Child Welfare:

Improving Social Service Program, Training, and Technical Assistance Information Would Help Address Long-standing Service-Level and Workforce Challenges

GAO-07-75: Published: Oct 6, 2006. Publicly Released: Oct 6, 2006.

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Despite substantial federal and state investment, states have not been able to meet all outcome measures for children in their care. Given the complexity of the challenges that state child welfare agencies face, GAO was asked to determine (1) the primary challenges state child welfare agencies face in their efforts to ensure the safety, well-being, and permanent placement of the children under their supervision; (2) the changes states have made to improve the outcomes for children in the child welfare system; and (3) the extent to which states participating in the Department of Health and Human Services (HHS) Child and Family Services Reviews (CFSR) and technical assistance efforts find the assistance to be helpful. GAO surveyed child welfare agencies in 50 states, the District of Columbia, and Puerto Rico and visited 5 states, interviewed program officials, and reviewed laws, policies, and reports.

In response to a GAO survey, state child welfare agencies identified three primary challenges as most important to resolve to improve outcomes for children under their supervision: providing an adequate level of services for children and families, recruiting and retaining caseworkers, and finding appropriate homes for certain children. State officials also identified three challenges of increasing concern over the next 5 years: children's growing exposure to illegal drugs, increased demand to provide services for children with special needs, and changing demographic trends or cultural sensitivities in providing services for some groups of children in the states' child welfare systems. Most states reported that they had implemented initiatives to address challenges associated with improving the level of services, recruiting and retaining caseworkers, and finding appropriate homes for children. These initiatives, however, did not always mirror the major challenges. For example, with respect to services, states most frequently identified that they were challenged by the lack of mental health and substance abuse services for children and families, yet only a fourth of the dissatisfied states reported having initiatives to improve the level of these services. In states where evaluations of their initiatives had been completed under a federal demonstration project, the evaluations generally showed that states had achieved mixed results across child welfare outcomes. States we visited reported that HHS reviews of their child welfare systems and training and technical assistance efforts helped them improve their child welfare programs. For example, officials in three of the five states we visited reported that the CFSRs prompted them to develop interagency strategies for providing an array of needed services to children and families. Similarly, nearly all states in our survey reported that HHS-sponsored technical assistance was helpful to some degree. However, HHS officials said that several factors limited their ability to use their technical assistance tracking system as a management tool. For example, not all service providers are included in the tracking system, and some providers inconsistently enter required data into the system. As a result, HHS may be limited in its ability to determine how best to allocate technical assistance resources to help maximize states' ability to address child welfare issues.

Recommendations for Executive Action

  1. Status: Closed - Not Implemented

    Comments: In 2007, HHS disagreed with this recommendation, adding that its Training and Technical Assistance (T/TA) process, implemented in 2005, was shared repeatedly with National Resource Centers (NRCs) and ACF regional staff. For example, several conference calls were held in 2006 and 2007 with representatives from these offices to discuss the use and updating of the system, as well as consistent data entry; and to design new screens to capture additional data. The procedure for requesting T/TA is now a central point-of-coordination for all on-site requests. The National Child Welfare Resource Center for Organizational Improvement (NCWRCOI) is responsible for coordinating, facilitating and evaluating on site-T/TA. NCWRCOI will facilitate the involvement of appropriate staff and other critical stakeholders in its needs assessment and development of a work plan. HHS believes that this will ensure a better coordinated response, avoid delays and duplication, and result in sound T/TA work plans. As of 2010, HHS continued to disagree with this recommendation and took no other action to centralize information and make it accessible to state and local staff and providers.

    Recommendation: To improve awareness of and access to various social services and to improve the department's ability to manage technical assistance provided to state child welfare agencies, the Secretary of Health and Human Services should develop a strategy to centralize information on federal assistance programs that are available to meet child welfare program and service needs and that can be accessed by state and local child welfare staff and providers. This strategy could follow a previous Administration recommendation to develop an Internet-based search for services through the Catalog of Federal Domestic Assistance (CFDA) that is linked to grantees by ZIP code.

    Agency Affected: Department of Health and Human Services

  2. Status: Closed - Implemented

    Comments: HHS agreed with this recommendation and said it intended to provide guidance to the resource centers requiring this reporting. In October 2007, the agency reported that its new process - Training and Technical Assistance (T/TA), implemented in 2005 -- was shared repeatedly with National Resource Centers (NRCs) and ACF regional staff. For example, several conference calls were held in 2006 and 2007 with representatives from these offices to discuss the use and updating of the system, as well as consistent data entry; and to design new screens to capture additional data. The procedure for requesting T/TA is now a central point-of-coordination for all on-site requests. The National Child Welfare Resource Center for Organizational Improvement (NCWRCOI) is responsible for coordinating, facilitating and evaluating on site-T/TA. A T/TA Coordinating Committee developed guidance on procedures for states and tribes to follow in requesting T/TA. NCWRCOI will facilitate the involvement of appropriate staff and other critical stakeholders in its needs assessment and development of a work plan. HHS believes that this will ensure a better coordinated response, avoid delays and duplication, and result in sound T/TA work plans. HHS' 2010 update reported the Children's Bureau funded a contract for a Training and Technical Assistance Coordination Center (TTACC) that will work with the National Resource Centers and Implementation Centers in coordinating the provision of training and technical assistance to States and Tribes. The TTAC has developed and will maintain TTA profiles of each state, including the status of program improvement efforts, the provision of TTA by the Children's Bureau's Implementation and National Resource Centers and other TTA providers. In addition, a new tracking system for TTA was launched in July 2010. The new system (One Net) will track and provide information on all TTA provided by the National Resource Centers and Implementation Centers.

    Recommendation: To improve awareness of and access to various social services and to improve the department's ability to manage technical assistance provided to state child welfare agencies, the Secretary of Health and Human Services should require all HHS technical assistance providers, including HHS regional offices and all national resource centers, to enter training and technical assistance data into the department's Technical Assistance Tracking Internet System.

    Agency Affected: Department of Health and Human Services

  3. Status: Closed - Not Implemented

    Comments: In 2007, HHS disagreed with this recommendation, noting that its Training and Technical Assistance (T/TA) process, implemented in 2005, was shared repeatedly with National Resource Centers (NRCs) and ACF regional staff. For example, several conference calls were held in 2006 and 2007 with representatives from these offices to discuss the use and updating of the system, as well as consistent data entry; and to design new screens to capture additional data. The procedure for requesting T/TA is now a central point-of-coordination for all on-site requests. The National Child Welfare Resource Center for Organizational Improvement (NCWRCOI) is responsible for coordinating, facilitating and evaluating on site-T/TA. NCWRCOI will facilitate the involvement of appropriate staff and other critical stakeholders in its needs assessment and development of a work plan. HHS believes that this will ensure a better coordinated response, avoid delays and duplication, and result in sound T/TA work plans. As of 2010, HHS continued to disagree with this recommendation and took no action to establish policies and procedures to ensure that complete and accurate data are reported in a timely way.

    Recommendation: To improve awareness of and access to various social services and to improve the department's ability to manage technical assistance provided to state child welfare agencies, the Secretary of Health and Human Services should establish policies and procedures to ensure that complete and accurate data are timely reported to the Technical Assistance Tracking Internet System.

    Agency Affected: Department of Health and Human Services

 

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