Working Draft Last Modified 2/11/2008 11:50:44 AM Pacific Standard Time

Printed 1/29/2008 5:04:34 PM Pacific Standard Time

Child Welfare Staffing Study

State of Oregon Department of Human Services (DHS)

Presentation to Oregon State Legislature

February 2008 Special Session

EXECUTIVE SUMMARY

• Situation: Increasing workload for Child Welfare (CW) caseworkers. Over the last several years, workload (per case) has increased due to increasing safety requirements and federal regulations. Workers seem to find themselves in a negative cycle that leads to suboptimal client outcomes and frustration.

• Approach: An activity-based (vs. case-based) workload and staffing analysis was performed. This study assessed workload per case at the caseworker level, based on a combination of (a) direct observations, (b) focus groups, and (c) a time survey of more than 1,000 caseworkers. The analysis provided a view of average time and activity demands, as well as variations driven by case types and differences across regions/branches

• Conclusion: A gap of 24 to 37% may exist between today’s staffing capacity and actual CW workload requirements. The gap, which assumes current processes and tools, is driven by work not being done today, significant overtime of caseworkers, and re-deployment of supervisors to case activities

• Implication: It would probably take a combination of levers for DHS to address this gap. First, the gap could be addressed by improving the efficiency of operations, and by reviewing procedures and policies for effectiveness and consistency in their execution. Some staffing increase may ultimately be required to close the gap entirely

DHS has engaged McKinsey & Company as independent advisors to help quantify the workload gap discussed in this presentation. DHS will consider McKinsey & Company's findings as it decides on how to address the identified gap.

Adoptions finalized within 24 monthsChildren reunified within 12 monthsChildren contacted face-to-face within 30 days

CW DOES NOT ACHIEVE MANY OF THE OUTCOME-RELATED FEDERAL PERFORMANCE TARGETS TODAY

Source: CAF Dashboard Report December 2007

Share of timely of CPS responses Share of timely CPS assessments

Target

85.078.482.074.8

Dec 06 Mar 07 Jun 07 Sep 07

71.171.670.268.9

Dec 06 Mar 07 Jun 07 Sep 07

54.952.854.1

Mar 07

54.7

Jun 07 Sep 07Dec 06

Cases of repeated maltreatment within 6 months

Cases of foster care re-entry within 12 months

9.17.3

Dec 06

n/a

Mar 07 Jun 07

n/a

Sep 07

10.110.39.6

n/a

Dec 06 Mar 07 Jun 07 Sep 07

80.676.377.4

Dec 06 Mar 07

80.8

Jun 07 Sep 07

6.1

100.0 100.0

100.076.2

8.6

Performance (state-wide)

Improvement direction

32.0

Percent

19.331.1

17.8

Dec 06

n/a

Mar 07 Jun 07 Sep 07

DHS DOES NOT RANK AMONG TOP U.S. STATES ON IMPORTANT CHILD WELFARE OUTCOME MEASURES

Oregon

Source: CFSR statewide assessment 2007; Final Report: Oregon Child & Family Services Report 2008

Highestquartile

Timeliness and permanency of reunification 29 1

Timeliness of adoption24 1

Permanency for children and youth in foster care for long period of time 16 1

Placement stability 30 1

National ranking of states, 2005

Composite measures

47

47

51

51

Rankings from most recent CFSR report (2005)

Lowestquartile Median

Oregon did not achieve “substantial conformity” in any of the 7 client outcome measures assessed in the Final CFSR Report published in February 2008

TWO NATIONAL REPORTS HAVE RAISED CONCERNS ABOUT THE WORKLOAD OF OREGON CW CASEWORKERS

Source: "Oregon Children, Adults, and Families – Expert Review of the Safety Intervention System", authored by NRCCPS and ACTION for Child Protection (2005); "Technical Assistance Report for the State of Oregon Department of Human Services", authored by L. Arnold, P. Devin, and S. Webster from NRCOI (2006)

• “Within the last decade, (CW) workload demand has increased considerably with nothing taken away”

• “With caseloads exceeding 20 per worker, it could very well be that workers are being expected to do 2–3 times what reasonably can be expected given the complexity and demands for each case”

NRCOI report, 2006

• “In general, staff are dedicated and competent, but in many instances they struggle with heavy workloads and insufficient resources. Many are frustrated with inefficient processes and automated systems that don’t work”

Holder report, 2005

Examples of new 2008 policies/procedures Examples of new 2007 policies/procedures

• Oregon Safety Model– CPS response to reports now within 24

hours in most cases instead of 5 days previously

– Protective Capacity Assessmentmore comprehensive, rigid, and evaluative than the previously used process

– More cross-functional cooperation required to ensure “safety through the life of a case”

– Foster family visits twice a year instead of once a year

– 15 hours training for foster families instead of 10 hours previously

• Senate Bill 412– Notification of all relevant parties in case

of neglect/abuse report regarding children currently in foster care

• Senate Bill 414– Proof of diligent efforts to reunify children

with families in regular court hearings– Higher frequency of supervised visits– Documentation of children’s academic

performance as part of regular court reports • House Bill 3113

– Review of certified child care facilities based on same standards as foster care certification

WHILE MAKING CHILDREN IN OREGON SAFER, CHANGES IN REQUIREMENTS HAVE ALSO INCREASED WORKLOAD DEMAND

*Passed in 2007, the Bills referenced below went into effect by January 1, 2008 as Oregon Revised StatutesSource: Interviews

IN RECENT YEARS, NEGATIVE CYCLES HAVE WORSENED THE GAP BETWEEN WORKLOAD AND STAFFING CAPACITY

How can the cycles be stopped sustainably?

• One-time effort to create “neutral” starting point – attempted by caseload adjustment 2007

• Continuous improvement of process efficiency to create “space” before new triggers hit

• Regular time studies and employee satisfaction studies to identify issues early on

Overall more work per case*

Less hours per case

Less effective service

Less satisfied workers

Higher turnover and sick leave

More workload

per worker

Less experienced workers

External trigger – e.g., new initiatives or policy requirements**

Negative cycle of

workload inflation

Negative cycle of worker

frustration

Increasing workload per worker drives the negative cycles

*Cases stay longer in the system, escalate to become critical, or get closed early but re-enter the system later on**There may be a third negative cycle related to legislation: High workload could increase the likelihood of individual high-profile incidents that may trigger new bills by legislature, which may in turn increase workload not only directly related to the specific risk but also in neighboring areas

Source: Interviews

CONCEPTUAL

More time for each case

More effective service in given time

Higher employee satisfaction

Less workload per worker

THERE ARE MANY WAYS TO STOP THE NEGATIVE WORKLOAD CYCLES AND ACHIEVE BETTER OUTCOMES FOR CHILDREN

Higher effective-ness of individual workers

More time for casework

Lower “actual” caseload

Higher share of effective workers

More effective processes

More efficient casework

More training

More clinical supervision

More peer support

Less time on non case-related work

More administrative and casework support

More specialization among caseworkers

Less sick leave

More caseworkers

Less vacancies

Faster ramp-up of new workers

Less turnover

Better selection of workers

More effective policies

More effective internal procedures

More standardized local execution

Simplified processes

“Front-loading” to avoid waste downstream

Higher individual efficiency

Adding case-workers is only one of many ways to reduce workload

STAFFING ANALYSIS WAS DEVELOPED THROUGH A RIGOROUSFACT-BASED ASSESSMENT OF ACTIVITY DEMANDS

Analysis of resultsTime activity surveyProcess mapping

Objective • Synthesis of current situation

• Map of relevant casework processes

• Quantified times spent on caseworker activities from sample period

• Data on complexity drivers

• Total workload in CW casework

• Model to adjust capacity demand over time

Approach • Conduct field visits to 5 locations (Ontario, Eugene, Roseburg, Portland, Salem) to understand situation

• Conduct focus groups with participants from all districts to map casework processes

• Develop comprehensive time activity survey for caseworkers and CETs

• Syndicate survey with district managers, program managers, supervisors, and focus groups

• Respond to caseworker questions on the survey

• Remove outliers and analyse activity times

• Work with team of field and central office managers to quantify work that does not get done

• Develop staffing model• Write and syndicate

final report

More than 120 caseworker activities and responsibilities mapped for different roles

1,041 completed surveys received (80% participation rate), equivalent to 3,100 worker days

Workload-based staffing model quantifying capacity gap in CW casework

Product

Dec 12 Dec 31 Feb 15

TOP-LEVEL INSIGHTS ON HOW CASEWORKERS SPEND THEIR TIME TODAY SHOW AREAS FOR CONSIDERATION

• Limited face-to-face time. Caseworkers in Oregon spend less than 30% of their time working directly with clients and collaterals, compared to, for example, 37% in the state of Washington

• High variation. Time spent on different tasks varies across districts, indicating potential opportunities for efficiency improvement and sharing of good practices

• Differences in offices and cases. Workload is partly driven by office characteristics – e.g., the ratio of SSAs and caseworkers, and local case mix – e.g., the share of ICWA cases

• Overtime. DHS caseworkers work significant overtime in the performance of their jobs – and only a part of the overtime is officially claimed

• Impact on outcomes. Districts facing a higher workload in general achieve lower client-related performance outcomes

Source: Time activity survey

CURRENT GAP BETWEEN CAPACITY SUPPLY AND WORKLOAD DEMAND MAY BE 24–37 PERCENT

100

Current capacity*

Performwork notbeingdone today

Meetadditional 2008 policyrequirements

Raiseservicequality

Relieve supervisors of casework tasks

Reduce caseworker overtime

124–137

Workloaddemand assuming current processes

*Actual SS1, SSA, and CET FTEs counting double-filled positions as 2 FTEs – i.e., real capacity in terms of available worker hours per daySource:Time activity survey; HR and budget data; interviews

% current capacity

1 2 3 4 5

Workload gap of 24–37% could be closed by

• Improving efficiency

• Reviewing procedures and their execution

• Adding 35–53% more FTEs, or

• Any combination of these

Work being done today…using current processes and tools

Gap to…

17–23 1–23–4 0–3

3–5

ESTIMATES

DHS FACES A SET OF OPTIONS TO ADDRESS THE WORKLOAD GAP IN THE SHORT AND MEDIUM TERM

* Addressing remaining 7% workload gap would require 10% more staff

1. Operational efficiency improvements

3. Fill remaining gap with additional caseworkers

Lever/option

Possible combination to close a workload gap of 24%

2. Reduced workload requirements in procedures and policies

Rationale/description

• Initial analyses indicate significant inefficiencies and redundancies in current processes

• Each 1% of gap not fixed by policies and efficiencies requires ~1.4% more FTEs due to non-available time

• Some procedures and policies may be overlapping or not consistently executed today

Preference

Up to 17% workload reduction may be possible

Closing the remaining gap would require at least 10% percent more FTEs at same case demand*

ESTIMATES

Recruiting foster parents

Matching children and families

Time related to foster care

Investing in prevention and resource recruiting “upstream” – either internally or through closer cooperation with community partners – could reduce workload for CW caseworkers “downstream”

~0.5~1.0

>30.0*

LARGER TIME INVESTMENT IN UPSTREAMACTIVITIES MAY RESULT IN EFFICIENCY GAINS DOWNSTREAM

Time investmentPercent of total time of all caseworkers

*Estimated using time for permanency work and share of subcare cases

Source:Time activity survey

EXAMPLE SUB CARE PLACEMENT

CLOSING THE REMAINING GAP BY ADDING FTEs REQUIRES UP TO A 1.42% INVESTMENT PER 1% WORKLOAD GAP

Other time off*Sick leave Vacancies**

TrainingOther non case-related work***

Case-relatedtime

70

Paid on-call timeBreaks

100% = 8 hoursShare of case-related time strongly influences overall capacity demand in a staffing model

Number of FTEs

Case-related workload [h]

Available time per worker [h/FTE]

=

Closing a workload gap of 1% requires 1.42% more FTEs

Percent

* Including both paid and unpaid leave**Has historically been significantly higher, up to 12% *** For example, general email and phone calls; general staffingsSource: Workload activity survey of CW caseworkers; HR and budget data; interviews

PRELIMINARY

DHS WILL ANALYZE CW EFFICIENCIES FURTHER AS PART OF THE BROADER TRANSFORMATION INITIATIVE PHASE 1

Next steps

Transformation initiative Phase 1

• Finalize CAF baselining• Continue development of

Wave 1 hypotheses• Continue external benchmarking

Child Welfare Staffing Study

• Finalize analyses• Write final report• Train selected CAF employees on

using and updating the staffing model

Feb

2007

MayJanDec Mar Apr

2008

Child Welfare Staffing Study (Phase 3)

Steering Committee Reviews

Today

Task/deliverable

TASK ONE: Benchmarking

TASK ONE: Base lining

TASK TWO: Strategic Improvement Plan

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CURRENT GAP BETWEEN CAPACITY SUPPLY AND WORKLOAD DEMAND MAY BE 24–37 PERCENT

100

Current capacity*

17–23

Performwork notbeingdone today

1–2

Meetadditional 2008 policyrequirements

3–4

Raiseservicequality

0–3

Relievesuper-visor timeof case-work

3–5

Reduce caseworker overtime

124–137

Workloaddemand assuming current processes

* Actual SS1, SSA, and CETFTEs counting double-filled positions as 2 FTEs – i.e., real capacity in terms of available worker hours per daySource: Time activity survey; HR and budget data; interviews; McKinsey analysis

% current capacity

1 2 3 4 5

Workload gap of 24–37% could be closed by

• Improving efficiency

• Reviewing procedures and their execution

• Adding 35–53% more FTEs, or

• Any combination of these

Work being done today…using current processes and tools

Gap to…

ESTIMATES

Quantify the workload gap and its influencing factors

Quantify efficiency potentialto close the workload gap