Seven hundred thousand children were neglected and/or abused in the U.S. in 2009, the latest year for which data is available. These children suffered from several forms of maltreatment, including neglect, physical and sexual abuse, and emotional neglect.[1] They are among the most vulnerable in our society, and federal and state governments make a significant investment to help them—about $25 billion for child welfare alone, which is just a small piece of what we spend annually on all public human services.
Unlike the private sector, agencies that provide public human services have been slow to adopt new technologies to improve services for the most vulnerable members of our society. As a result, most states and localities are using outdated and cumbersome technology systems (“legacy systems”) that impede effective management and result in a range of negative bureaucratic practices, including:
- Wrong Focus: poorly designed technology systems overly emphasize compliance instead of features that would enable workers to help children and families more effectively.
- Poor Decision Making: management is disconnected from real-time information. Lack of information and coordination leads to poor decision making about policy and resources and insufficient support for frontline caseworkers. At the front lines, workers do not have access to the real-time data that could help them make better decisions about keeping children safe.
- Frustrated Workforce: overworked and disengaged caseworkers often delay entering data into the legacy system, causing two problems: incorrect data entry, (to get to the next screen), leading to “dirty” data; and, decisions being made by workers and supervisors based on the partial or outdated data found in the system.
- High Turnover: stress on disconnected frontline caseworkers inflates turnover rates.
Taken together, it’s clear that outmoded case management systems bring out the worst in human services bureaucracies. Employees are required to spend up to 60% of their time as data entry clerks, agency managers focus solely on compliance, and the system is not responsive to or aware of the families it is meant to serve.
While these challenges are specific to public human services, they offer important lessons to both government and private sector organizations about how technology can improve management and help large organizations adapt to change.
Taking a bold first step to address this technology challenge in human services, Case Commons™ has developed a Web 2.0 case management tool that will revolutionize child welfare case management. This approach is designed to achieve a range of critical outcomes in child welfare management and practice, and has enormous potential to change public and private human services bureaucracies. Through an innovative and practice-oriented use of technology, Casebook demonstrates the power of technology to make organizations of all kinds more open and engaging.
[1] Child Maltreatment 2009. U.S. Department of Health & Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau. 2010. http://www.acf.hhs.gov/programs/cb/stats_research/index.htm#can.
As previously mentioned, the dated information management many human services agencies employ lead to four distinct management challenges:
- Wrong Focus
- Poor Decision Making
- Frustrated Workforce
- High Turnover
1. Wrong Focus
Out of date and burdensome technologies focus on compliance instead of outcomes for children and families. This leads to several misplaced priorities within child welfare agencies.
First, these legacy systems require caseworkers to spend hours filling out linearly organized screens instead of investing time working with children and families. These numbers are stark: anecdotal reports estimate that caseworkers spend between 50 and 80 percent of their time filling out up to 150 forms per child.[1] For some caseworkers, this is a pen and paper process, but for others it can involve entering data on as many as 800 linearly structured screens, (also called “green screens”), of legacy systems, while they receive little of value in return.
Second, legacy systems discourage caseworkers from collaborating and communicating with their peers in related departments. Because these systems don’t have built-in tools for collaboration, working together requires phone calls and in-person meetings, even for simple questions or advice. Caseworkers often are unable to edit or work simultaneously on a case.
2. Poor Decision Making
Clunky systems can contribute to situations where caseworkers and supervisors have to make critical, life-shaping decisions based on bad data. Agency managers often do not have access to data they can trust (let alone real-time data). This is because many frontline caseworkers are behind on data entry – which usually can only be entered via a workplace portal – or enter bad data as “placeholders” because they often are not able to move to the next screen until all required data on previous screens is completed. This means managers cannot spot trends quickly, deploy services efficiently, allocate funds effectively, and improve performance across jurisdictions.
In addition, because they are organized by “case” each agency or department has only a single piece of the picture, unable to fully grasp the realities facing an individual or family whose needs may cross into other parts of the system. For example, many families with children in the child welfare system have contact with at least one other human services agency such as juvenile justice or mental health services. This lack of coordination means children and families often do not receive all the services they need in an efficient manner and crucial services are delayed.
Casebook is organized by “family” and has the ability to loop persons into different groups, such as household, assistance group, or biological or chosen family. This method of organizing the data model is more efficient and accurate, reducing redundant data entry and enabling caseworkers from different agencies to view – if allowed by privacy laws – a more complete picture of the entire group of involved persons.
3. Frustrated Workforce
Frontline caseworkers pay an enormous price for being required to use out of date and demanding technologies, largely because these technologies do little to reduce the already unreasonable workload many frontline caseworkers shoulder.
Government surveys of state child welfare agencies have found that frontline caseworkers in many states experience more than double the recommended caseload,[2] with caseworkers having an average caseload of 24 to 31 despite recommendations that they only be assigned 12 to 15. One study found that, in some states, caseworkers have taken on up to 110 children each.[3]
Technology should improve efficiency, but the perverse reality is that the existing technology infrastructure does little to alleviate administration burdens—and often adds to them. These unrealistic demands mean frontline caseworkers have little time to devote to the work they have trained for and are passionate about—working with children and families.
Legacy systems amplify these burdens. Linear data entry and cumbersome data retrieval make these already demanding tasks overwhelming. Despite all of the time that goes into these tasks, caseworkers are often unable to retrieve or use this data in a timely, useful manner. The reality is that many of these legacy systems are so dated that young workers have often never seen the type of outdated technology they employ before becoming caseworkers.
4. High Turnover
Due to low morale and unreasonable workloads, child welfare has high levels of staff turnover. The Child Welfare League of America reports that, between October 2000 and March 2001, public agencies suffered a turnover rate of one in five (20 percent) for frontline caseworkers and almost one in ten (8 percent) for supervisors.[4] This results in an average tenure of less than two years. In some “hotspots” rates of attrition are even higher. A study of child protective services caseworkers in Texas in 2008 found that of the 38 percent of positions vacated from one year to the next—29 percent of previous caseworkers had quit and 4 percent were fired. Only 5 percent were promoted, and less than 1 percent retired.[5]
Technology plays a role in this revolving door. Because many legacy systems add to caseworker burdens rather than relieve them, they contribute to the persistent lack of appropriate staffing experienced in many agencies.
[1] Government Accountability Office. (March 2003). HHS Could Play a Greater Role in Helping Child Welfare Agencies Recruit and Retain Staff.
[2] Based on caseload recommendations issued by the Child Welfare League of America.
[3] Government Accountability Office. (March 2003). HHS Could Play a Greater Role in Helping Child Welfare Agencies Recruit and Retain Staff.
[4] Child Welfare League of America. (2008). CWLA 2008 Children’s Legislative Agenda: Child Welfare Workforce and Training. http://www.cwla.org/advocacy/2008legagenda04.htm
[5] Center for Public Policy Priorities. (February 4, 2009). A Better Understanding of Caseworker Turnover within Child Protective Services. Center for Public Policy Priorities.
One part of the solution is to build automated case management systems that support and fit into the day-to-day work of caseworkers and managers, encourage collaboration, provide the best possible data, and allow the needs of clients – the most vulnerable children and families – to take center stage. By focusing on users and shifting agency orientations from top-down (compliance focused) to outside-in (child and family focused), Web 2.0 technologies like Casebook can make sure that case management software facilitates good management instead of getting in the way.
Not only will these technologies contribute to better outcomes for children and families, but they can improve human services agencies, bureaucracies and management by providing frontline workers, managers and administrators the tools they need to:
- Empower Caseworkers
- Encourage Collaboration
- Promote Transparency and Trust
- Provide Real-Time Data and Decision Tools
Using tools that provide the best in Web 2.0 and emerging technologies to support and improve human services case management, it’s possible to directly enhance operations and bureaucracies in agencies in several distinct ways.
Empowering Caseworkers
User-designed software tools provide value for caseworkers and managers, helping them do their jobs better and see how their work contributes to the overall goals of their division and the agency as a whole. By facilitating and speeding up data capture, technologies like Casebook allow caseworkers to spend more time working with children and families – the mission of their work – and less time filling out data forms.
In addition, Web 2.0 technologies can make real-time, valuable data available to workers, so that it is something they can use, instead of something they enter and never see again. This means frontline caseworkers are able to use the data they have entered to make their own work easier –like search for a family member – and to collaborate with others.
Modern tools also allow caseworkers to immediately gain access to the resources they need to help children and families and to help system leaders understand what’s working, what’s not, and how to improve outcomes. For example, before a caseworker makes a decision about a case, through the use of predictive analytics, he can quickly and easily research what statistically has been most successful in other cases. Another caseworker can self-track her progress against agency goals and quickly find needed information by clicking on a suggested link.
Together, these technologies create a democracy of information, empowering caseworkers by allowing them to see how their work fits into the overall goals of the agency.
Encouraging Collaboration
Through built in tools for collaboration, technologies such as Casebook can allow all caseworkers and managers to work together using the same information. For example, electronically shared forms save time preparing for group meetings and virtual participation by some staff saves travel time. Caseworkers can also add information and make suggestions on cases—a capability missing from legacy systems.
Collaboration does not end within agency walls, either. Using modern technology tools, caseworkers can invite outside “collaterals” on a case, such as law enforcement officials, teachers and healthcare caseworkers, to appropriately contribute to cases, thereby providing richer information and encouraging a new level of contact between individuals important to the child and his or her family’s life.
Promoting Transparency and Trust
In many legacy systems, critical data are perceived as either unavailable or unreliable. Sometimes, case information is locked within reporting systems and cannot be easily retrieved. In other cases, even when caseworkers do have access to data, they may not trust these unreliable case management systems and choose to maintain their own lists of important information.
New technology introduces an unprecedented level of transparency, permitting managers and frontline caseworkers to jointly track agency goals and easily spot where caseworkers are succeeding or struggling. With real-time data, these technologies also help human services teams share and discuss insights with one another.
Providing Real-Time Data and Decision Tools
Using web-based, client-centered design and development in conjunction the powerful analytics tools that the newest technologies enable, data can be made available to individuals at all levels of an organization.
Any organization – whether in human services or the private sector – can leverage emerging technologies to improve management and bureaucracies. The first steps in embracing user driven technology solutions to management problems involve a shift in culture:
- Consider the Possible: take the time to learn about what new technologies exist and how they could help improve decision making, encourage collaboration and create a democracy of information.
- Understand that Technology Can Be Used to Improve Bureaucracy and Management: particularly in human services, managers tend to focus on compliance instead of how best to deliver services. With new Web 2.0 tools, technology can support practice, making it easier for frontline caseworkers to complete their work, and communicate with one another and for managers to keep track of work flows and make decisions.
- Create a Shared Vision of Technology Helping the Client: the success of new and disruptive technology projects depends on buy-in from all levels of the organization. For the Web 2.0 tools to be put to optimum use, it is critical that everyone within an organization understand how new technology can improve the lives of children and families, and enhance agency efforts.
- Define Objectives: managers must decide how systems will benefit from the new technology, how their own work will be improved, how the system will help caseworkers and, most importantly, how it will help improve results for vulnerable children and families.
- Focus on Users and Frontline Caseworkers: although they are the majority, users are often ignored when new technology is developed and deployed. Yet users input all the data that is used for all management analyses. Therefore, for any technology project to be successful, the system must meet the needs of users. The management benefits of newly designed, web based, user driven systems cannot be achieved without their input.
Technology now offers for human services the same promise it held for the private sector over a decade ago. Up-to-date and emerging technologies facilitate the use of best practices and make possible advances, such as integrated services, that seemed a distant dream a mere decade ago.
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