Child Welfare Staffing Study

1. Child Welfare Staffing Study State of Oregon Department of Human Services (DHS) Presentation to Oregon State Legislature February 2008 Special Session

2. WCO-OHR001-20080118-03 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.

3. 19.3 WCO-OHR001-20080118-03 CW DOES NOT ACHIEVE MANY OF THE OUTCOME-RELATED FEDERAL PERFORMANCE TARGETS TODAY • Performance (state-wide) • Target Percent • Improvement direction Share of timely of CPS responses Shareof timely CPS assessments • 100.0 • 100.0 • 80.8 • Dec 06 • Mar 07 • Jun 07 • Sep 07 • Dec 06 • Mar 07 • Jun 07 • Sep 07 Children contacted face-to-face within 30 days Children reunified within 12 months Adoptions finalized within 24 months • 100.0 • 76.2 • 32.0 • 54.7 • n/a • Dec 06 • Mar 07 • Jun 07 • Sep 07 • Dec 06 • Mar 07 • Jun 07 • Sep 07 • Dec 06 • Mar 07 • Jun 07 • Sep 07 Cases of repeated maltreatment within 6 months Cases of foster care re-entry within 12 months • 8.6 • 6.1 • n/a • n/a • n/a • Dec 06 • Mar 07 • Jun 07 • Sep 07 • Dec 06 • Mar 07 • Jun 07 • Sep 07 Source: CAF Dashboard Report December 2007

4. WCO-OHR001-20080118-03 DHS DOES NOT RANK AMONG TOP U.S. STATES ON IMPORTANT CHILD WELFARE OUTCOME MEASURES Rankings from most recent CFSR report (2005) • Oregon • National ranking of states, 2005 • Lowestquartile • Median • Highestquartile • Composite measures • Timeliness and permanency of reunification • 47 • 29 • 1 • Timeliness of adoption • 47 • 24 • 1 • Permanency for children and youth in foster care for long period of time • 51 • 16 • 1 • Placement stability • 51 • 30 • 1 Oregon did not achieve “substantial conformity” in any of the 7 client outcome measures assessed in the Final CFSR Report published in February 2008 Source: CFSR statewide assessment 2007; Final Report: Oregon Child & Family Services Report 2008

5. 5 WCO-OHR001-20080118-03 TWO NATIONAL REPORTS HAVE RAISED CONCERNS ABOUT THE WORKLOAD OF OREGON CW CASEWORKERS Holder report, 2005 • “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” 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)

6. WCO-OHR001-20080118-03 WHILE MAKING CHILDREN IN OREGON SAFER, CHANGES IN REQUIREMENTS HAVE ALSO INCREASED WORKLOAD DEMAND Examples of new 2007 policies/procedures Examples of new 2008 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 * Passed in 2007, the Bills referenced below went into effect by January 1, 2008 as Oregon Revised Statutes Source: Interviews

7. WCO-OHR001-20080118-03 IN RECENT YEARS, NEGATIVE CYCLES HAVE WORSENED THE GAP BETWEEN WORKLOAD AND STAFFING CAPACITY • CONCEPTUAL • External trigger – • e.g., new initiatives or policy requirements** • Less experienced workers • 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* • More workload per worker • Negative cycle of worker frustration • Negative cycle of workload inflation • Higher turnover and sick leave • Less effective service • Less satisfied workers • Less hours per case • 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

8. WCO-OHR001-20080118-03 THERE ARE MANY WAYS TO STOP THE NEGATIVE WORKLOAD CYCLES AND ACHIEVE BETTER OUTCOMES FOR CHILDREN • Simplified processes • More efficient casework • “Front-loading” to avoid waste downstream • Higher individual efficiency • Less time on non case-related work • More time for each case • More time for casework • More administrative and casework support Adding case-workers is only one of many ways to reduce workload • More specialization among caseworkers • More caseworkers • Lower “actual” caseload • Less vacancies • Less sick leave • Less workload per worker • More effective policies • Higher employee satisfaction • More effective processes • More effective internal procedures • More standardized local execution • Less turnover • More effective service in given time • Higher share of effective workers • Better selection of workers • Faster ramp-up of new workers • More training • Higher effective-ness of individual workers • More clinical supervision • More peer support

9. WCO-OHR001-20080118-03 STAFFING ANALYSIS WAS DEVELOPED THROUGH A RIGOROUSFACT-BASED ASSESSMENT OF ACTIVITY DEMANDS • Dec 12 • Dec 31 • Feb 15 •  •  •  • Process mapping • Time activity survey • Analysis of results • 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 • Product • 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

10. WCO-OHR001-20080118-03 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

11. 100 WCO-OHR001-20080118-03 CURRENT GAP BETWEEN CAPACITY SUPPLY AND WORKLOAD DEMAND MAY BE 24–37 PERCENT • ESTIMATES • % current capacity 3–5 • 124–137 0–3 3–4 1–2 17–23 • 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 • Current capacity* • Performwork notbeingdone today • Meetadditional 2008 policyrequirements • Raiseservicequality • Relieve supervisors of casework tasks • Reduce caseworker overtime • Workloaddemand assuming current processes 1 2 3 4 5 • Gap to… * Actual SS1, SSA, and CET FTEs counting double-filled positions as 2 FTEs – i.e., real capacity in terms of available worker hours per day Source: Time activity survey; HR and budget data; interviews

12. WCO-OHR001-20080118-03 DHS FACES A SET OF OPTIONS TO ADDRESS THE WORKLOAD GAP IN THE SHORT AND MEDIUM TERM • ESTIMATES • Possible combination to close a workload gap of 24% • Preference • Lever/option • Rationale/description • Operational efficiency improvements • Initial analyses indicate significant inefficiencies and redundancies in current processes • Up to 17% workload reduction may be possible • Reduced workload requirements in procedures and policies • Some procedures and policies may be overlapping or not consistently executed today • Fill remaining gap with additional caseworkers • Each 1% of gap not fixed by policies and efficiencies requires ~1.4% more FTEs due to non-available time • Closing the remaining gap would require at least 10% percent more FTEs at same case demand* * Addressing remaining 7% workload gap would require 10% more staff

13. 1.0 WCO-OHR001-20080118-03 LARGER TIME INVESTMENT IN UPSTREAMACTIVITIES MAY RESULT IN EFFICIENCY GAINS DOWNSTREAM • EXAMPLE SUB CARE PLACEMENT • Time investment • Percent of total time of all caseworkers • >30.0* • ~1.0 • ~0.5 • 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” * Estimated using time for permanency work and share of subcare cases Source: Time activity survey

14. 9 WCO-OHR001-20080118-03 CLOSING THE REMAINING GAP BY ADDING FTEs REQUIRES UP TO A 1.42% INVESTMENT PER 1% WORKLOAD GAP • PRELIMINARY Percent 100% = 8 hours • Share of case-related time strongly influences overall capacity demand in a staffing model • Vacancies** • Sick leave • Other time off* • Case-related workload [h] • Breaks • Number of FTEs • = • Available time per worker [h/FTE] • Paid on-call time • Training • Other non case-related work*** • 70 • Closing a workload gap of 1% requires 1.42% more FTEs • Case-relatedtime * Including both paid and unpaid leave ** Has historically been significantly higher, up to 12% *** For example, general email and phone calls; general staffings Source: Workload activity survey of CW caseworkers; HR and budget data; interviews

15. WCO-OHR001-20080118-03 DHS WILL ANALYZE CW EFFICIENCIES FURTHER AS PART OF THE BROADER TRANSFORMATION INITIATIVE PHASE 1 • Child Welfare Staffing Study • Transformation initiative Phase 1 2007 2008 Task/deliverable Dec Jan Feb Mar Apr May TASK ONE: Base lining TASK ONE: Benchmarking TASK TWO: Strategic Improvement Plan Child Welfare Staffing Study (Phase 3) Steering Committee Reviews Today • Next steps • Finalize analyses • Write final report • Train selected CAF employees on using and updating the staffing model • Finalize CAF baselining • Continue development of Wave 1 hypotheses • Continue external benchmarking Quantify the workload gap and its influencing factors Quantify efficiency potentialto close the workload gap