHSC’s job portal, where they could then look at any jobs available at one of the HHSC agencies. Additionally, DFPS sent job information to candidates identified through candidate resume searches, as meeting specific job criteria.
Retention efforts included: expanding office space; reducing case loads to below target in all categories; and expanding the STARS program to support, train and retain staff. The DFPS exit survey began in January, and is expected to provide valuable data once enough time has passed to collect it. Skills-based training for new supervisors has increased, and every region has a tenured worker leadership development program that prepares workers who are interested in promoting to supervisor roles or simply for leadership roles in their current units.
Some projects in progress are: the CPS realistic job preview video, this video will share the mission of CPS, job challenges, and job rewards; the Rookie First Year on-boarding project will enhance current on-boarding practice and is expected to reduce turnover by targeting new workers who leave the agency in their first 1 to 1 ½ years on the job as a caseworker.
Localized retention efforts that began last year include the Bexar County retention pilot, which ended in September and is now a self-sustained program. CPS caseworker turnover in Bexar County decreased incredibly from 2007 to 2008, and is still decreasing, from 47.5 percent to 32.4. APS caseworker turnover has also decreased in Bexar County from 43.6 to 29.6. Major accomplishments include a yearlong series of integrity coaching classes, which help the supervisors learn how to coach their staff, help them diagnose a problem, and then form a solution. Bexar County piloted the regional employee exit survey that led to the creation of the department’s agency-wide exit survey.
Ms. Tompkins reported on items being proposed during this legislative session that relate to retention and recruitment efforts. She gave an update to the DFPS LAR item; both the House and Senate have adopted some portion of the request, and the department is hopeful that at least some retention/ recruitment funding will come out of this session. Additionally, the classification plan proposed in the LAR would increase the protective services beginning salary to a Specialist II.
While it is known that a weakening economy will help decrease turnover, it is important to note that turnover has been decreasing since 2007. Intensive retention efforts in 2008 contributed to the decrease; numbers fell the first quarter and dropped again the second quarter. Traditionally, agency turnover will increase during the last two quarters of the fiscal year; people start moving and leaving their jobs in the summer. Ms. Tompkins iterated that reduced caseworker turnover results in lower caseloads and better outcomes for clients.
Commissioner Heiligenstein thanked everyone for incredible work and good progress toward retention; she recognized the small boost from the economy as people are more hesitant to leave their jobs in this environment. Historically the department has always over-hired and over-staffed in anticipation of caseworker positions and to avoid greater burden on remaining caseworkers. However, now that casework positions are becoming vacant less often, the department must adjust accordingly by filling vacancies less rapidly. This decision is made in order to pace ourselves so as not to exceed this year’s appropriation, or risk going over the appropriation for the next year.
A key reason staff leave is an issue with either peers or supervisors. Commissioner Heiligenstein stated, with the enormity of the staffing up the past few years, adding an additional 3500 staff, we now have some very short tenured staff, and they are terrific for stepping up to the plate to fill management positions, but clearly the burden is on the commissioner and her managers to be sure they equip so many new supervisors with both the programmatic skills and the staff management skills to be able to do a better job. Training and retention of these staff are big investments. Therefore additional funding has been requested from the legislature to target retention efforts. Statistically, if employees stay the first year, the odds of losing them are halved. Any efforts to retain staff past that first year are very solid investments.
Dr. Furukawa stated he is thrilled to see this kind of results presented. He stated it is fun being a member of this council when you can go back to places like Bexar County and be a cheerleader for the retention effort, and in this instance, there is a lot to cheer about. Ms. Salazar-Harper questioned how Texas fares compared to other states. She would expect other states to experience the same struggles and was curious if the department has studied turnover in other states. Ms. Tompkins reported other Data from other states has been analyzed; they have the same struggles as Texas and also have high turnover. Efforts showing to be successful in other states are comparable to efforts the department is making and in other areas of the child welfare field.
4.c. CFSR Round 2 Report and Program Improvement Plan – Liz Kromrei, CPS
Liz Kromrei reported on the status of the Child and Family Service Review (CFSR) process, a federal review process that all 50 states, Washington, D. C. and Puerto Rico experience. The National Child and Family Service Review process began in 2001. It is a qualitative review that uses interviews with youth, family, foster care providers, staff, and key stakeholders to measure state achievement in areas of safety, permanency and well-being of children and families. The process begins with a statewide self-assessment focusing on data and performance and the program. The self-assessment, done in partnership with external stakeholders, is an opportunity for the department to evaluate strengths and challenges. The second phase of the process is the onsite review where federal and state review team members analyze a tiny random selection of cases. Stakeholders are also interviewed in this phase. The CFSR philosophy is that no state is expected to pass, but instead, each state is expected to move into the next step: a Program Improvement Plan (PIP) to avoid any federal penalties. There are seven outcomes that are associated with safety, permanency, and child and family well-being, and there are seven systemic factors. What the CFSR looks at are systems. The goal is for each state to have the systems needed to have an effective child welfare system.
Ms. Kromrei reminded the Council that after Round 1 the department had been assessed a financial penalty because of one area. The department appealed this decision and in the midst of the appeal process, the federal partners rescinded the penalty. The department then moved on to Round 2. The onsite review, which is a very time-consuming and staff-intensive process that included hundreds and hundreds of appointments taking place in the span of a week, was conducted in March of 2008. This time the review team visited El Paso, Dallas, and Harris County. In January DFPS received a preliminary draft of findings and was given the opportunity to respond in writing to items in the draft that the department did not feel were factual or correct. The Administration for Children and Families (ACF), the federal partners, gave DFPS the final report on March 25. Ms. Kromrei touched on the report’s highlights.
Safety 1 assesses whether children are first and foremost protected from abuse and neglect; this is an outcome that CPS did not achieve 95 percent on. ACF’s greatest concern was inconsistency. The review team saw good use of formal risk and safety assessments but did not see the follow through that they were looking for. The review team was also looking at response time in Safety 1. It is important to note that the time period for the Child and Family Service Review is October 2006 through March of 2008. This is the time when CPS shortened the required response time for priority 2 referrals and initiated the use of case screeners, so it was a time of great procedural change and as a result, there were consistency issues.
Safety 2 determines whether children are safely maintained in their homes when possible and appropriate. Risk and safety assessments were found to be inconsistent here. The review team indicated CPS has good formal processes but needs to improve on follow through and using the content of those assessments.
Permanency 1 is an area that looks at a sample of cases and also at a lot of statewide data. The way the review team analyzes data changed from Round 1 to Round 2 making it difficult to compare results from the two rounds. However the review was able to identify areas for the department to work on in this regard. Texas has a very low rate of children re-entering into foster care, which was identified as a strength; however, work to move children out of the foster care system more quickly is necessary, particularly with regard to the children in permanent managing conservatorship.
Permanency 2 measures the continuity of family relationships and connections being preserved for children. The review team looks for signs that foster children’s relationships with their parents are being preserved outside of just parent-child visits. Desirable examples are parents being included in medical and school appointments. These are the types of things that are easier to do with lower caseloads, so CPS’ turnover and its cause and effect relationship to caseload has negatively impacted Permanency 2.
Well-being 1 assesses whether needs of children and families and foster parents are being assessed appropriately and whether they are provided for; whether the children and families are engaged in making their service plans; whether caseworkers have enough visits with children and with parents. This is the area that was associated with the penalty in Round 1. In this area, changes were also made in the way that the review team measured families where a child is in DFPS conservatorship. The review team wanted to see that the children in PMC also sustained regular contact with parents and this had not been measured before. Policy changes regarding contact and data collection have been made to address this measurement. CPS will need to improve family-based safety services by seeing all children regularly, every single child and every single parent in the family-based safety services program; whether they are non-custodial parents or parents holding down a couple of jobs and therefore difficult to contact, contact with all of them will be required. The review team noted that contacts are much stronger among the conservatorship cases.
In Well-Being 2, the department achieved the 95 percent bar for meeting the educational needs of children in care. This achievement is impacted by the educational specialists, excellent advocacy by the caseworkers with regard to children’s school needs, and the children’s educational portfolios. The department met this standard.
Well-Being 3 determines whether children’s physical and mental health needs are being met, with physical health having a stronger weight than mental health. The review found some instances where medical needs could have been better met. For example a child may have an adequate number of doctor’s visits but may not be visiting a dentist regularly or maybe their mental health needs were assessed and have not been delivered; it may be that substance abuse services are not available in a particular community and travel is required. Such challenges to Well-Being 3 were reported lacking in this outcome.
Systemic factors ensure that systems are in place to provide for child welfare in Texas. The statewide information system looks at the computer system to ensure that it works as intended. The review team was very impressed with IMPACT, the amount and type of data we collect, and the reports we are able to generate from the data.
The case review system requires work in the Program Improvement Plan (PIP), but the case review system discussed is more of the legal case going through the process. Several strengths were named with regard to the legal case process such as: timely case reviews and permanency hearings; the Texas Family Code time frame helps in this regard. The department files petitions for termination when required and in a timely manner. It was noted that the department could do a better job of notifying stakeholders of hearings and engaging them in hearings, as well as in the development of case plans.
Our federal partners were also impressed with the department’s quality assurance system, probably mostly because it looks like their quality assurance system so they can relate to it. Ms. Kromrei asked if she could brag a bit on the leadership of Dan Capouch, who has the skills and knowledge to lead the system. His team reads over 1400 cases every year; they also talk to all people involved similar to what our federal partners did when they reviewed 65 cases. They were also impressed with how information is used and how the feedback loop to staff works.
Training was found to be in substantial conformity. When interviewed, some stakeholders talked about the challenge of turnover undermining training, but overall, training was deemed to be in good shape, and new staff’s training needs are being met. Also being met are ongoing staff’s training needs and training of foster and adoptive parents.
The second of two systemic factors to focus on in our PIP is service array. The greatest challenge we face as an agency is not being able to control the service array. When we talk about whether substance abuse services are being offered throughout the state, DFPS cannot control whether these substance abuse services are available, but we do work hard to access them and advocate for our clients to receive them. The availability of mental health service provides a similar example. The department was commended for strengths gained from the medical passport provided by the STAR Health system, but work remains in this area. Gaps of this nature are located most significantly in rural, rather than urban, areas.
Responsiveness to the community was found to be in substantial conformity, which we can attribute to CPS Reform. CPS has worked hard to improve partnerships with our stakeholders, with families we serve, and with our youth who are in foster care. Foster and adoptive parent licensing recruitment and retention efforts were also found to be in conformity, with some room for improvement. Actually, improvements in this area have already been initiated since the on-site review. Our greatest challenge is that Texas still does not have the capacity necessary to meet the needs of high-end children, children with specialized needs.
The department is in the midst of PIP negotiations with our federal partners. A draft will be submitted at the end of the month, which will be followed by months and months of negotiations until a final PIP is agreed upon. The PIP for Round 1 included something to address each piece of the review. Since then, the Administration for Children and Families has learned through experience across the states that it is more productive to spend time and effort on improvements that will impact multiple outcomes rather than individually addressing each outcome.
The PIP for Texas will not be a list of everything CPS believes could be done if there was additional funding, nor will it include changes that would demand a significant effort. The DFPS PIP will be an attainable plan. We learned from Round 1 that a state is assessed penalties not on how significant their progress has been, but rather on their failure to complete their PIP and their targets, so it is important that our plan is realistically attainable. The focus of our PIP will be on four themes: workforce recruitment and retention, building placement capacity, addressing barriers to permanency, and strengthening family-based safety services program.
Upon completion of negotiations, the meter starts for three years; two years to finish all of the PIP tasks and another year for our data to begin to report the targets we have agreed to. There is much methodology about how to set targets; CPS will be adhering to this methodology to ensure the targets are achievable. Dan Capouch will shepherd CPS through this process.
Judge Johnson questioned whether the Council should be concerned when seeing that the agency is in substantial conformity in six areas but not in conformity in eight other areas. Ms. Kromrei responded that although it’s difficult to compare other states, this is fairly consistent. The systemic factors are easier to pass than the actual case reviews as we are supported by data. Case review measurements have changed and CPS has room to improve in these areas. Most states are not passing a good portion of the CFSR, and no state has passed all seven outcomes. What the department should be concerned with is the need to ensure that we lay out a PIP that is doable; to make the required measured improvement and to avoid a penalty. It is very difficult to compare Round 1 to Round 2 and say, “how many did we pass in Round 1 and how many did we pass in Round 2” because the way that that data points are counted and measured has significantly changed between the two rounds.
Judge Johnson then asked Ms. Kromrei if the review could be compared to a scale of one to ten, where would we fall, based on this assessment, ten being the highest. Ms. Kromrei stated that the review is not set up to be compared to such a scale. The review process acknowledges that no state child welfare system is perfect, so the review is designed to say, where are you strong and where do you have challenges? If you look at all of measurements being equal, they are almost half and half, which is not out of the realm of what we understand the Texas child welfare system to be because we know we have areas needing improvement. The review is not designed to drill down to a one-rating score, which is very difficult to address. The department’s concern is whether or not we will achieve what we need to achieve with our PIP; this is our biggest focus. We are going to have a realistic PIP and realistic targets; we will not be one of the states that is unable to complete the program improvement plan.
4.d. APS As You Go Project – Susan Thomson and Tommy Reed, APS
Mr. Karl Urban was pleased to recommend the APS As You Go Initiative as a presentation to the Council. As You Go has been a great success and has become a model for the way the agency introduces new initiatives to staff. Prior to As You Go, evaluation and implementation of new support tools was less than optimal because the department made the tools available without giving much thought to the agency’s culture for support processes. The As You Go initiative was handled by first preparing and training staff on expectations and use of the new tool.
A large part of the initiative’s success is because of the people involved. Mr. Urban asked Susan Thomson, Director of Field Operations, and Tommy Reed Region 2/9 Director, to explain the project since As You Go was their brain child and they were the ones to shepherd the initiative through implementation.
Ms. Thomson reported that the As You Go slogan and the initiative encompasses the broader culture change in caseload management for APS that includes staff working in a dramatically more mobile environment; and better utilization of available mobile technology, training and work processes and practices. This change is designed to provide service to APS clients through greater efficiencies, enhanced flexibility, and improved staff satisfaction and retention. The initiative is about changing attitudes toward documentation, and adopting a new philosophy where documentation is a part of the case activity itself, not a separate activity to be scheduled days later. It’s also about changing how you do documentation, where you document, and when you document.
Before the initiative, documentation was done on office desktops. Documentation obviously had to be done in the office and after the fact of the case interview. APS policy required that documentation be done by day 14 of the case activity. With the As You Go initiative, caseworkers are now documenting using a stylus pen and tablet at the client’s home, or in the worker’s car, or in a library or restaurant, or even at the worker’s home; at any location that is most convenient to the interview site. Documentation is done concurrent with the case activity or interview itself, or immediately thereafter. This initiative is a product of the caseload management efficiency work group founded in September 2007, and chaired by Tommy Reed.
Mr. Reed reported that the workgroup was composed of program administrators, supervisors, caseworkers, a regional program specialist, a program policy specialist, a functional analyst, and the Adult Protective Services curriculum developer. The workgroup’s initial objective was to develop guidelines for supervisors to use in instilling good caseload management practices in new case workers.
APS caseworkers were given tablet PCs a number of years ago during reform. APS has had several years of experience with the tablet PC since then, and realized the program was not utilizing them to their full potential; this led the workgroup to rethink the program’s approach to documentation. With training and practice, the caseworkers can now use the writing stylus feature to document directly on the tablet PCs in the field during interviews and with most clients in their homes. Documentation is now connected directly to the case activity while memory recall is optimum, and the table PCs provide the worker electronic access to the most current case activity.
The concept of documenting during or immediately after a case activity was a significant departure from the program’s casework tradition, and the work group realized that while this change would require significant training and effort to implement, the key would really be in the program’s ability to change our institutional culture. The objectives of the workgroup expanded over time and the final report included 10 recommendations that became As You Go’s concurrent documentation initiative.
Expectations for APS caseworkers are that: they will use their tablet PC with the stylus pen in the field and will maximize the use of all the PC’s features; documentation will to be incorporated with other casework rather than being treated as a separate action; and documentation will be done on an As You Go basis. A case activity is not complete until key information is entered and documented in the case. If documentation cannot be completed during a home or facility visit, then it should be done immediately after the visit in the most expedient location available.
The cultural change process began with the introduction of expectations at a campaign kick-off event held June 17, 2008. The initiative was presented to an audience of approximately 170, which included all APS supervisors. As You Go has resulted in more effective and efficient management of work loads. Immediate documentation has the best chance for accurate recall; aids in the ability of a specialist to assume the cases of another specialist who becomes unavailable due to illness or other unforeseen events; enables supervisors, subject matter experts and program administrators to provide meaningful and timely case consultation; and reduces the overall time spent on case documentation which frees up more time for caseworkers to spend with clients.
Major accomplishments include: training over 725 staff in 72 two-day sessions held from July through early October; 13 follow-up training-in-a-box modules which were developed by the APS training division and delivered by supervisors; skills practice labs offered October through December for staff needing extra assistance; implementation of policy and performance metric changes compatible to next-day documentation; input from the APS regional program improvement committees (PIC); and dissemination of As You Go best practices. Changes have also been made in IMPACT to further facilitate the use of mobile technology.
Performance metrics have improved since the implementation of As You Go. Percentage of case initiations documented by the next day has improved from 73 percent in April 08 to 90 percent in February 09. The percentage of face-to-face contacts documented by the next day has also increased, from 50 to 80 percent. Documentation of monthly status updates has increased from 48 to 82 percent. Additionally, syncing cases into MPS increased substantially after staff was trained in the new technology. MPS is an application that resides on the tablets to enable caseworkers to work on case documentation while in the field without relying on network connectivity. Increased use of MPS is a measure of increased use of mobile technology in the field. Syncs per day in April 08 were under 200. Currently syncs per work day are never under 300, often top 400, and on a particularly busy day last month they exceeded 500.
The cultural change was essential to the success of this initiative. Regional staff have supplemented training with panel discussions and other presentations of the As You Go philosophy at their regional staff meetings, which ensures workers not only master the skills necessary to use the tablets outside the office, but also that supervisors are equipped to manage a mobile work force. The campaign kick-off event for supervisors in June included a presentation and a panel discussion by subject matter experts on HR policies, travel policies, and other operational issues related to supervision of mobile staff.
An APS worker, Elena Esparza, states that knowing that the client’s information is up to date in IMPACT brings relief and confidence because anyone can follow up with the case if something should happen to the principal worker. Ms. Esparza has experienced increased ability to focus on other cases and reduced anxiety and stress because of the As You Go initiative. Having access to current documentation also helps the on call worker who may receive new referrals on a current case. Ms. Esparza now has more time to provide services to clients and with the additional time she has saved, she is able to document her daily travel, and is ready to submit for travel reimbursement the last day of each month. Being mobile allows her to work faster and even close cases faster. When her supervisor is on leave, Ms. Esparza has the confidence to seek subject matter experts and program administrators’ help, knowing that they can go into cases rely on current information for assessments.
Ms. Salazar-Harper, council member, noted that after the As You Go initiative was implemented in El Paso County, she had the opportunity to go on a ride-along with a caseworker, and she was able to see first-hand the efficiency of the tablet PC. The caseworker told Ms. Salazar-Harper that it was the best thing that had ever happened for APS. Commissioner Heiligenstein stated that this was part of legislative reform for APS. The legislature not only made a large investment in numbers of staff, but also in the tools to help them do the job right. She thanked Tommy, Susan, Karl, and their team and she congratulated APS staff for the improvements made.
Dr. Furukawa asked if this initiative has led to development of templates for caseworkers to use during interviews. Ms. Thomson advised that one of the challenges they still face with using the tablets to their maximum potential is the fact that IMPACT was really built on the platform design for desktops; therefore, it will take appropriation of some additional funds to revise IMPACT to allow such templates to be created and accessed via the tablet PCs. The department is doing what it can to maximize functionality with the funds that are available.
4.e. Commissioner’s Report Including: Agency Administrative and Legislative Updates
Commissioner Heiligenstein acknowledged two members, whose terms are expiring, who have given much of their time, energy and talents to the Council. Rick Hoffman, past Council chair and former board member of the Department of Protective and Regulatory Services, and Judge Johnson will be remembered for sharing their time and talents in the work to protect the unprotected. The Governor has appointed two new council members: Christina Rawls-Martin of Mission, Texas; and Pastor Scott Rosenbach of Amarillo, Texas. Both will now be eligible to serve on the Council.
Session Update
Commissioner Heiligenstein introduced Jennifer Sims who provided the following Session update. This week, the House should be debating the appropriations bill which has made its way through its appropriate Committees, the House Appropriation and Senate Finance Committees, and is now being debated on the House floor. The department will keep the Council apprised. The bill has come through Senate Finance and will be making its way to the Senate floor, and after that will be where the real appropriation bill gets worked out, in Conference Committee between the House and the Senate.
A couple of LAR items have been recommended for funding in both the House and Senate versions. Both versions currently provide funding to implement the mandatory portions of the new federal legislation, Fostering Connections. The Fostering Connections bill requires CPS to conduct diligent searches on all relatives to a child, to be certain every possible relative placement is located as a resource for that child. One-time seed money for expanding the number of transition centers has also been recommended.
The differences in the House and the Senate approaches to funding are fairly broad. The House recommended more funding by using the federal economic stimulus funding from the federal government. The Senate is reticent to spend stimulus funding. This will be the underpinning of the larger debate between the House and the Senate.
Of interest to the Council is the Fostering Connections bill and its optional components which include a new innovative approach to helping children who have been deemed by the courts to remain in the care of CPS until they age out of foster care. These are children who cannot go home and cannot be adopted, often because parental rights have not been terminated. The department has petitioned the legislature for funding for a permanency care assistance program that would enable the department to provide financial support to relatives who are willing but cannot afford to assume legal custody of these children.
This bill would enable transfer of guardianship from DFPS to a relative and at the same time expand the pool of available relatives by providing ongoing financial support to that relative until the child reaches age 18 (or up to age 21 for some children). The clear advantage is that the child would remain with a relative and the advantage to the taxpayer is that this proposed program is actually less expensive than traditional foster care. Additionally, once the conservatorship is transferred to the family, the state would no longer be a factor in the child’s life, so the costs of casework and court actions would be saved. Another exciting benefit of this proposed program is increased funding to support the youth who have aged out of care. These youth would be able to stay in foster care up to age 21, and the department could support them in independent living settings.
A priority item for funding from the Appropriations Committee must be the Adult Protective Services program. There is some confusion in the legislature in terms of availability of federal funds to help pay for existing staff, so ensuring the department receives the state funds needed to supplant the loss in federal funds is critical to retain APS staff. The House has fully funded requests for APS staff.
DFPS is also diligently working on strengthening transition services for youth aging out of foster care. This work includes assuring that youth have Preparation for Adult Living (PAL) caseworkers available to them. PAL workers typically carry a caseload of about one worker to 250 youth, so their ability to really work with the youth is very limited. Therefore, the department is requesting funding for additional PAL workers to bring down the caseload to one worker to 150 youth.
The commissioner thanked Cindy Brown, CFO, and her team who have worked tirelessly around the clock recrunching numbers and doing terrific work in helping legislators and their staff understand some complicated issues such as the need for rate increases in foster care and sufficient numbers of staff to meet case needs as well as complete tasks identified in the CFSR federal standards. Commissioner Heiligenstein also acknowledged the providers DFPS works with every day, including Dan Adams and Kim Kofron.
Over 7,000 bills have been filed and DFPS is closely tracking around 650 of them. Legislators have filed a thousand more bills this session than last and have fewer House committees this session to handle them. In addition to having more bills and fewer committees they have adjusted to the challenge of a change in leadership in the House. Unlike Senate Bill 6 in 2005 and Senate Bill 758 in 2007, this session does not have an omnibus reform bill for DFPS.
There is a bill targeting the Department of Aging and Disability Services (DADS) in terms of what should be the role and the capacity of state schools, and this bill could affect how abuse and neglect investigations are handled by APS. APS staff has done a terrific job during reform. Credibility is high and legislators are looking to APS to protect individuals in these facilities; thus, this bill could potentially affect APS workloads.
Regarding the budget, the Agency is on good footing overall in terms of not taking reductions. We will continue to work on filling the funding gap to provide for APS staff. We have all been busy with our work on the budget, monitoring the 650 bills, and having the right people at the right place at the right time to provide resource witnesses for legislative requests. Thanks go to Jennifer Sims and her Government Relations team who have provided round-the-clock, seven-days-a-week support and appraisal of session happenings.
The department does not attend every single hearing, but does monitor the ones we do not attend. As a result, there are many late nights and early mornings during this process. During this period of session, debates can take up much of the day and hearings are happening later into the evening; days will be stretched the next six weeks or so.
Senate Bill 69 by Senator Nelson, has a committee substitute which maintains the 5 percent outsourcing pilot that was proposed in Senate Bill 758, and there is a provision which would allow Licensing to co-locate with child placing agencies when it is feasible to do so. SB 69 would also provide a mentor program for foster parents and exit interviews for foster parents who decide to leave the system. House Bill 1052 by Senator Uresti has been folded into Senate Bill 69, and will additionally create a Foster Child Bill of Rights. A Foster Parents Bill of Rights, will be created in House Bill 3107.
House Bill 3492 will create a pilot for the outsourcing of case management functions for CPS in Bexar County. HB 3492 has a fairly substantial fiscal note and has been left pending; we are not able to predict what will happen with this bill.
House Bill 3604 is attempting to better assess adoptive parents and better monitor children’s long term treatment plans. This bill was initiated after a very tragic child death in Texarkana involving an adoptive parent. Originally, the bill proposed that psychological evaluations be given to all adoptive parents, and now the authors of the bill are looking for a way to better assess adoptive parents and keep an eye on children’s treatment long term without a psychological evaluation.
Commissioner Heiligenstein represented the Department earlier this week in the hearing about a bill intended to collect lessons learned from the Agency’s previous experience in Eldorado. House Bill 4255 has provisions relating to increased penalties for not reporting child abuse or neglect, reporting of births, and relating to bigamy charges. At the hearing, the department was appreciative of the opportunity given by legislators to lay out what CPS did, what DFPS did, and why. The hearing also gave DFPS an opportunity to publicly thank everyone who helped care for the children and their parents. The Commissioner also thanked Dan Adams, stating what Cal Farley’s did for the children was remarkable. Much of the information that has been promulgated is anecdotal and not necessarily factual, so the department appreciated the opportunity to lay out the facts and to publicly acknowledge the remarkable job that providers and staff did under tremendous pressure. CPS staff and all who pitched in to help behaved in a way that was professional, poised, and gracious to everyone. The Commissioner is very proud of all.
Twenty to twenty-five bills address different aspects of state schools. Ultimately it may be that Senate Bill 643 will become the vehicle for all as other bills are rolled into or taken from it. The bill has been voted out of Committee and now goes to the House floor. A few of the provisions of SB 643 require video surveillance at all state schools, an independent ombudsman for state schools, a separate state school for individuals who are alleged offenders, and a mortality review team. Currently, APS conducts investigations of abuse, neglect or exploitation in state schools. Provisions would add another layer by including the HHSC Office of Inspector General (OIG) to be more involved in the criminal side of investigations. The OIG would determine if criminality was involved and then take the lead if so determined. SB 643 would increase the accountability of staff and volunteers through background checks and drug testing. It will also increase staff training requirements. Other provisions may be added as it goes to the House floor.
On Senate Bill 68, the Attorney General issued an opinion last summer saying that the Childcare Licensing Division of DFPS does not have rule-making authority to exempt certain programs from licensure. Senate Bill 68 has provisions for establishing which summer programs could be exempt from licensure.
Much attention is being given to workforce and retention efforts. DFPS is pleased to share that turnover is dropping. Commissioner Heiligenstein referred to the Rider 13 Report presented earlier in the Council meeting by Sally Tompkins.
June 1 is the last day of the session, and June 21 is the last day the governor can veto bills. The Council has been given a summary of exceptional items that have been submitted to the legislature. This summary details which of the items the House and the Senate have recommended for funding. DFPS is working closely with Executive Commissioner Hawkins to ensure the department’s case is well articulated for the Conference Committee. DFPS will provide an update to the Council at the June Meeting, catching the Council up on what happened with session and the budget, and what next steps will be to build the FY 2010 operating budget.
The department has begun compiling information in preparation for the upcoming Sunset Review. No time can be wasted although staff is exhausted from working the session. The Sunset Commission’s very rigorous review will continue until 2011. The commissioner assured the Council that they will be involved in the Sunset process and mentioned a travel rider has been requested to accommodate for increased travel for the council members.
Deputy Commissioner, Joyce James is taking the leadership role in the Sunset process which will touch every facet of the agency. Sunset is the regular assessment of the continuing need for a state agency. In addition to DFPS, the Health and Human Services Commission (HHSC), the Department of Aging and Disability Services (DADS), the Department of State Health Services (DSHS), and the Department of Assistive and Rehabilitative Services (DARS) are five of twenty-five other Texas agencies scheduled for Sunset Review for the 2011 legislative session. The Sunset Commission sets a date when an agency will be abolished unless legislation is passed to continue its function. The review creates an opportunity for the legislation to study each agency and to make changes to the agency’s mission or its operations as deemed necessary. The review takes up to eight months, and will include opportunities for the Council to participate in the review. Gigi Edwards Bryant will be the council representative for Sunset preparation.
Sunset Review begins with the completion of a self-evaluation report; our opportunity as an agency to identify problems, opportunities, and issues that we believe should be considered during the Sunset Review. The self-evaluation report is under development and will be submitted to HHSC to be shared with the Sunset Commission in August. This report will provide a thorough orientation of DFPS’s mission, function, history, funding, organization, and programs. The report will include evaluation of efficiency and effectiveness in doing business; whether the Council and Advisory Committees are functional; success in meeting mission goals and objectives; coordination with other agencies, possible duplication of activities, and the promptness and effectiveness of addressing complaints. The report will also identify policy issues that may impact agency operations and require resolutions through changes in state law that the sunset review may be able to assist with. During the evaluation process, Sunset staff will solicit input from interest groups, professional organizations and the public.
The result of the sunset review will be a report released some time between January and May with recommendations for statutory changes by the legislature and recommendations to improve internal operations. The Sunset Commission will conduct a public hearing where HHSC and DFPS will formally respond to the staff recommendations and for the public to also comment on the report that will be put forth by the Sunset Commission. The Council will be apprized of Sunset progress and will be able to hear public comment specific to Sunset Review at the July Council Meeting.
Commissioner Heiligenstein re-introduced Audrey Deckinga, the new Assistant Commission for CPS, who has many years of experience in the program and stated they are very fortunate to have her return to the agency, since she spent the last three years working for Dr. Charles Bell at HHSC. Commissioner Deckinga has brought back expanded knowledge in a number of critical areas including Medicaid and services to people with disabilities.
Ms. Deckinga stated that she appreciates her time at HHSC. She worked with the Department of Aging and Disability Services and learned a lot about state schools and long-term care and intends to use that knowledge here to assist the children and to work cooperatively with APS as well. She is very honored to be in this position; adding that the staff at DFPS are outstanding. Their commitment and dedication to protecting children is unparalleled, and she is pleased to be back and working with the Council, the staff and stakeholders again.
4.f. Chair’s Report on Council Members’ Activities – Ommy Strauch
Chair Strauch stated many of the recent activities of the Council members are listed in the Council binders. She said farewell to Rick Hoffman and to Judge Johnson, thanking them for their service. Chair Strauch noted that April is Child Abuse Prevention Month; blue is the color worn in observation of this month. She thanked all who are involved in CPS work and led the Council in a moment of silence in remembrance of the children who lost their lives this past year as a result of abuse and neglect. The Chair’s Report includes local events observing Child Abuse Prevention Month. Chair Strauch outlined work in the communities, and on behalf of the Council, she thanked CPS workers and local communities for their work.
Agenda Item 5 – Old Business
5.a. Recommendation to adopt rule changes in 40 TAC, Chapter 746, Minimum Standards for Child-Care Centers concerning the director’s qualifications and the age range of children in child-care centers* – Sasha Rasco, CCL
CCL Assistant Commissioner Rasco reminded Council members that this recommendation is for the adoption of proposed rules to clarify minimum standards for childcare centers concerning the director’s qualifications and the age range of children in childcare centers. The recommended rule change is a technical one needed to correct a publication error and an error in the age cut-off for services. No public comments have been received. The department asks that the Council recommend the rules be adopted effective June 1, 2009.
Mr. Hoffman moved that the council recommend for adoption by the HHSC the amendments to 746.1017, 746.1601, and 746.1609 concerning minimum standards for childcare centers as reflected in the Council’s April 17, 2009 agenda item 5.a. Judge Johnson seconded the motion. The motion carried.
Judge Johnson and Mr. Hoffman made farewell statements to the Council, and Ms. Strauch presented them with certificates of appreciation for their dedication and years of service.
Agenda Item 6 – Adjourn*
Chair Strauch adjourned the meeting at 11:27 am.
* Denotes Action Item