Report 2013-110 Recommendation 2 Responses

Report 2013-110: Child Welfare Services: The County Child Welfare Services Agencies We Reviewed Must Provide Better Protection for Abused and Neglected Children (Release Date: April 2014)

Recommendation #2 To: San Francisco Human Services Agency, City and County of

To ensure that referral response decisions are accurate, the San Francisco County CWS agency should develop policies requiring a supervisory review of the hotline tool and a monitoring system to ensure that supervisory reviews are completed.

1-Year Agency Response

Policy To date the Policy Unit has developed new policies and Desk Guides (aka procedures) which clearly detail how and when supervisory oversight and review is to occur. Supervisory Oversight is being incorporated into all relevant FCS Policies. Sections in the new SDM and Emergency Response/After Hours (ER/AH) Policy Manuals (PM) and Desk Guides (DG) include specific language and instruction related to the audit recommendations.

Hotline With 2 Hotline Supervisors now in place, every referral is reviewed daily for timeliness, accuracy and completion. The supervisors have received extensive training and coaching.

The responsibilities for review and approval of the SDM Hotline Tool for both the Hotline and After Hours supervisors are outlined in the SDM DG. Effective 4/6/2015, it is now required that for every referral received, the supervisor review the Hotline Tool in Web-SDM prior to approving and documenting their approval of the referral in CWS/CMS. Additionally, the new policies require systematic reviews by the Program Directors, to ensure that the supervisory reviews are completed.

Training The Hotline and After Hours staff has received extensive retraining on the utilization of SDM and Safety Organized Practice (SOP). This training is ongoing.

QA/CQI San Francisco continuous to participate in the statewide pilot of the new Children and Family Services Review (CFSR) case reviews, using a standard federal tool. Six CQI Analysts have been hired and trained on the use of the tool, and are conducting comprehensive case reviews of 10 cases per month in the areas of safety, permanency and well-being. This additional oversight will be supplemented by additional targeted reviews specific to the new policies once the CFSR case review process is finalized via the pilot.

- See Supporting Documentation.

California State Auditor's Assessment of 1-Year Status: Fully Implemented

6-Month Agency Response

The Policy Unit has been in place since August 30th. We convened 3 workgroups to address key areas of the audit recommendations including: SDM,Supervisory Oversight, and Safety. The workgroups, staffed by directors and supervisors, developed recommendations to address audit deficiencies. Policy worked with the workgroups to ensure that policy issues are addressed. The unit prioritized the policies needing development and is currently working with Subject Matter Experts (SME) to revise/develop the policies and detailed Desk Guides for all staff.

To ensure better monitoring of decisions made at the Hotline we added 4 additional staff to the Hotline (for a total of 8) and will hire a second supervisor to provide better oversight and review of referrals. In the meantime, the current Hotline supervisor and director have received individual CWS/CMS training including how to enter, review, and approve referrals.

The SDM workgroup identified a need to develop separate policy and training for After Hours staff. The new Training Coordinator will be responsible to structure all trainings including Hotline and After Hours. Staff will undergo extensive retraining on the utilization of SDM and Safety Organized Practice (SOP).

Q.A./Continuous Quality Improvement (CQI)

To date we've hired 1 supervisor and 3 Analysts, and plan to hire 3 additional CQI staff in January 2015.

CSFR Pilot San Francisco is one of 5 counties participating in a statewide pilot of the new Children and Family Services Review(CSFR) process. The new CSFR review tool focuses on safety, permanency and well-being through seven outcomes and seven systemic factors including. We will begin piloting the CSFR tool starting November 2014, by reviewing 8 to 10 cases using the new tool by December 2014 and 8 cases a month starting in January 2015. During the pilot, we will assess the tool for compliance with the Audit and will add additional review items as needed.

California State Auditor's Assessment of 6-Month Status: Pending

60-Day Agency Response

To date we have hired a Policy Supervisor who will develop policies and procedures requiring supervisory review of the hotline tool. The supervisor will come on board June 9, 2014. Additionally, we are in the process of redirecting 5 Protective Services Worker (PSW) positions to the Policy unit. We expect to have them on board by July 21, 2014. Once the policy unit is established, policies and procedures will be developed requiring supervisory review of all hotline referrals.

We are waiting for approval to hire 6 Quality Assurance (Q.A.) staff including 1 supervisor and 5 analysts to ensure compliance with new policies that require supervisory reviews to be completed timely and accurately for all hotline referrals. Once in place, Q.A. will develop a monitoring system and tools for ongoing compliance monitoring.

California State Auditor's Assessment of 60-Day Status: Pending

All Recommendations in 2013-110

Agency responses received are posted verbatim.