Over the last 30 years I have worked to implement case management systems, advocating for innovative, well-designed technology. With great state partners we implemented mobility solutions, new portals for intake, imaging solutions, forms engines, ever more interfaces and creative dashboards, and reporting tools. It was great work. There was nothing more rewarding than celebrating a roll-out with cake, speeches, and hugs (remember hugs?) to celebrate the great collaboration.
Surprisingly, with each new system, the child welfare outcomes didn’t significantly improve. The caseworkers thought the systems were too complex, took too long to use, and said “meh.” This experience isn’t unique. Unfortunately, child welfare systems across the country haven’t fundamentally improved child welfare. What were we all doing wrong?
Why were we failing to fulfill the promise of new technology? The answer: We did not address the fundamental problems of child welfare.
The new promise of CCWIS is to build systems that support and coach and help caseworkers move the work.
As we build the next generation of Comprehensive Child Welfare Information Systems (CCWIS), it’s critical that we embrace a new promise. A promise that our technology systems will no longer be mere failure trackers focused on deadlines but rather success coaches that help to improve visibility, case flow, and give staff back the capacity they need to improve outcomes. It’s time for what’s next.
The Challenges When Automating Child Welfare
There are three fundamental challenges we face when we build child welfare systems. When not addressed, we resort to tracking lists of tasks and deadlines and focus on compliance and failures, which are poor substitutes for improvement.
The Work Is Largely Invisible
Casework isn’t visible to managers. The caseworker knows what’s happening, but no one else does unless they happen to ask. Until something happens, or a deadline passes, there is very little visibility. There are two key reasons for this. First, there is so much variability in the processes. Each office does things differently. Supervisors have ways they want the work to be done, or an office stopped using a certain form, or someone comes up with a better way to use a system, and it adds to a virtual fog. Significant variation blurs the big picture. Second, the true status of a case sits buried in forms or notes that no one has time to read. And you can’t manage what you can’t see. All we see is piles, but we have no idea what’s in those piles. Without visibility, you can’t know what’s coming, or actively manage in order to avoid a crisis.
There Isn’t Enough Capacity
Child welfare faces a capacity crisis. From analysis across seven states, nearly every critical business function is operating at 25 to 50 percent below the staff capacity they require to complete the work they are asked to do. That’s a significant short.fall and challenge. When you don’t have time to keep up, staff is forced to cut corners, spend less time with families, produce lower quality documentation, and leave safe kids in care longer.
Each new generation of the system collects more data, is more comprehensive, and requires more from staff. Saving a few clicks won’t make up for the profound lack of time caseworkers have to complete their work. Beyond the inconsistencies, the processes grow ever more complex, are filled with activities to document and protect the user, and aren’t well aligned with the needs of the client or customer. The systems aren’t designed for caseworkers. They are designed for accountability and the increased burden isn’t a primary concern or even a consideration when systems are developed.
The Work Sits
Cases should always be moving at the speed of the family. But they don’t. They wait on courts, they wait on staff, they wait on services, and they wait on approvals. Most of these systems don’t know what needs to happen next. They alert only on deadlines. Agencies pay a substantial penalty for work that sits. But nagging staff for being late on less important tasks doesn’t help get more cases to closure. The question that we need to consider when developing systems, but often fail to do, is, “What should drive our caseworkers—dead.lines or urgency?”
The systems provide dashboards for active cases by worker, but they are bland lists—lists of contacts, lists of approvals, lists of court dates, and lists of lists. The lists, however, don’t move the cases and work piles up in unseen corners. Again, when developing systems, we have often forgotten to ask, “How do you know what is most important, and what comes next for each case, and how you can best intervene?”
What’s Next, A New Promise
The new promise of CCWIS is to build systems that support and coach and help caseworkers move the work. We can begin to anticipate and fix bottlenecks before they cause issues and provide capacity so that staff has the time to complete the work.
An effective CCWIS should make the work visible to everyone. From the front line to the central office, everyone should be able to see the size and scope of what needs to be done and, most important, what needs to be done next. All we know today is that Bernadette has the case, she has lots of other cases, and many things are late. For every case, we need to provide clear insights regarding what needs to happen now, what is scheduled, what the next milestone is, who is involved, and what are the barriers to progress. Not every case is the same, and knowing the intended direction is crucial. For example, what if there was a shortage of drug treatment? It means that placements would likely extend until the service was avail.able. That has a significant impact across an office where dozens of cases may be held up in a bottleneck due to a limited-capacity service. With clear visibility, you can manage that challenge. The system has to put this information up front for you to see when you access a case, review a unit, or look at an office, and to provide the visual status so you can manage cases by situation.
Working with states on “visibility engines,” we can provide detailed, actionable status on every case, and with active management, it results in backlogs being cleared. Leadership meetings can be structured to deter.mine what needs to be done to close things out. More important, what are we waiting for? In one state, this allowed a child welfare agency to reduce the number of open safety assessments by 85 percent, sustain that improvement, and their management team now knows precisely why each assessment remains open.
The way to increase capacity is by reimagining your current processes and rethinking how the work can be completed while still managing risk. For example, an assessment or investigation generally takes 30–45 days to close. But the actual work time is closer to 20 hours. Why do we take so long to close the case? It’s because we are waiting. We’re waiting on collaterals, waiting on schools, waiting for drug screening results, and waiting to document decisions. If we can arrange the work to minimize the waiting, we gain capacity. We can also design processes that differentiate work by case type. Situations where a child is clearly safe can be managed differently than other cases, building even more capacity, and standardization also improves visibility.
The results when you build capacity in child welfare are staggering. States that have focused on capacity have found that they can generate more than 80 percent more capacity in assessment, allowing them to real.locate 25 percent of their staff to permanency while reducing subsequent substantiations by 45 percent because they spend the right time with the right clients. They even see a 65 percent reduction in reunified children reentering care because they have the capacity to make better decisions. All of the efforts to protect themselves and waiting rob our workers of the vital capacity they need to make critical decisions impacting children’s well-being. Process design—done before or in concert with CCWIS—should clear the way for workers to make this increase in capacity happen.
Make it Smart
Technology should make our process smarter, meaning it should tell us things we would not know without it. By providing intelligent status and notifications, the system can inform the team working on a case about what’s next for the family and child. It can help evaluate and anticipate what needs to happen to meet case goals or key events. What has to be completed before the next court date? Is a case behind or ahead of the case plan? Do we have indications that parents aren’t cooperating, and what will that do to reunification targets? These are active case management insights. Today, the actions and insights that move a case are buried in forms and the implications can be lost. We need to bring these issues to the forefront. We need smart process support to tell us what is next.
We can also make systems smart by leveraging data from outside the agency to monitor for changes in families and coach the caseworker about when they should act. For example, we can look for changes in life circumstances that may impact our ability to reunify. If a protective parent has lost their job, has no transportation options, has become homeless, had a law enforcement action, or stopped participating in WIC, we can highlight the opportunity to make contact. By using these smart tools to provide coaching and risk mitigation at the right moment, we can eliminate blind spots.
The Time to Commit to the Promise Is Now
With this focus on a new promise, we can pursue CCWIS projects that transform child welfare. In the states that are embracing this new promise, it’s already starting to pay off. Capacity is up, cases move, fewer children are in care, and there is more time to focus on higher risk families. It’s a change that is long overdue. We can’t let this opportunity pass. Let’s promise not to build more failure tracker systems. We must move beyond compliance and provide needed supports.
Instead, let’s build CCWIS solutions that can coach workers to success with solutions that help us be stronger, faster, and achieve more. We must focus on making the work visible, dramatically increasing capacity, and then build smart coaching supports. By addressing the real process problems and tackling them with the new promise of technology, we’ll throw a go-live celebration for the ages. We can elbow bump, and the cake will be delicious. We are overdue for what’s next.
*Originally published as A New Promise for CCWIS (Policy & Practice, August 2020)