DCF issues statement in response to report on death of Fall River teen

In the wake of a Massachusetts report issued concerning the death of a Fall River boy and the involvement of DCF, the organization has issued a statement.

“The death of David Almond is heartbreaking and the Department mourns for him. Every child deserves to live in a safe home, free from harm. Immediately following his death, DCF took action to address critical issues raised, including urgently reviewing internal policies and practices to reduce safety risks for children.”

“The Department of Children and Families (DCF) is deeply appreciative of the thorough and comprehensive investigation by the Office of the Child Advocate (OCA) that was requested by the Secretary of Health & Human Services. The OCA’s investigation highlights critical areas for improvement across education, at both the local and state level, and the roles of providers, mandated reporters, the courts and DCF, and we are in the process of evaluating and acting on the recommendations. Some are already underway, including creating a new position of Director of Disability Services to provide direct support to DCF social workers, supervisors and managers on cases involving families and children with disabilities and retraining staff on assessing child safety risk and parental concerns. DCF is committed to working with its child-serving partners to strengthen the safety net for the Commonwealth’s most vulnerable children. As the OCA’s findings demonstrate, a child welfare agency must partner with other child service systems to make critical decisions about risk and safety for children.”

“The Department will continue to work with law enforcement, the judicial system and others to support the ongoing criminal investigation to see that justice is served for David.” – DCF spokesperson

Immediate Actions initiated in October 2020

On October 21, the Case Investigation Unit (CIU) was assigned the case for investigation. The CIU is a team of social worker investigators and managers who are responsible for the Department’s internal comprehensive child fatality reviews.

Between October 21 – October 25, a team of Senior Central Office Leadership and Area Directors from other Area Offices worked to review electronic records of the assigned social worker’s cases, Of the 14 other families assigned to the social worker all were seen in person in October and September to determine if any children needed to be immediately seen and reviewed with DCF Regional and Central Office leadership.

The following week, the same senior management team reviewed the electronic case records for all 57 electronic cases assigned to all social workers in the unit and reviewed with DCF Regional and Central office leadership. None of the cases required immediate safety intervention.

On November 2, 2020, all Fall River Area Office staff were retrained on assessing child safety risk and parental concerns following by parental substance use training series that began in January 2021 and will continue through September 2021.

In early February, the Fall River Area Director retired and the Area Clinical Manager was terminated. Two highly experienced senior managers from other area offices replaced former Fall River Area Office leadership to run day-to-day operations and work with the regional office to assess practice and decision-making and work with staff and managers on ongoing improvements.

During February and March 2021, DCF provided general risk assessment retraining for more than 300 supervisors statewide in 29 area offices. This training focused on synthesizing information from the case record, social worker observations, families, providers, and others who see the child regularly and making a decision about the level of risk to the child’s safety. Two more trainings are scheduled for April.

DCF has issued the following response to OCA recommendations in the report:

RECOMMENDATION #1: The DCF administration should revise the DCF Supervision Policy and workforce training curriculum to ensure all levels of the DCF workforce receive frequent and structured supervision that supports the development of task-oriented skills, but also the essential clinical formulation skills needed to accurately assess the safety and risks to a family.

-From October 2020- January 2021, DCF provided intensive supervision training for Fall River Area Office supervisors and managers and retrained more than 300 supervisors state wide on assessing child safety risk and parent capabilities.

-The Department’s Supervision Policy, established in 2016 as part of the first phase of the Department’s agency reform, will be reviewed beginning in April and updated by the end of July with requirements to affirmatively address feedback from providers, community partners, and other expert and accrediting entities in supervision.

RECOMMENDATION #2: The DCF Ongoing Casework and Documentation Policy and Family Assessment and Action Planning Policy should be revised to expand guidance and direction regarding social workers’ contact with caregivers, service provider, educators, other professionals, and natural family supports.

-DCF will update the Ongoing Casework and Family Assessment and Action Planning policies to expand guidance and direction regarding social worker contact with a range of collateral contacts including other family members, service providers who have contact with the family or people in the community, and educators that may have given them knowledge that would relate to the family assessment.

-To support consistency in team decision-making beginning early in a child’s foster care placement, DCF is expanding its Initial Placement Review pilot program from 10 offices to 20.

-When there is a complex case or a difference of opinion about the direction of the case, Area Office leadership must convene an Area Clinical Review Team meeting with the casework management team to take a more comprehensive look at the facts of the case and the factors that may be impacting child safety risk, such as untreated mental health, substance misuse, or domestic violence. The Department’s specialty social workers with expertise in these specific areas may also participate in these meetings. The Department is piloting a new protocol to improve efficacy and consistency of these reviews.

-DCF is re-procuring its congregate care services network, which uses multi-disciplinary team meetings with DCF senior managers and providers to identify and address issues that may arise while serving children in group care. This RFR was issued in February with contracts anticipated to be in place by October 1.

RECOMMENDATION #3: The DCF administration should create guidance that provides: (1) specific criteria for when and why parental assessments are needed from external providers; (2) a standard process for parenting assessment referrals that includes relevant DCF and family history; and (3) a mandate that the DCF case management team provide the parenting evaluator specific parental capacity questions that are related to the protective concerns of the case and the individual needs of both the children and caregivers.

-DCF will review current contracts and adjust requirements for providers who conduct parental assessments. This service will be re-procured in July 2021 and implemented in January 2022.

-DCF will develop practice guidance for staff and work with lead agencies on appropriate referral and use of parental assessments.

RECOMMENDATION #4: The DCF administration, in collaboration with their education experts, should conduct a comprehensive review of internal policies and procedures to determine how to effectively prioritize the educational needs of DCF involved children. Based on the results of this review, DCF should update or develop policies and procedures to ensure this examination promotes the educational success of DCF involved children.

-By the end of June 2021, DCF and DESE will review educational needs of DCF children served in foster care and children served at home.

-DCF is reviewing and updating its education policy to address children’s educational needs and stability as part of reunification planning. Revisions will promote educational stability and progress for children and youth in special education settings, including collaboratives, day educational settings and residential schools.

-Unless there are extraordinary circumstances, children and youth will remain in their school until the end of a school year or end of a semester.

-DCF has worked closely with DESE throughout the pandemic, including:

Holding 25 virtual school reopening meetings with 230 school districts to share concerns and discuss resources needed for children and families to participate in remote or in-person learning.

DCF and DESE jointly developed a tip sheet for educators on best practices for working with students during remote learning.

In January, DESE reissued the tip sheet as an expanded document, “Promoting Student Engagement, Learning, Wellbeing and Safety During Remote and Hybrid Learning.”

DESE’s Special Education guidance provided school districts with criteria for identifying students with complex and significant needs to prioritize for in person learning, including children in foster care.

RECOMMENDATION #5: The DCF administration should conduct a comprehensive review of DCF practices related to individuals with disabilities and develop a policy that promotes (1) workforce development and training; (2) evidenced-based best practices for effective case management and safety and risk assessment and planning; and (3) requirements for case documentation about an individual’s disability.

-The Department identified the need for additional expertise in the field of disabilities. DCF is in the process of hiring a Director of Disability Services who will be an experienced child welfare practitioner reporting to Associate Deputy Commissioner for Protective Operations to coordinate best practices for keeping children with intellectual and developmental disabilities safe and supporting their families in the process. The Director’s responsibilities will include:

Providing timely one-on-one consultations on cases involving children or youth with disabilities and caregivers with disabilities.

Collaborating with statewide and regional disability coordinators who will work on resolving complaints and concerns for parents with disabilities.

-DCF is drafting a Parents with Disabilities Policy to ensure that DCF-involved parents with disabilities are provided an equal opportunity to benefit from and participate in DCF services, programs, and activities consistent with the requirements of the Americans with Disabilities Act. This policy will be developed by July 2021 date with input from the Department of Justice and sister state agencies with expertise in disabilities.

RECOMMENDATION #6: The DCF administration should review their current processes for safety assessment and develop an evidenced-based process for assessing safety that includes (1) a structured framework for examining the potential safety of a child within a family unit; (2) the actions that should be taken because of the safety assessment; (3) how the findings will be communicated to the family; and (4) how and when safety assessment should be used as a tool for monitoring.

-Prior to this case, the Department had begun to address the need for a formal review prior to reunification and has developed a new reunification review process that has started to be used as of March 2021.

Teams of managers and social workers review all cases of children scheduled to reunify in 120 days or less.

The reunification review emphasizes improved parental capabilities, rather than completion of tasks in an action plan, to determine if reunification is safe and appropriate.

-Subsequent to each review, legal and clinical managers are required to address disagreements and approve case recommendations. The reunification review emphasizes improved parental capacity to determine if reunification is safe and appropriate.

-The Department is working to incorporate a nationally-recognized, research-based actuarial tool to assess child safety risk prior to reunification, using the same evidence-based approach as introduced in the Protective Intake Policy.

RECOMMENDATION #7: The DCF administration should develop guidance and training for the DCF workforce that sets standards clarifying (1) which families are appropriate for virtual home visits; (2) when a family previously approved for virtual home visits must be transferred to in-person visitation only; (3) how to recognize warning signs and assess safety and well-being of a child during virtual home visits; and (4) indicators of child abuse and neglect during virtual home visits.

-Visiting children in-person is the gold standard for assessing risk and safety in child welfare. There were no national best practices for video conferencing prior to the pandemic. In March 2020, the Department issued a four-page guidance with practice tips for video conference visits that aligns with COVID-19 guidance issued by the federal Children’s Bureau.

-In May, DCF will revise virtual visit guidance from March 2020 to address post-COVID-19 use of telehealth strategies in child protection as a supplement to routine in-person visits.

RECOMMENDATION #8: The DCF administration must enhance its quality assurance infrastructure to provide additional levels of qualitative monitoring and to create feedback loops that promote a culture of continuous learning

-In 2015, DCF established a Continuous Quality Improvement Unit (CQI) to conduct targeted case reviews to identify practice strengths and needs The unit, overseen by the Department’s Assistant Commissioner for Continuous Quality Improvement, includes a supervisor and five experienced social workers who work with the Regional and Area Offices to assess concerns and improve quality of case practice.

-DCF is currently implementing a new statewide protocol to strengthen the use of CQI-related data when Regional and Area Offices are reviewing critical cases with supervisors and social workers.

-In addition to the Department’s CQI process, all U.S. child welfare agencies are subject to periodic reviews by the federal Children’s Bureau known as Child and Family Service Reviews (CFSRs), which monitor the agencies’ performance on standard, key children welfare measures.

COVID-19 and Child Welfare

Very little was known about managing COVID-19 when the children returned home in March and it was unclear how long the stay-at-home order would remain in effect. Like everyone across the Commonwealth both families and staff were concerned about community spread and contracting a virus with mostly unknown consequences.

-In March 2020, the federal Children’s Bureau issued guidance establishing the ability of state child welfare agencies to use videoconferencing to maintain contact with children, families, and foster parents during the emergency declaration.

-Throughout the pandemic, DCF responded in-person to all emergencies and when serious concerns on a case arose and the after-hours child abuse hotline remained fully operational on nights, weekends, and holidays.

-In March 2020, the Department released guidance for staff that addressed best practices for videoconference visits and required supervisor and managerial involvement to determine whether an in-person visit was necessary. This coincided with managers and supervisors reviewing cases and using risk indicators to identify emergent cases. In August, the Department provided specific guidance to managers and staff to prioritize in-person visits based on the last time the Department made contact of any kind with the child.

-As PPE became more readily available, the Department acquired and maintained a plentiful inventory of masks, gowns, cleaning supplies, face shields, gloves, and goggles, enabling the Department to transition to more in-person visits starting in mid-June with congregate care Family Time.

-As infection rates declined during the summer, and Massachusetts initiated its reopening plan, the Department began increasing in-person non-emergency investigations and routine visits alternating between in-person and virtual visits every other month.

-The Department readjusted its in-person visit guidance when COVID-19 cases began to spike in December 2020, reiterating the importance of staff wearing additional PPE when an in-person visits and reiterating the use of the risk reassessment tool when managers and supervisors disagree about the appropriateness of an in-person visit.

Agency Reform:

Since 2015, the Baker administration has been intentionally rebuilding DCF and continues to address longstanding issues through an unprecedented ongoing system-wide reform. Out of necessity, DCF needed to first stabilize staffing and infrastructure of the agency and address outdated core polices and systems with the greatest impact. Phase 1 of the reform included:

Adding more than 650 staff positions including 300 additional front line social workers, more than 100 social worker technicians and 100 managers to increase managerial oversight.

Reduced caseloads to historic lows and maintained average caseloads near the target of 15 to 1 per ongoing social worker since May 2018. Average caseload was 18.71 in May 2016 when the caseload peaked and was 14.36 for January 2021

Re-writing/developing core policies including intake, foster care review, family assessment and action planning, missing or absent children, and supervision.

27% decline in home removals since 2014 attributable to changes to the Protective Intake and Family Assessment and Action Planning policies, which increase the quantity, quality, and frequency of information the Department reviews, and supports better decision-making about the most appropriate intervention for families.

Over the last five fiscal years, the number of children who did not have a recurrence of maltreatment within six months declined 38.6% from 2,119 children in FY16 to 1,302 children in FY20.

Reform Phase 2

The second phase of reform has focused modernizing the foster care system and strengthening support of foster parents by:

Hiring social workers dedicated to recruiting foster homes for all 29 offices. Since the initial 15 recruiters began in 2017, DCF has a net gain of 250 foster homes.

Making case practice changes that resulted in an historic high of children in kinship placements (59%).
Placement stability is the highest years as the result of prioritizing kinship placements where national research shows children are more likely to be stable, enhancing support and communication to retain foster parents, and adding foster care recruiters to focus on year-round continuous recruitment:

Placement stability improved by 42.0%. between FY2018, when the Department initiated foster care reforms, and FY2020.

76.4% of children had two or fewer moves in foster care over a period of 12 months, a 12.4% improvement over the FY2018 rate (68.0%)

Average placement stability for CY20 is 79.9%

Re-entry into foster care within 12 months of reunification has decreased by 12% since FY16. Improvement is attributable to more frequent assessments of families through the introduction of the Family Assessment and Action Planning Policy, leading to stronger decision making about appropriateness of permanency.

Establishing a nationally recognized process for expediting adoptions when it is safe to do so, increasing adoptions 56% from FY15-FY19 and by 31% from FY16-FY20 (the pace of adoptions has been hampered by court closures due to COVID-19).

Children in foster care decreased by 15% since FY19, attributable to increased clinical staffing, the addition of 7 adoption workers statewide, and the Department’s concentrated efforts to identify and address barriers to adoption.

Restructuring and modernizing foster care review by automating scheduling and updating the case documentation process with more detailed findings from each review.

Building a new Congregate Care Network from the ground up that is rooted in the latest research and current best practices to replace a model that had not been updated in how many years.

Enhancing support and communication to retain foster parents, e.g. annualizing funding for in-home services when children have behavioral challenges, developing a foster parent e-list and Intranet with resources and timely updates, creating a foster parent portal where foster parents can view real-time information about the child including medical needs, school enrollments, and other important information.

Increasing foster parent stipends every year of the current administration and increasing payments by $100 per child for seven months of the pandemic to help foster parents cover pandemic-related costs.