How can child welfare leaders safely decrease investigation backlogs?

Backlogs resulting from overdue child protective services (CPS) investigations are a threat to children’s safety and create stress for child welfare staff and leaders. For families who may be the subject of a lingering investigation, the uncertainty generates added anxiety. In addition, investigation backlogs introduce inefficiency into already-stressed systems and can be detrimental to permanency and well-being.1

Investigation backlogs often develop insidiously and can become embedded as part of agency culture and accepted as status quo. While clearing backlogs takes time and prolonged effort, doing so can lead to increased child safety, decreased staff and family stress, decreased worker turnover, and more effective use of caseworker time.

Contributing factors

Backlogs often result from a combination of several factors, including:

  • Hotline screening policies and processes: CPS staff in systems with broad screening policies and ineffective screening processes investigate a higher than necessary percentage of hotline calls. As a result of unreliable decision-making processes at the front end, time and resources are spent investigating cases that could have been screened out (and, alternatively, may miss those that
    need intervention).
  • Overworked investigators: Backlogs can be both a cause and a result of unmanageable workloads. Insufficient staffing, challenging workloads, and high turnover rates lead to overworked investigators, who may determine a child is safe but not complete the steps necessary to close the case given the pressure to respond to new investigations. In addition, investigators who do not have time to see a child and make a safety determination also leave the child at risk of harm.
  • Ineffective data monitoring and management of workflow: Jurisdictions that do not track open and overdue cases and do not strategically distribute investigations among investigators are at high risk for backlog.
  • Reactive and burdensome policies: In some instances, policy makers and jurisdiction leaders operate in crisis mode (“managing by fatality”). The response to child deaths and other critical incidents is one of firing staff or adding more policies (such as a new safety model or time-consuming documentation processes) that make the investigation process more cumbersome. This reactive approach creates a culture of fear and defensive practice leading to increased turnover and removals of children by caseworkers who are “erring on the side of caution.”
  • Outside influences: Outside influences, such as economic recessions affecting the number of available caseworkers and child maltreatment rates, can affect backlogs. Child deaths and other critical incidents, particularly those in which the child was already involved in the child welfare system, raise media attention and can increase the number of calls to hotlines.

Philadelphia’s experience
Philadelphia developed backlogs due in part to a confluence of events both in and outside of the child protection agency. One backlog developed when a high-profile child death resulted in increased media coverage, which increased the number of hotline calls and led to a new child safety model that took time for staff to learn. Later, the Sandusky case resulted in a spike in maltreatment reports (in part through media coverage and in part through expanding the pool of mandated reporters).

Strategies to approach and sustain backlog reduction

Jurisdictions that have successfully reduced backlogs and sustained their success have implemented simultaneous strategies within a broader, multifaceted approach tailored to the unique needs of their agency and system. Some agencies have found that their backlog was a symptom of larger systemic issues, such that addressing it was one part of comprehensive system transformation, while others have found that implementing targeted changes directly related to screening, assessment, and investigations have been sufficient. Ultimately, because the underlying causes of investigation backlogs vary from one jurisdiction to another, one-size-fits-all solutions have not been effective.

Leadership has to have their hands in this and personally lead this charge. You have to make this urgent, and you have to show staff as a leader that you’re willing to get deep in it with them.… We had calls every Friday at 7:30 a.m. I led those calls personally.

– Jeff Lukich, DLH Corporation (formerly of Georgia Division of Family and Children Services)

Identify root causes

Once a backlog has been identified, an important first step is determining the factors at play. Conducting a root cause analysis (including a thorough review of data and discussions with staff at multiple levels) ensures that the strategies developed to address the backlog match the particular problems and needs of the agency. Increased attention in the short term can decrease a backlog, but a backlog will always recur if the root causes are not accurately identified and addressed.

In Oklahoma, after systematically working through a large backlog with an all-hands-on-deck approach, the backlog began increasing again as soon as agency leaders stopped focusing on it. They realized they had not taken the time to analyze the drivers of the backlog, incorrectly assuming it was due to a staff shortage. While developing plans to address the second backlog, agency leaders discovered a root cause: lack of expectations around case closures. There were expectations around the number of open cases a CPS caseworker could have at one time, but there was no expectation around how many cases they should close per month. Some closed two cases per month, while others closed 10. Oklahoma then developed an expectation about the number of investigations each caseworker should close per month, which now contributes to their success in keeping the backlog minimal.

Prioritize leadership involvement

Jurisdiction leaders who have led their systems through the successful elimination of a backlog have been actively involved in all aspects of the process, consistently communicating the message that safely eliminating the backlog is everyone’s responsibility. Leaders have experienced success when they have sought to inspire staff at all levels of the agency, encouraging, supporting, and championing their teams as they work through the backlog, and maintaining an engaging message regarding the importance of reducing the backlog to ensure children’s safety. Effective jurisdiction leaders do not dictate the details of how the backlog should be tackled; rather, they provide support and resources to field offices as they develop and implement local solutions. 

Successful leadership strategies to reduce backlogs have included visiting offices in person to check in with staff and provide support, leading or attending regular check-in calls, and tracking the details of backlogged cases. Close involvement of leadership throughout the backlog reduction effort also makes it easier to address needs (such as staff reallocation or overtime authorization) as they arise.

Examine and continually monitor data

Caseworkers, supervisors, and managers often do not have effective mechanisms to accurately track and monitor caseloads, including determining the number of open and overdue cases. In addition, there may not be a statewide, centralized database for agency leaders to use to assess case progress in real time. Having this data easily accessible through timely reports or dashboards is critical for monitoring progress and deploying resources where they are most needed.

A manager or director can use these dashboards to identify where the backlog is highest and focus efforts in those locations. Once the backlog has been successfully reduced, leaders will want to create and maintain mechanisms for the ongoing and regular daily or weekly review of data. They will also want to set some thresholds, where going above a certain threshold kicks in a new set of processes to prevent the backlog from growing again.

When New York City was working through its backlog, agency leaders relied heavily on weekly reports that provided information about open cases at the caseworker, supervisor, and manager level. These reports allowed managers and deputy directors to clearly see where the backlog was highest so they could identify barriers and target resources as needed. Managers could also see their progress compared to other units, which resulted in a friendly competition that boosted their progress.

We’re freeing up capacity by getting those cases closed quicker, with reduced documentation. We’re getting them closed quicker because there’s an easier route to get to a supervisor to actually get those cases closed. We’re freeing up the capacity of the local caseworkers to [handle] unsafe cases in a timely manner.

– Mark Tschampl, Idaho Department of Health and Welfare

Consider temporary or permanent staffing changes

A variety of staffing models have been used to successfully work through backlogs. Some jurisdictions instituted temporary voluntary or mandatory overtime, while others hired temporary staff or reallocated existing staff for a period of time.

Los Angeles explored the use of overtime to ensure it was being managed as effectively as possible. Leaders discovered that the staff who were using overtime were not necessarily the most efficient. In close cooperation with the union, leaders identified staff who did not have a backlog and had not been using overtime. These efficient workers utilized overtime to address the backlog in their respective offices.

Other jurisdictions hired temporary caseworkers and relied heavily on case aides for administrative tasks associated with closing cases. In Georgia, caseworkers from counties with lower backlogs were temporarily deployed to counties with higher backlogs. Oklahoma created multiple strategies to provide additional support for frontline staff, including a program called “Backlog Buddies,” in which experienced child welfare staff from across the state volunteered to assist staff struggling with a backlog.

Key information to include on a CPS dashboard:

  • number of open assessments
  • number of open investigations
  • number of overdue assessments
  • number of overdue investigations
  • length of time open
  • due date of assessment
  • status of case in terms of reaching a safety decision (for example, pending initial contact or waiting for collaterals)
  • closure rate (number of assessments closed per month)
  • target number of cases closed per month
  • number of alleged victims who have not yet received an initial contact
  • staff vacancy rate
  • use of overtime

Implement temporary or permanent policy and practice changes

Jurisdictions working through backlogs also implemented policy and practice changes, some of which were temporary and some of which ultimately became permanent. Many of these changes involved the assessment and decision-making process. New York City, for example, revised policy so that if a family needed services but the investigation was not yet complete, the ongoing services team would accept the family and begin services while the investigation continued. After implementing hotline-guided decision making (similar to structured decision making), Philadelphia began diverting cases with no active safety threats to the prevention unit so families could receive needed supports, such as emergency financial assistance.

Georgia found it useful to streamline documentation requirements, implementing the Situation-Background-Assessment-Recommendation process (commonly used in health care). In addition, the state instituted a waiver process, in which all cases open more than 45 days required a waiver approved by a regional director. This approach motivated caseworkers to complete cases so they wouldn’t have to request a waiver, and kept leaders engaged because they were required to sign a statement attesting that they personally waived the case to stay open for investigation.

Arizona implemented a permanent change in the way offices manage reports of maltreatment. They created groups of three neighboring offices (called “geo groups”) which help each other out with investigating reports. If one office has a high level of vacancies or a high caseload overall, it shifts some of its reports to one or both of the other offices. The three geo groups communicate with each other throughout the week via a shared electronic document.

The energy, effort, and tools to reduce a backlog is significantly different from the energy, effort, and tools that it takes to sustain it.

– J Michael Faust, Arizona Department of Child Safety

Host regular meetings focused on the backlog

Standing meetings (recommended at a weekly cadence) during which the backlog is discussed in detail ensures appropriate focus on the backlog. Guided by data, these meetings allow for regular monitoring, checking progress toward targets, sharing of strategies, and, often, friendly competition. When Oklahoma was reducing its backlog, directors reported weekly about what their team had committed to, what barriers they removed, and what barriers they were committed to removing the following week. After resolving the backlog, these meetings can be repurposed for sustainment discussions.

Idaho: A collaborative approach to child safety
Idaho decreased its backlog — and has sustained the decrease — in large part due to changes in the assessment process, including dedicating a centralized group of supervisors to helping investigators close out safe cases. Idaho implemented a comprehensive safety assessment model to determine which cases were safe — those that did not need an investigation — and which were unsafe, those that needed an investigation. When a case is determined to be safe, the safety assessor can call into the centralized consultant group to discuss and close the case. (Cases in which a child is unsafe stay with the local supervisor for coordination of transfer of case management and services). During the call, the safety assessor presents the case findings, and the consultant annotates the case and closes it in the system in real time. This allows safety assessors to reach supervisors much more quickly because local supervisors are not always available. This model has resulted in a huge turnaround for Idaho, with both the average length of time to closure and the average caseload among investigators decreasing significantly.

Engage in clear, consistent two-way communication

Having a structured communication plan that allows for two-way exchange is also critical. This includes providing regular, detailed, and consistent messaging that conveys a sense of urgency and allows staff to see and celebrate their progress. Given that policies and practices may change as part of the backlog reduction effort, clear policy and practice guidance needs to be communicated as well. This process involves soliciting feedback from staff regularly — and in particular at the beginning of implementation — so that procedures can be adjusted as necessary. Not only will staff be more invested in the process, but the process can be improved based on their input.

Partner with the labor union

Engage the union as a partner. When Los Angeles was addressing its backlog, jurisdiction leaders and staff worked closely with the union, meeting in person monthly to track data, identify systemic barriers, and develop strategies to overcome barriers. The union was included as a partner from the beginning, with the recognition that it would not be possible to overcome the backlog or sustain improvements without effective collaboration.

Focus on prevention

One potentially powerful long-term solution to prevent investigation backlogs is to move upstream, decreasing the number of hotline calls coming in by strengthening local communities, supporting a range of different prevention programs and supports such as Family Resource Centers, crisis nurseries, and home visiting.

These reports represent kids and families.… We needed to re-message and help staff understand that it wasn’t just about getting something done but it was also about the safety and well-being of families and children.

– Zeinab Chahine, Casey Family Programs (formerly with New York City Administration for Children’s Services)

Key considerations

When developing and implementing a plan to reduce a backlog, keeping the following considerations in mind can help ensure long-term success.

Ensure children’s safety and well-being

That children’s safety is paramount must be communicated to staff clearly and often. While reducing the number of backlogged cases is an urgent priority, leaders do not want staff to get overly focused on numbers, forgetting the children and families behind the numbers. Although staff are responsible for documenting the steps they take, their work should not reflect a transactional approach with children and families, and leaders should emphasize the special vulnerabilities of infants and toddlers when prioritizing efforts.

Sustainability is critical

Because backlogs generally develop quickly without being noticed, each leader in the chain of command (or their designee) should be assigned to monitor for backlog at all times. An agency may choose to establish a threshold above which a process is triggered to ensure the backlog doesn’t continue to grow unchecked. Leaders have found it helpful to include backlog prevention in Continuous Quality Improvement plans and to develop accountability structures that are formalized in policy and practice standards.

Take time to plan first

Tackling an investigation backlog can feel like a high stakes, high pressure race. However, leaders who have successfully eliminated backlogs caution against addressing it too quickly or through heavy-handed administrative measures. Although having a backlog is an urgent situation, taking the time to identify the primary reason(s) for the backlog and to create protocols that address root causes will pay off. Assembling a workgroup with representatives from multiple departments, including hotline, investigations, ongoing/in-home services, human resources, technology, facilities, and training is a first step toward identifying root causes and developing an effective backlog reduction workplan. A jurisdiction may need to develop immediate ways to address the backlog to move the workload to a comfortable level, but it will also need to put policies in place that ensure progress is sustained over the long term.

Rethinking the status quo may be necessary

Jurisdiction leaders and staff can become so used to having a backlog that they don’t even realize the problem; and the more the backlog builds, the more overwhelming it is to consider addressing it. Educating leaders and staff about the negative repercussions of a backlog and sharing case studies of jurisdictions that have successfully reduced their backlogs can help agencies understand that it is both prudent and possible to address the issue.

Reframe “accountability” through principles of safety science and safety culture

In addition to changing agency norms so that backlogs are no longer considered part of “how we do business,” jurisdictions may need to move from a culture of compliance and blame to one focused on quality performance and accountability. Staff are often afraid of the word “accountability” because they equate it with punishment. Reframing accountability as a two-way process to ensure staff receive needed support, rather than as a punitive measure, can help staff at all levels overcome this fear.

Some agencies are also integrating the principles of safety science to look at systemic factors and balance system responsibility with individual accountability. Applying safety science principles to create a safe environment to proactively identify and address system vulnerability and avoid reactive and blameful approaches has the potential to improve outcomes for families and children. 

Address staff turnover and morale

Having a large backlog can make staff feel overwhelmed, hopeless, and frightened. Stress and fear lead to increased turnover, which not only impacts progress in decreasing the backlog but is costly, as the jurisdiction then needs to invest in hiring and training new staff.

When working to reduce a backlog, noticing and celebrating both small and large successes helps staff feel that their efforts are paying off and can encourage them to continue their work. Simple gestures such as lunch parties or doughnuts on Saturday mornings can improve staff morale. In Arizona, letting staff know the moment they had achieved “net zero” (that is, the backlog was stabilizing rather than continuing to increase), provided a sense of relief and increased staff motivation. Several jurisdictions noted that positive peer pressure created a sense of healthy competition, which increased the momentum as staff worked through backlogged cases.

Watch for unintended consequences

Several leaders cautioned about the unintended repercussions from an intense focus on backlog reduction. In Philadelphia, for example, the agency focused so intensively on reducing its backlog that it “lost sight of permanency” and ended up with a significant number of children in care for long periods of time.

Finally, leaders expressed the importance of creating a sustainable long-term strategy, instead of dependency on short-term resources that had been deployed to clear up the backlog.

1 Based on interviews with Anne Marie Ambrose, Casey Family Programs, September 9, 2019; Zeinab Chahine, Casey Family Programs, September 20, 2019; Brian Clapier, Casey Family Programs, September 16, 2019; Jackie Contreras, Casey Family Programs, August 19, 2019; Dan Cowan, Casey Family Programs, and Jami LeDoux, Oklahoma Department of Human Services, August 21, 2019; Michael Faust, Arizona Department of Child Safety, October 21, 2019 and November 8, 2019; Matt Gebhardt, Casey Family Programs, August 21, 2019; Jeff Lukich, DLH Corporation, September 3, 2019; and Mark Tschampl, Idaho Department of Health and Welfare, September 25, 2019.

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This strategy brief outlines how Arizona engaged in an intensive, multi-pronged strategy to reduce its investigation backlog.

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READ STORY

Hawaii employed various strategies to earn buy-in from staff and community stakeholders during its transition to a centralized hotline.

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This strategy brief outlines strategies for how CPS agencies can screen-in reports of infants and toddlers in a way that keeps them safe.

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This document provides key themes and lessons learned from five states on practices involving intake screeners in their child welfare systems.

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Dr. Rhema Vaithiananthan and Erin Dalton provide an overview of predictive risk modeling and its applicability in child welfare to support decision-making at the hotline.

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