State of Florida Department of Children and Families

Transcription

1 State of Florida Department of Children and Families Charlie Crist Governor George H. Sheldon Secretary John K. Cooper Regional Director DATE: January 27, 2009 TO: FROM: Jack Sidoran, Circuit 18 Administrator Phebe Powell, Circuit 18 Operations Manager Traci Klinkbeil, Central Region Quality Assurance Manager John Lewis, Quality Assurance Specialist SUBJECT: Eighteenth Judicial Circuit Child Protective Investigations Semi-Annual Quality Assurance Review The semi-annual Quality Assurance (QA) review for Circuit 18 Child Protective Investigations was conducted December 1 through December 5, On December 18, 2008, QA presented preliminary review findings at the exit conference. The QA review sample included investigative reports closed between August 31, 2008 and October 29, Application of a 90% confidence level and 10% confidence interval reflected sixty-three (63) investigations. This review included half the 90/10 sample, which resulted in the review of thirty-two (32) reports, including five (5) reports that involved emergency removal. Please find a summary of the review findings attached. cc: Stephanie Weis, Family Safety Program Manager Central Region 400 W. Robinson Street Suite S1129 Orlando Florida Mission: Protect the Vulnerable, Promote Strong and Economically Self-Sufficient Families, and Advance Personal and Family Recovery and Resiliency

2 Central Region Comprehensive Child Protective Investigations Semi-Annual Quality Assurance Review Report Circuit: 18 Date of Review: December 1 through December 4, Sample Period: Investigative reports closed between August 31, 2008 and October 29, Introduction The Central Region Quality Assurance (QA) Unit conducts a comprehensive review of a sample of closed investigations in each circuit on a semi-annual basis to assess the level of qualitative interventions and compliance with Florida Statute and Administrative Code. The Child Protective Investigation (CPI) Excellence in Child Protection Review Tool was revised effective July 2008 to focus on qualitative standards. This review represents the first comprehensive CPI semi-annual QA review of Circuit 18 in Fiscal Year 08/09 and the initial use in the Circuit of the new Quality of Practice Standards for Child Protective Investigations Review Tool. The review process included detailed reviews of a random sample of investigative case files and surveys completed by key community stakeholders. Purpose of the Review The purpose of the review is to provide analysis and documentation of oversight and broad assessment of the circuit s performance in responding to child investigations, as well as longer-term practice improvement for child protective investigation, supervision and assessment of compliance with rule and statute. The review process provides administration, managers and staff with quantitative and qualitative feedback on areas of strength or high performance and opportunities for improvement. Methodology For this semi-annual comprehensive QA review, the following standardized statewide parameters effective July 2008 determined the sample size methodology. The circuit receives their review sample list 30 days prior to the on-site review to allow for preparation time. The sample consists of reports closed during a 60 day period, prior to the circuit receiving its sample list to allow the ability to capture recently closed investigations. A sampling methodology based on the 90% confidence level and 10% confidence interval formula found in the Department s Random Number Sample Size Calculator provides the circuit with a 90% confidence level that the findings represent the total population. The sample selection uses the Florida Safe Families Network (FSFN) Child Investigation and Special Condition Status Report District-Daily. The sample excludes Special Conditions, institutional investigations and investigations closed as No Jurisdiction or Duplicate. The semi-annual review utilized one-half of the 90/10 random sample. Circuit 18 CPI QA Review Page 2

3 Circuit 18 consists of two counties, Brevard and Seminole, providing child protective investigations. In Brevard County, the Department of Children and Families (DCF) maintains investigative responsibility through two service centers, Palm Bay and Rockledge. In Seminole County, the Sheriff s Office conducts child protective investigations. For that reason, the Circuit 18 semi-annual review did not include Seminole County and any report references to Circuit 18 will pertain to Brevard County only. Utilizing the above stated methodology, the population size consisted of 843 Circuit 18 reports closed between August 31, 2008 and October 29, Applying a 90% confidence level and a 10% confidence interval to the 843 reports resulted in a random initial sample of 63 reports. Of the 63 reports, selection of the first report and every other report arrived at a random sample of 32, including three reports resulting in emergency removal. Of the 32 reports randomly selected, one required substitution from the initial sample of 63 due to it being an incorrectly coded as Closing-No Services, when in fact it closed as a No- Jurisdiction report. Review methodology excludes No-Jurisdiction reports from the sample. In order to meet the needs of the Central Region, the final random sample must include at least five reports resulting in emergency removal. For Circuit 18, this involved substituting two reports, with two replacement reports from the initial random sample of 63. In-home cases in which no removal or shelter occurred accounted for 27 of the 32 reports in the final sample (84% in-home). Investigations that resulted in emergency removal accounted for five of the 32 reports in the final sample (15% out-of home). There were six over-sample reports randomly selected. During the on-site review, one report required substitution with an over-sample report. This occurred due to the service center inadvertently requesting a different report with a similar report number from the Iron Mountain storage facility. Of the 843 investigations, Palm Bay investigative units closed 51% and Rockledge investigative units closed 49%. The 32 random reports closely approximated these percentages in that 50% of the sample consisted of reports closed by investigative units in each service center. (See Chart 1) Chart 1 N=32 Circuit 18 CPI QA Review Page 3

4 The random distribution of the final sample of 32 reports per service center was as follows: Palm Bay Service Center 16 investigations, Unit three reports, Unit five reports, Unit two reports, Unit three reports, Unit 511 three reports. (See Chart 2) Chart 2 n=16 Rockledge Service Center 16 investigations, Unit four reports, Unit two reports, Unit six reports, Unit one report, Unit 811 four reports. (See Chart 3) Chart 3 n=16 Circuit 18 CPI QA Review Page 4

5 Circuit 18 consists of five CPI units located in the Palm Bay service center under the direction of one Program Administrator (PA), and five CPI units located in the Rockledge service center under the control of another PA. In addition, the Palm Bay and Rockledge service centers have a shared Operations and Management Consultant II (OMC II) position allocated. During the 60 day period under review, the Rockledge service center reports a CPI and supervisory vacancy and four new investigators who were in training or assigned restricted caseloads. Prior to the period under review, the Rockledge service center reports assigning a senior CPI to Children s Legal Services (CLS) to assist with legal cases, a CPI and supervisory vacancy and four new investigators who were in training or assigned restricted caseloads. The Palm Bay service center reports no vacancy issues. The QA review took place on-site at each service center. This allowed QA staff an opportunity to meet and network with investigative staff to discuss report related issues and inquire as to obtaining supporting documentation. The first morning of the on-site review consisted of an entrance debriefing with Circuit 18 management staff to discuss the new Child Protective Investigation (CPI) Excellence in Child Protection Review Tool and the Request for Assistance (RFA) and challenge processes. At the conclusion of the service center on-site review, each PA received a preliminary findings debriefing. Through the Central Region QA Real Time review initiative, Circuit 18 Child Protective Investigations staff is familiar with the CPI Excellence in Child Protection Review Tool. The Region QA Specialist assigned to Circuit 18 completes the Real Time reviews. The QA Specialist randomly selects one investigation from each unit closed the previous week by the supervisor of that unit. Upon completing the individual file review, the QA Specialist provides one-on-one, face-to-face feedback with the CPI Supervisor and reviews the completed tool. QA staff encourages the CPI s presence, but it is not a requirement. In addition, Central Region QA staff meets the needs of Circuit 18 CPI and CPI Supervisors by attendance at monthly service center meetings and providing immediate technical assistance or training at the request of the PA. Review Instrument The QA unit reviewed investigations using the CPI Excellence in Child Protection Review Tool revised effective July 2008 to focus on qualitative standards. Although qualitatively driven, the review tool includes some important compliance standards; for instance, measuring if statutory requirements were met in referring the child to the Child Protection Team (CPT) when required. The main qualitative standard (#24) requires the reviewer to determine if the investigation was thorough. Table 1 illustrates the review elements no longer measured in the revised review tool. Table 1 On site investigation Timeframe for victims seen Initial assessment timeframe The supervisory review timeframe Documentation of disagreements in medical assessment findings and recommendations resolved through consultation and multidisciplinary staffing Circuit 18 CPI QA Review Page 5

6 Opposing medical opinions and third party expert medical consult Completion of TANF eligibility Shelter order documentation of reasonable efforts Table 2 illustrates the review elements changed or added to the revised review tool. Table 2 Correct Incident Date entered only in reports with verified findings Appropriate steps taken to ensure child safety- Now measures the thoroughness of the investigation in addition to assessing child safety Appropriate supervisory guidance and direction provided- Now separately measures second party guidance, follow through and ongoing supervisory guidance CPT information provided and shared can now be documented anywhere in the file, not just the chronological notes. ICWA- All investigations require inquiry, only reports involving a removal require the ICWA form If placement of the child outside of the home was a possibility, the CPI requested Early Service Intervention to determine if the Community Based Care could provide family preservation services that would allow the child to remain safely in the home- Added but not measured at this time The standards and interpretive guidelines provided in the Quality of Practice Standards for Child Protective Investigators dated September 25, 2008; Version IV is located on the Center for Advancement of Child Welfare Practice website under the Quality Counts icon. The CPI Excellence in Child Protection Review Tool continues to allow the reviewer to identify Partial Achievement when assessing each review element. A standardized answer key provides guidelines for assessing the degree of compliance with each review element. The Quality of Practice Standards for Protective Investigators specifically directs each reviewer to refer back to the scoring rubric when determining partial compliance. The CPI Excellence in Child Protection Review Matrix provides a review of findings for 35 rated review elements and a rollup of the Circuit s overall performance. Each question continues to be equally weighted and evaluated, and utilized the following rating scale: Requirement Achieved, Substantially Achieved, Partially Achieved, Not achieved or Not Applicable. A Requirement Achieved rating indicates all the specific requirements achieved, no improvements needed. A Substantial Achievement rating indicates specific requirements achieved with some deficiencies or omissions. A Partial Achievement rating indicates specific requirements achieved with significant discrepancies or omissions. A Not Achieved rating indicates specific requirements not met. A Not Applicable rating indicates the review element was not required in the case under review. Not Applicable ratings do not affect the overall result of the review. Circuit 18 CPI QA Review Page 6

7 Currently under development is the Statewide QA web-based reporting system that will compile review data and analysis of the findings. Each investigation compiled in the webbased system is an individual report and will determine specific data at the Circuit, Region and State level for reporting and analysis. With the availability of the data in the QA web based system, analysis of performance over time and across reviews will identify areas for improvement. This will allow the region to identify systemic issues occurring within the Region as well as at the individual circuit level and compare statewide performance. Summary of Review Findings Circuit 18 achieved an overall performance rating of 91%, an Initial Response Domain rating of 92% and an Emergency Removal Domain rating of 68%. The graphs below depict the percentage results (by service center and by circuit) for the December 2008 review. For the overall performance rating see Chart 4, for the Investigative Response Domain rating see Chart 5, and for the Removal Domain rating see Chart 6. Chart 4 N=32 Chart 5 N=32 Circuit 18 CPI QA Review Page 7

8 Chart 6 n=5 List of standards and roll-up data for Circuit 18 Investigative Response Standards Background Checks 1.1 Required background checks were completed timely and the information was appropriately used to assess risk to each child. 88% 1.1. Background checks were completed on all household members 90% 1 and report subjects age 12 and older. a Prior Abuse Reports. 92% b DJJ. (age 12-26) 92% c Local Law Enforcement. 99% d FDLE. 98% e Department of Corrections. 98% Child Welfare Out of State. (if the record reflects the family resided f 76% in another state) g Prior Case Management Records. 89% h 911 Calls or Calls for Service. 87% i Other 100% Background checks were completed within the established timeframes on all household members and report age 12 and older. Information obtained from the background checks was used to appropriately assess risk to each child. Diligent Attempts 91% 97% Diligent attempts were made at least daily when a child victim was not seen immediately or within 24 hours of report receipt. If the initial attempt to contact the child victim was unsuccessful, regular attempts (daily and at varying locations and times of the day) are required until all child victims were seen. Seeing Children Timely All other children named in the report and/or residing in the home were seen timely. 93% 91% Circuit 18 CPI QA Review Page 8

9 Interviewing Children An interview was conducted and addressed all maltreatments with the alleged child victim(s) and other child(ren) named in the report and/or residing in the home. 99% Interview(s) with child victim(s) 99% Interview(s) with "other" child(ren) 100% Interviews with Caregivers 1.5 Interviews that addressed all maltreatments were conducted with the mother, father, other caregiver and alleged caretaker responsible (alleged perpetrator, if other than the mother or father), and other adult household members. 90% Interview with mother. 92% Interview with father. 90% Interview with alleged caretaker responsible. (if not the mother or father) 88% Interviews with other adult household members 86% Observations and Interactions of the Children Specific and relevant observations and interactions of the children with family members were completed and documented during the course of the investigation. Safety Assessment The initial safety assessment process was completed with sufficient thoroughness to identify risks and develop a safety plan if needed. Factors for Second Party Review 76% 97% The investigator and supervisor identified appropriate factors requiring the completion of second party review and such review was completed and completed within 72 hours. Collateral Contacts Relevant collateral contacts were completed during the course of the investigation. Obtaining Pertinent Information from Collaterals Pertinent information was obtained from the collateral contacts and was considered when assessing the overall safety of the child and/or the need for services. Professional Assessment of Others Consideration of other professionals assessment findings and recommendations in the determination of child safety and ongoing protective interventions was documented in the investigation record or automated information system. Children's Legal Services Staffing 98% 93% 100% 100% Circuit 18 CPI QA Review Page 9

10 1.12 A Children s Legal Services staffing was held when required, and when the investigation was legally sufficient, a petition was filed or a valid reason for not filing a petition was documented. 96% A Children s Legal Services staffing was held when required. 100% A dependency petition was filed or a valid reason for not pursuing dependency was documented, when the Children s Legal Services staffing documented legal sufficiency. Referral to the Child Protection Team The alleged child victim(s) was referred to the Child Protection Team and the referral was made timely when required. 87% 88% A referral was made to the Child Protection Team (CPT) when required. 88% The referral was timely. 88% Documentation of Child Protection Team Discussion The date, time, and specific information discussed with the Child Protection Team (CPT) at the time of initial referral were documented in the investigation file. 94% Following Child Protection Team (CPT) Recommendations CPT assessment findings and recommendations related to child safety were followed or the rationale for not following the assessment/recommendations was documented. Supervisory Review of Exceptions When the report met mandatory Child Protection Team referral criteria and a face-to-face medical evaluation was not done, the investigation record documented the supervisor approved the exception decision. Incident Dates The correct Incident Date was entered in the investigation report with verified findings. Maltreatment Findings All maltreatment findings were supported by the information gathered and appropriately documented in the investigative record. 100% 100% 60% 93% 1.19 Requests for Early Services Intervention If at any point during the investigation placement of the child outside of the home was a possibility, the CPI requested Early Services Intervention (ESI) to determine if the Community Based Care could provide family preservation services that would allow the child to remain safely in the home. Identification of Service Needs 100% Circuit 18 CPI QA Review Page 10

11 1.20 Based on the child/family needs, the immediate service and/or ongoing service needs were appropriately identified for the child, mother, father, other caregiver and/or caretaker responsible, if 98% other than the mother or father. a Child. (Not restricted to focus child or child identified as the victim in the abuse hotline report.) 100% b Mother. 98% c Father. 82% d Other Caregiver or Caretaker Responsible. (if other than the mother or father and has access or ongoing contact with the child) 100% Referral for Services 1.21 If immediate services or ongoing supervision was needed, referrals for these services were documented for the child, mother, father and other caregiver or caretaker responsible (if other than 94% the mother or father). a Child. (Not restricted to focus child or child identified as the victim in the abuse hotline report.) 100% b Mother. 91% c Father. 100% d Other Caregiver or Caretaker Responsible. (if other than the mother or father and has access or ongoing contact with the child) Engaging Services If documentation reflects the need for immediate services and/or ongoing supervision, the investigation record contained evidence the services were engaged. Communication Between the Child Protection Investigator and Case Manager If there was an active services case when the report was received, timely and appropriate communication and collaboration between the CPI and Case Manager occurred to assure mutual understanding of history and current events. Ensuring Child Safety The investigation was thorough and appropriate steps were taken to ensure child safety. 100% 92% 83% 95% American Indian or Native Alaskan The case file documents CPI s discussion with the parents or legal custodian as to whether or not they are of American Indian/Native Alaskan descent. Supervisory Guidance and Direction Appropriate supervisory guidance and direction were provided that ensured a thorough investigation was being completed. 88% 92% a Initial supervisor guidance 96% b Second party review guidance 98% Circuit 18 CPI QA Review Page 11

12 c On-going supervisor guidance 85% Supervisory Follow-up 1.27 Follow through occurred on the supervisory guidance and direction provided, or there was documentation that it was no 92% longer necessary. a The CPI followed through on the supervisory guidance and direction. 92% b The CPI supervisor ensured CPI followed through on supervisory guidance and direction provided or the reason (s) the guidance and direction provided was no longer necessary was documented. 92% c 1.28 The CPI supervisor ensured the CPI followed through on the 2nd party reviewer guidance and direction, or documented justification that actions were no longer necessary. Results Determination The Results Determination (closure options) documented in the automated information system is the appropriate choice based on the information obtained during the investigation. 92% 100% Section l - Investigative Response Total Percentage Achieved 92% Emergency Removal Standards Section ll - Emergency Removal Total Percentage Achieved 68% Services Prior to Removal 2.1 Prior to the removal, the CPI made concerted efforts to provide appropriate services that would allow the child to remain safely in his/her own home. Indian Child Welfare Act 2.2 The investigation file documented compliance with the Indian Child Welfare Act (ICWA) through timely initiation of the search process, completing the required ICWA eligibility form (DCF Form 1000), and by notifying the court when required. 100 % 40% The investigation file contained a completed ICWA Eligibility DCF Form The ICWA checklist was completed if the child reported to be a member of a tribe or was eligible to be a member of a tribe. 40% NA If American Indian or Native Alaskan heritage was claimed, the search process was initiated timely by contacting the designated tribe or Bureau of Indian Affairs. The court was advised if the child was determined to be a member of a tribe or eligible to be a member. Placement Priority 2.3 Once the decision was made to remove the child, placement priority was given to responsible relatives/non-relatives rather than licensed care. NA NA 100 % Circuit 18 CPI QA Review Page 12

13 Background Checks and Home Inspections 2.4 When the CPI placed the child with relatives/non-relatives the 89% investigation file contained evidence of required background checks and a physical inspection of the home prior to the child s placement The required background checks were completed prior to the 94% 1 child s placement. 1 Prior Abuse Reports. 94% 2 Department of Juvenile Justice (ages 12-26) 56% 3 Local Law Enforcement. 75% 4 Florida Department of Law Enforcement (FDLE) 100 % 5 NCIC 100 % 6 Department of Corrections. 100 % 7 Child Welfare Out of State (if the record reflects the family resided 0% in another state) Calls or Calls for Service. 75% 9 Prior Case Management Records. NA 10 Other (for example, military records as needed) 100 % 2.4. A physical inspection of the home was completed during the home 89% 2 study process prior to the child s placement An evaluation of the prospective caregiver s capacity to protect was completed prior to the child s placement. 94% Placement of Sibling Groups 2.5 If removal involved a sibling group, the siblings were placed together with a relative or non-relative caregiver (not in licensed care) when it was in their best interest. Child Health Check-Up 2.6 If the child was removed and placed in a licensed home or with a relative or non-relative caregiver, a Child Health Check-Up was completed within 72 hours of removal The Child Health Check-Up was completed within 72 hours of the 1 child s removal and a copy is in the investigation file If the Child Health Check-Up was not completed within 72 hours of the child s removal, the Child Health Check-Up was completed at some point thereafter and a copy of the chart was in the investigation file. Emergency Intake Forms 2.7 The Emergency Intake Form was completed and accurately identified the current medical information and/or needs of the child as known by the parent, guardian or legal custodian. 100 % 71% 75% 28% 20% Overall Total Percentage Achieved 91% Analysis of Investigative File Review Data Investigative Response Overall Circuit 18 attained an Investigative Response Domain rating of 92%. This domain consisted of a range of individual ratings from a low of 60% to a high of 100%. Circuit 18 CPI QA Review Page 13

14 Review element 1.1. Background Checks consisted of three sub-elements and achieved an overall individual rating of 88%. Deficiencies included documentation of Child Welfare Out of State checks (if the record reflects the family resided in another state), rated 76%, and Calls for Service rated as 87%. Prior Case Management Records is a new review subelement and applied to only 10 reports, with five reports having all of the required documentation and the other five reports having some level of acknowledgement or assessment that a prior case management record existed. Historically, call for service records have rated lower than other background checks. In four of the reports, the CPI requested local law enforcement records, but failed to identify the family s address to obtain a call for service history. Review element 1.2 Diligent Attempts, achieved an individual rating of 93%. This element applied to three reports and in the one report that did not document daily diligent efforts, the reviewer noted a storm as a mitigating factor. Review element 1.3 Seeing Other Children Timely, achieved an individual rating of 91%. This element applied to 10 reports and in each report, the investigator observed the other child prior to report closure. Review guidelines changed significantly regarding this review element to include the following guidelines: Document 9 if all of the other children should have been and were seen within 24 hours. Document 7 if all of the other children were seen within 72 hours. Document 5 if all of the other children were seen after 72 hours but before closure. Document 0 if only some or none of the other children were seen before closure. Review element 1.4 Interviewing Children, consists of two sub-elements and achieved an overall individual rating of 99%. Interviews occurred with victims (99%) and for other children (100%). Twenty-five reports required interviews with victims while seven reports also required interviews involving other children old enough to interview. In one of the 25 reports requiring victim interviews, the victim was not interviewed as to all the reported allegations. Review element 1.5 Interviews with Caregivers, consists of four sub-elements and achieved an overall individual rating of 90%. The sub-element, interviews with mother was 92%; father 90%; alleged caretaker responsible 88%; and other adult household members, which applied to seventeen reports, achieved the lowest rating with 86%. Review element 1.6 Observations and Interactions of the Children, achieved an individual rating of 76%. Reviewers noted the following deficiencies: No observations documented regarding interactions between the child and family members/ subjects of the report. Children interviewed at school, thus precluding familial observations. Circuit 18 CPI QA Review Page 14

15 No observations documented regarding developmental progress, particularly regarding younger children. Non-specific physical observations such as no marks or bruises when describing more than one child. Although this review element is the same as used on the former QA review tool, the accompanying guidelines give much more precise criteria for rating specific relevant observation. This review element provides an opportunity for improvement for the Circuit. Review element 1.7 Safety Assessment, achieved an individual rating of 97%. This element rates completion of the initial child safety assessment with sufficient thoroughness to identify risks and develop a safety plan if needed. Of the three reports that adversely affected this review element, reviewers noted the following: Two reports had inappropriate, non-specific safety plans that did not extend beyond the caretaker s written pledge not to abuse or neglect the child. In one report there was a lack of documentation that prior report history assessment or discussion with the current case manager occurred prior to submission of the Initial Safety Assessment. No discussion occurred with Case Manager prior to closure. Review element 1.8 Factors for Second Party Review, achieved an individual rating of 98%. This element represents a standards change from the March 2008 review in that the current review instrument measures both the appropriate identification and timeliness of second party review in one element instead of two. In the one report that adversely affected this review element, the CPI did not identify the appropriate second party review factors and as a result, the second party review did not occur until submission of the updated assessment. Review element 1.9 Collateral Contacts, achieved an individual rating of 93%. A change from the previous review guidelines is that non-custodial parents who maintain a relationship with the children in the report should constitute relevant collateral contacts. In the nine reports that adversely affected this review element, reviewers found that in four of the reports, the CPI did not contact or interview the non-custodial father, although he was involved in the child s life. Other collateral contacts not made included those with neighbors, therapists, school personnel or extended family members. In two of these reports, investigators did not follow the supervisory guidance regarding appropriate collateral contacts that needed to be made prior to closure. Review element 1.10 Obtaining Pertinent Information from Collaterals, achieved an individual rating of 100%. This review element demonstrates that when investigators do make relevant collaterals they are appropriately assessing the information provided. Review element 1.11 Professional Assessment of Others, achieved an individual rating of 100%. This review element applied to one report in which the CPI obtained and considered an assessment relating to the parent s non-compliance in her substance abuse Circuit 18 CPI QA Review Page 15

16 treatment program through the Central Florida Treatment Center. The child s removal was due in part, to the investigator s consideration of this professional assessment. Review element 1.12 Children s Legal Services Staffing (CLS), consists of two subelements and achieved an overall individual rating of 96%. The first sub-element rates whether the CPI assessed the case as high risk for any reason and conducted a CLS staffing. There was a CLS staffing completed in all 19 of the required reports (100%). The second sub-element rates whether the CPI filed a dependency petition or documented a valid reason for not pursuing dependency, when CLS documented legal sufficiency. This sub-element also asks the QA reviewer to rate their agreement with the decision and document if factors existed to warrant a dependency petition. When CLS documented legal sufficiency, thirteen of 15 reports (87%) met the requirements of filing a dependency petition or documenting a valid reason for not pursuing dependency. Two review instruments adversely affected this review element. In one report, CLS documented that the CPI needed to gather more information and if the father returned to the home complete a shelter petition, and if he was not in the home complete a non-shelter dependency petition. The CPI determined that the father no longer resided in the home however; the QA reviewer found no evidence that the CPI conducted a CLS re-staffing with the additional information gathered or completed a non-shelter dependency petition. The QA reviewer generated a Request for Action (RFA) that involved a CLS staffing that determined that legal sufficiency did not exist. In another report, at commencement the family was receiving Voluntary Protective Services (VPS) with documentation of the mother s non-cooperation. The CPI documented a telephone call with CLS indicating a lack of probable cause. The QA reviewer disagreed with the CLS assessment that probable cause did not exist due to a number of high risk factors. The high risk factors included: a history of prior reports; the CPT report findings on the companion case; the young age of the mother; her significant arrest history; her drug use history; her positive test for cocaine during the current investigation; her consistent refusal of services and her history of non-cooperation when agreeing to services in the past. Review element 1.13 Referral to Child Protection Team (CPT), consists of two subelements and achieved an overall individual rating of 88%. The first sub-element rates whether the CPI made a referral to CPT when required, and the second sub-element rates whether the CPT referral was timely. This review element applied to eight reports. One report adversely affected this review element, wherein the child received treatment at the hospital for a possible concussion. The investigator did not refer to CPT as mandated due to a possible head injury. Review element 1.14 Documentation of Child Protection Team Discussion, achieved an individual rating of 94%. Expected documentation includes; consideration of CPT assessments and recommendations, implications for child safety and CPT rationale for accepting reports as consultations, medical examinations or interviews. This review element applied to seven reports. One report lacked any documentation pertaining to CPT discussion other than the date and time of CPT contact. Circuit 18 CPI QA Review Page 16

17 Review element 1.15 Following Child Protection Team Recommendations, achieved an individual rating of 100%, two applicable reports. Review element 1.16 Supervisory Review of Exceptions, achieved an individual rating of 100%. This review element applied to six reports. Review element 1.17 Incident Dates, achieved an individual rating of 60%. This review element represents a change in the standards in that it only applies to reports with verified findings. During the review, this element applied to 10 reports. In the four reports adversely affecting this review element, the report narrative accurately identifies the correct incident date but the correct date is not reflected under maltreatment findings. This review element offers Circuit 18 an opportunity for improvement. Review element 1.18 Maltreatment Findings, achieved an individual rating of 93%. Five reports adversely affected the rating for this element. The QA reviewer determined that in the first report in addition to Verified findings for Family Violence Threatens Child, credible evidence supported Some Indicators as opposed to No Indicators of Threatened Harm based upon the mother and children s statements, the father s refusal of services and the parent s intentions to reconcile. The second report closed with Some Indicators of Inadequate Supervision and Family Violence Threatens Child. The QA reviewer determined that the report supported credible evidence of Some Indicators of Inadequate Supervision, but not enough evidence to support Some Indicators of Family Violence Threatens Child. The CPI closed the third report with No Indicators of Substance Misuse, however the case file documented that the caretaker responsible tested positive for Cocaine on two occasions adversely impacting the safety of the children by contributing the family s loss of housing with the grandmother. The investigator sent the test results to the laboratory for confirmation; however, the final confirmation was not in the case file. In the fourth report, the QA reviewer felt that the CPI did not sufficiently document their investigative activity and as a result, the report closed with No Indicators of Inadequate Supervision, yet the child was sheltered. In the fifth report, the CPI closed the report with No Indicators of Family Violence Threatens Child, however credible evidence supported Some Indicators of Threatened Harm based upon the law enforcement report, the statements of the adults involved and a work place incident report. While the children in this report did not disclose witnessing domestic violence, they stated that they were aware of fighting between the parents and know that the father struck the mother in the face causing a black eye. Review element 1.19 Requests for Early Services Intervention, achieved an individual rating of 100%.This standard is not mandated statutorily or required in Administrative Code, Operating Procedure or CBC contracts. It is a best practice measure (Quality Practice Standard) which reads: ESI will prevent unnecessary placements by initiating family preservation services. It will also start a multi-disciplinary team pre-placement process when placement is necessary, which will enhance stability. Circuit 18 CPI QA Review Page 17

18 There is no tabulation of this response into the overall findings for the CPI review during the first review period. Data gathered from this question provides baseline information for the state in developing future practice directives Review element 1.20 Identification of Service Needs, consists of four sub-elements and achieved an overall individual rating of 98%. At 82%, the sub-element of identifying service needs for fathers rated the lowest. In one report that adversely affected the sub-element of identifying service needs for fathers, the CPI did not identify that the father required a substance abuse assessment in spite of his ongoing drug use in the home. Review element 1.21 Referral for Services, consists of four sub-elements and achieved an overall individual rating of 94%. The sub-element of mother achieved a rating of 83%. One report adversely affected this review sub-element, in that the CPI identified that the mother requested counseling but did not document making a counseling referral. Review element 1.22 Engaging Services, achieved an individual rating of 92%. One report closed with Verified and Some Indicator maltreatment findings had an adverse effect on this review element in that the CPI did not document communication with Intervention Services to confirm initial contact and engagement with the family. Review element 1.23 Timely and Appropriate Communication between the CPI and Case Manager, achieved an individual rating of 83%. The review element represents a change to the review standards in that communication and the timeliness of the communication are one element. This review element applied to four reports, two reports did not fully meet this standard. In one report, the CPI made one attempt to contact the Case manager four days after report receipt. In another report, the CPI did make direct contact with the Case Manager, but prior to closure left a voice mail message instead of making direct contact regarding future action to take if the family did not comply with their case plan. Review element 1.24 Ensuring Child Safety, achieved an individual rating of 95%. Since the Circuit 18 June 2008 review, the standard for this element has changed significantly in that the thoroughness of the investigation as well as child safety is measured. Because this element is one of the most critical, in order to determine the rating, reviewers are to consider the ratings applied to review elements 1.1, 1.4, 1.5, 1.10 and Specifically, the investigator should utilize and assess prior reports and background checks on all report subjects, conduct interviews and address maltreatments with all children, adult household members and report subjects, obtain pertinent collateral contact information and consider this information when assessing child safety and service needs and ensure service engagement prior to report closure. Of the 32 reports reviewed, 26 reports (81%) achieved the requirement with a rating of 9, five reports (16%) substantially achieved the requirement with a rating of 7 and one report (3%) partially achieved the requirement with a rating of 5. In the one report that partially achieved this requirement, the CPI staffed the investigation with CLS on two occasions; on the first occasion, the CPI was to obtain additional information and re-staff the report. At the second staffing, the CPI was to find out if the father was in the home and if so, complete a shelter petition, if not, the CPI was to Circuit 18 CPI QA Review Page 18

19 complete a non-shelter petition. The CPI did not file the non-shelter petition or document a rationale for not doing so. This report resulted in a Request for Action (RFA). Review element 1.25 American Indian or Native Alaskan (ICWA), achieved an individual rating of 88%. Since the June 2008 Circuit 18 review, the standard for this element has changed in that the Investigative Response Domain only measures ICWA inquiry instead of inquiry and completion of the ICWA Eligibility Form Review element 1.26 Supervisory Guidance and Direction, with three sub-elements achieved an overall individual rating of 92%. Since the June 2008 Circuit 18 review, this element has changed significantly in that second party guidance and ongoing supervisor guidance are separate sub-elements. The sub-elements of initial supervisor guidance and second party review guidance each rated at least 94% or higher for each service center. For the sub-element of on-going supervisor guidance, achieved a rating of 85%. One report partially achieved the requirement with a rating of 5 and another report did not achieve the requirement with a rating of 0. In the first report, the supervisor did not give or follow-up on directives regarding adequate childcare arrangements, ensuring that the drug screen was in the file, completion of background checks or completion of a re-staffing with CLS. In the second report, the supervisor did not provide further directives regarding the completion of criminal history checks, implementation of a safety plan, and appropriate action to take once the CPI could not locate the youngest child, and learned that the family was moving to South Carolina and Georgia. Review Element 1.27 Supervisory Follow-up, with three sub-elements achieved an overall individual rating of 92%. Since the June 2008 Circuit 18 review, this element has changed significantly in that supervisory follow-up on second party review guidance is a separate sub-element. For each of the sub-elements: of investigator follow-through, supervisory follow-up, and follow through on second party reviewer guidance, the circuit achieved a rating of 92%. Seventeen reports required second party review and hence supervisory follow-up on second party reviewer guidance. Review element 1.28 Results Determination, achieved an individual rating of 100%. QA rated this element using the guidance that Circuit 18 had received during the period under review that is reports closed with community services only, are to have a results determination of closed-no services. For the Circuit 18 June 2009 review, these reports will be rated with the current guidance which requires a results determination of closedservices. Emergency Removal Five reports, (15%) of the review sample, comprised the emergency removal domain. The five reports consisted of four Palm Bay reports that resulted in relative placement and one Rockledge report that resulted in licensed placement. Overall Circuit 18 attained an Emergency Removal Domain rating of 68% with Palm Bay achieving a rating of 74% and Rockledge achieving a rating of 40%. This domain consisted of a range of individual ratings from a low of 20% to a high of 100%. Circuit 18 CPI QA Review Page 19

20 Review element 2.1 Services Prior to Removal, achieved an individual rating of 100%. Review element 2.2 Indian Child Welfare Act (ICWA), achieved an individual rating of 40%. Since the June 2008 Circuit 18 review, the standard for this element has changed in that the ICWA Eligibility Form 1000 rating is included in the Emergency Removal domain only. Three of five reports did not achieve the requirement. Review element 2.3 Placement Priority, achieved an individual rating of 100%. This review element measures the investigators priority of placing with relatives/ non-relatives rather than licensed care. This priority is evidenced by the number of unlicensed placements (4), compared to the number of licensed placements (1), randomly selected. In the one placement that resulted in licensed care the CPI made significant attempts to place the child with family friends and relatives; however was unsuccessful. Review element 2.4 Background Checks and Home Inspections, with three subelements achieved an overall individual rating of 88%. The sub-element of required background checks achieved a rating of 94%. However, local law enforcement, calls for service, DJJ and Child Welfare out of state record checks achieved significantly lower ratings. The sub-element of physical inspection of the home achieved a rating of 89% and the sub-element of an evaluation of the caregiver s capacity to protect the child achieved a rating of 94%. In the one report that adversely affected these two sub-elements, the completed home study documented that the home has "3 bedrooms,1&1/2 baths" but did not document any further information to describe the residence, the sleeping arrangements for the eight household members, whether firearms were present or if there is a pool or adjacent body of water. In addition, the home study approving placement with grandparents did not include the investigator or supervisor s signature. Review element 2.5 Placement of Sibling Groups, achieved an individual rating of 100%. This review element applied to only two reports. Review element 2.6 Child Health Check-up, with two sub-elements achieved an overall individual rating of 71%. Three of the five reports had a Child Health Check-Up completed within 72 hours of the child s removal and achieved a rating of 75%. One of the five reports (28%) had a Child Health Check-Up completed more than 72 hours after the child s removal and one report had no documented Child Health Check-Up. As evidenced by the investigator s ability to obtain copies of the Child Health Check-Up during the on-site file review, the issue may be due to systemic issues of investigators obtaining copies of the screenings rather than the children not receiving the required health screenings. The issue of whether children are receiving health screenings or investigator s are not obtaining copies is one that Circuit 18 should explore. Review element 2.7 Emergency Intake Forms, achieved an individual rating of 20% with one of five reports having the correct form. Circuit 18 CPI QA Review Page 20

21 Additional Review Elements In addition to the statewide CPI Excellence in Child Protection Review Tool, Central Region QA is also incorporating the following additional review elements during its circuit level semi-annual CPI reviews conducted in FY 08/09. There will be analysis conducted on these additional review elements with assessment provided to Central Region and Circuit 18 management staff. These additional review elements are not included in the Circuit 18 review rating for CPI Excellence in Child Protection Review Tool. (See Chart 7) Chart 7 Central Region Additional Review Elements Matrix Percent Achieved 1. TANF eligibility correctly completed for the investigation. 88% 2. Was the Red Flag checklist appropriately completed and Red Flag Designation correctly identified if the investigation met criteria for Red Flag Protocol. 86% 3. If the investigator documented taking pictures of the home, children, etc. are the pictures in the case file. 50% 4. Was there a gap in time during the investigation of investigative tasks completed by the investigator (i.e. case commenced on July 1 st and no further case activity completed until closure, July 22 nd ) 23% 5. If during the investigation, a child was determined to be missing, were the missing child reporting requirements completed 100% 6. Did the investigator immediately orally notify the state attorney or local law enforcement of the report if any of the following situations occurred? There was a threat to the child s immediate safety or well-being, the family was likely to flee, the child died due to abuse, abandonment, neglect, the child was a victim of aggravated child abuse, or the child was a victim of sexual battery or sexual abuse. Did the investigator transmit a fully written report to the state attorney and local law enforcement within three working days 100% 7. Did the investigator provide notification to the family regarding their Rights & Responsibilities / HIPPA 91% 8. If the report involved a case transfer, were transfer procedures followed 9. If the report involved egregious abuse or termination of parental rights occurred in the past did the investigator adhere to CFOP Justification to keep report open longer than 60 days: If a report was not closed within 60 days, was it due to an active, concurrent criminal investigation, a death case in which the medical examiner s report had not been completed, or a child that had been declared missing 11. Use of Injunction Process: If the report involved a situation which required restricting the access of a parent or caregiver NA NA NA NA Findings below relate to the additional review elements: TANF eligibility improperly documented or the form was partially completed in three of 32 reports reviewed. One report did not have a TANF form completed. Circuit 18 CPI QA Review Page 21

22 Appropriate assessment of the Red Flag designation and completion of the checklist occurred in the 23 reports of 27 reports where applicable. Of the two reports reviewed that documented the investigator taking pictures, one report had the pictures in the file. In two of the reports, a time gap occurred in investigative activity from 12 to 24 days. During the review, these two reports achieved an overall rating of 83% and 86%. In the one report where applicable, the CPI correctly completed the missing child reporting criteria. In the 10 reports where applicable, appropriate notification of the state attorney or local law enforcement occurred. In 29 of 33 reports, the CPI documented providing the family Rights and Responsibilities and HIPPA information. Requests for Action QA reviewers generated three Requests for Action (RFA) during the course of this review. Two RFAs involved Palm Bay reports, one a safety concern and the other an administrative concern. In the safety concern, CLS recommended that if the father was in the home, then the investigator should complete a shelter petition, and if he was not in the home, then the investigator should complete a non-shelter dependency petition. The QA reviewer found no evidence that either occurred. The recommended action consisted of management staff in the service center conducting a staffing with CLS to determine if legal sufficiency did in fact exist. The same evening, a CLS staffing attended by the PA, the CPI supervisor and CLS attorney determined that no probable cause existed for dependency action or removal. In the administrative concern, the CPI requested an Out of Town (OTI) inquiry for an interview and face-to-face contact with the father. There were no Chronological notes entered into the FSFN data system regarding the father s interview by the OTI investigator. After receiving the RFA, the CPI entered the OTI chronological notes of the father s interview into the FSFN data system. One RFA involved a Rockledge report and an administrative concern. The RFA regarded an open subsequent report involving the same report participants. The open report had a number of High Risk factors that required an update of chronological note documentation and assessment. QA recommended specific actions that the Rockledge service center responded to by updating chronological notes regarding the ongoing investigation to include interviews with both mothers, observations of the home, Case Manager contact, substance abuse screening, service referral and CLS staffing. Circuit 18 CPI QA Review Page 22

23 Stakeholder Surveys The review instrument for stakeholder interviews is comprised of three sections. The first two sections have 19 response elements and the third section is for additional information, comments or concerns. Respondents are asked to rate Circuit 18 Child Protective Investigations in each of the areas using a five point scale, including Strongly Agree, Agree, Neutral, Disagree and Strongly Disagree. For the Circuit 18 CPI review, stakeholder surveys occurred with 11 community stakeholders to include local Case Management Agency Directors, Community Based Care (CBC) Care Center Managers, Family Care Manager Supervisors, Guardian Ad Litems (GAL), and CLS attorneys. Regarding the 19 response elements, stakeholders responded positively, i.e., agree or strongly agree 56% of the time, which was a nine percent decrease from 64% achieved during the June 2008 review. Neutral responses were recorded 15% percent of the time, which was an increase of two percent from 14% during the June 2008 review. There were 29% disagree or strongly disagree responses, which was an increase of seven percent from 22% during the June 2008 review. (See Chart 8) Chart 8 N=11 Most positive stakeholder responses were in the areas of having investigative staff accessible and meeting often with members of the stakeholder s organization. There were several negative stakeholder responses identified which included concerns regarding: satisfactorily resolving disagreements, responsiveness to ideas and solutions, having an effective working agreement, a strong partnership at the administrative/management level, following case related recommendations, sharing pertinent case related information, keeping stakeholders informed of changes and providing them with timely information, and investigators following up on their cases. (See Chart 9) Circuit 18 CPI QA Review Page 23

24 Chart 9 Stakeholder Survey Matrix 1. Has a good working relationship with my organization. 2. Provides their staff with the needed support to do their jobs. 3. Has staff that is accessible to my organization. 4. Meets often with me or members of my organization. 5. Is responsive to my ideas and solutions. 6. Can satisfactorily resolve issues or disagreements between our organizations & do so timely. 7. Has a Working Agreement with my organization that is thorough and effective. 8. Has a strong partnership with my organization at the administrative/ management level. 9. Has a strong partnership with my organization at the direct service staff level. 10. Consults with us on child welfare services for their families as appropriate. 11. Follows our case-related recommendations. 12. Shares pertinent case-related information with us. 13. Keeps us informed of changes affecting shared child protection cases when appropriate. 14. Provides timely information to assist in our work. 15. Does a good job identifying children at risk. 16. Does a good job identifying children needing emergency services or removal and placement. 17. Does a good job in following up on cases. 18. Does a good job in arranging or referring to community services. 19. Able to satisfactorily resolve case related issues. % Agree/ Strongly Agree 64% 63% 100% 73% 64% 36% 40% 46% 46% 55% 36% 46% 46% 36% 55% 64% 50% 56% 64% The following are some positive and negative comments from the stakeholders. Circuit 18 CPI QA Review Page 24

25 There is an excellent relationship between CLS and Child Protective Investigations. Sometimes we do not receive all of the needed information relating to non-custodial fathers. Having a CPI assigned to CLS has been very beneficial. We have an open door policy and staff cases on a daily basis. The investigators do a good job completing the CLS staffing form. The Blackberry has enhanced the investigator s communication ability. Child Protective Investigations needs to improve communication with the Guardian Ad Litem (GAL) program. Investigators initiate very little contact when we are involved in mutual cases. CPIs do not invite the GAL to attend staffings relating to mutual cases and do not consider the GAL to be a resource. The Working Agreement/ Memorandum of Understanding (MOU) is thorough however, CPIs do not adhere to it. There is little partnership at the administrative or management level. However, at the administrative level our joint meetings have helped. Due to personal relationships, there is partnership at the direct services level. Growing pains occurred following the relocation to the new service center, but we are working through them. Overall, CPIs do a good job. The MOU contains a conflict resolution element and usually we can reach an agreement when required. Many investigators do not seem to know that an MOU exists. If CPIs followed the MOU, it would eliminate many issues of conflict. Team staffings to determine the level of services have been helpful. Staff enjoys a good partnership at the direct services level. Investigators do not always address all allegations. Investigators refer families that are High Risk to Voluntary Protective Services (VPS) who have no intention of complying. Only a few supervisors attend Team Staffings. Overall Performance Based on FSFN Data Due to the focus change from compliance to quality, removed from the new CPI review instrument are elements measured in the Florida Safe Families Network (FSFN) data information system. Utilizing FSFN report, Child Investigations and Special Conditions Status, the number of Circuit 18 reports received (excluding Seminole County, institutional, duplicates, special conditions and non-jurisdiction reports) between September 1, 2008 and October 31, 2008 increased by 85 reports from 363 received in September 2008 to 448 received during the month of October This represents an increase of 19%. This is consistent with historical data within Circuit 18 where reports received increased during the months when children attend school. Data from FSFN report, Child Investigations Disposition Detail A by District, determined the following information regarding maltreatment findings. In September 2008, Circuit 18 (excluding Seminole County, duplicate and non-jurisdiction reports) closed 17% of their reports with Verified maltreatment findings, 20% with maltreatment findings of Some Indicators and 63% with No Indicators of abuse or neglect. These figures remained comparatively consistent through October 2008 when 13% of the reports closed with Verified maltreatment findings, 21% closed with Some Indicators of abuse and neglect and 66% of the reports closed with Circuit 18 CPI QA Review Page 25

26 No Indicators of abuse or neglect. When comparing Circuit 18 data to statewide data, Circuit 18 has a lower rate of reports closed with Verified or Some Indicator maltreatment findings, and a higher rate of reports closed with No Indicators than the statewide average. Statewide data obtained from FSFN report, Child Investigation Most Serious Finding on Closed Investigation-Statewide by Agency (report run date 11/8/08 excluding duplicate and non-jurisdiction percentages). These figures represented in Chart 10 below compares Circuit 18 October 2008 maltreatment finding rates to those statewide. Chart 10 The statewide performance goal for case commencement within 24 hours is 99.9%. FSFN report Child Investigations Commenced by Time-Statewide by District by County was utilized to obtain commencement rates. In August 2008, Circuit 18 attained a commencement rate of 99.2%. In September 2008, the number of timely commencements increased to 99.8%. In October 2008, the number of timely commencements decreased to 99.5%. This is below the statewide commencement goal of 99.9%, but it is above the October 2008 statewide commencement average of 99.4%. The statewide performance goal for seeing victims within 24 hours is 85%. FSFN report Child Investigation Alleged Victims Seen by Time was utilized to obtain victim seen performance rates. Circuit 18 Brevard County continued to exceed this performance measure by achieving 90.47% in August, 96.4% in September and 93.08% in October Circuit 18 also exceeded the October 2008 statewide average of 86.63%. The statewide performance goal for submitting safety assessments to the supervisor within 48 hours is 99%. FSFN report Initial Child Safety Assessment Submitted to Supervisor by Time-Statewide by County was utilized to obtain these performance rates. Circuit 18 exceeded this performance measure in August and September by achieving 99.8% and in October 2008 by achieving 99.6%. Circuit 18 also exceeded the October 2008 statewide average of 96.1%. In August 2008, Circuit 18 investigations submitted for approval within Circuit 18 CPI QA Review Page 26

27 45 days of Intake averaged 99.8%. In September 2008 and October 2008, this performance measure increased to 99.9%. Circuit 18 consistently exceeds the statewide average of 84.16% for this performance measure. The statewide performance goal of supervisory review of safety assessments within 72 hours is 98%. FSFN report Initial Child Safety Assessment Reviewed by Supervisor by Time-Statewide by County was utilized to obtain these performance rates. Circuit 18 continued to exceed this performance measure by achieving 100% in August, 99.41% in September and 99.82% in October Circuit 18 also exceeded the October 2008 statewide average of 98.56%. In order to continue to demonstrate improvement in these performance measures, Circuit 18 should continue regular usage of FSFN reports. Management in Circuit 18 should run individual reports on a daily basis in order to determine performance levels at the individual and unit level. Within the overall Circuit 18 sample of the 843 reports that were the basis for selecting investigations for this review, 1% percent resulted in court ordered in-home protective supervision, 5% resulted in voluntary protective services, 6% resulted in court ordered emergency removal and 88% did not result in ongoing case management services (Chart 11 below). Chart 11 Comparison of Current Findings and Prior Review Findings In the June 2008 QA review; Circuit 18 achieved an overall performance rating of 91%; the sample size was 64 investigations and included four that resulted in emergency removal. In the December 2008 review, Circuit 18 again achieved an overall performance rating of 91%. The percentage in the Initial Response Domain was 91% in the June 2008 review and 92% in the December 2008 review. The percentage for the Emergency Removal Domain was 68% in the June and December 2008 reviews. The graphs below depict the Circuit 18 CPI QA Review Page 27

28 percentage results (by service center and circuit) from the June 2008 review and the December 2008 review. In addition, for comparison purposes, the Circuit 18 (circuit level only) results from the November 2007 review are included. See Chart 12 for the overall percentage; see Chart 13 for Initial Response Domain and Chart 14 for Removal Domain. Chart 12 Chart 13 Circuit 18 CPI QA Review Page 28

29 Chart 14 The following chart displays the dates and the overall percentages for the most recent CPI reviews in the Central Region. QA has reviewed each of the other four circuits within the Central Region using the Quality of Practice Standards for CPI tool. (See Chart 15) Chart 15 Due to the significant changes in the QA process (half as many cases reviewed and ensuring 5% involve emergency removal) and the review instrument (several elements revised or eliminated) caution should be used when comparing the results of previous reviews to the current review. A more prudent action is to compare specific elements and sub-elements that share similar guidelines. For this reason, review elements in which the guidelines changed will not be included in the following discussion. Following Circuit 18 CPI QA Review Page 29

30 the upcoming June 2009 review, a results comparison of all review elements and subelements between those findings and the findings in the December 2008 review will be possible. Based on the compiled data, the following are positive overall trends in Circuit 18 between the June 2008 and December 2008 reviews. Review element 1.1 Background checks: o Sub-element 1.1.1c Local Law Enforcement increased from 95% to 99%. Sub-element 1.1.1d FDLE increased from 96% to 98%. o Sub-element 1.1.1e Department of Correction increased from 96% to 98%. o Sub-element 1.1.1f Child Welfare Out-of-State significantly increased from 66% to 76%. In the June 2008 review, this sub-element applied to 10 reports and in the current review, it applies to seven reports. Review element 1.2 Diligent Attempts, increased from 86% to 93%. In the June 2008 review, this element applied to seven reports and in the current review, it applies to three reports. Review element 1.4 Interviewing Children, increased from 93% to 99%. o Sub-element 1.41 Interview(s) with child victim(s) increased from 95% to 99%. o Sub-element 1.42 Interview(s) with other children increased from 96% to 100%. Review element 1.5 Interviews with Caregivers: o Sub-element Interview with father increased from 86% to 90%. Review element 1.7 Safety Assessment increased from 95% to 97%. Review element 1.9 Collateral Contacts increased from 90% to 93%. Review element 1.10 Obtaining Pertinent Information from Collaterals increased from 97% to 100%. Review element 1.20 Identification of Service Needs increased from 93% to 98%. o Sub-element 1.20a Child increased from 97% to 100%. o Sub-element 1.20b Mother increased from 95% to 98%. o Sub-element 1.20d Other Caregiver or Caretaker Responsible significantly increased from 40% to 100%. During the June 08 review, the other caretaker sub-element applied to five reports in the current review it applied to three reports. Review element 1.21 Referrals for Services: o Sub-element 1.21a Child increased from 91% to 100%. Circuit 18 CPI QA Review Page 30

31 o Sub-element 1.21c Father significantly increased from 0% to 100%. In the June 08 review this sub-element applied to one report therefore, it is problematic determining whether this accurately characterizes an increase. However, in the current review this sub-element applied to five reports thus demonstrating an area of strength within Circuit 18. Review element 1.22 Engaging Services increased from 85% to 92%. The following charts display some of the most significant positive trends in Circuit 18 between the June 2008 review, and the December 2008 review (See Charts 16 and 17) Chart 16 Chart 17 Based on the compiled data, the following are negative overall trends in Circuit 18 between the June 2008 review, and the December 2008 review. Circuit 18 CPI QA Review Page 31

32 Review element 1.1 Background checks: o Sub-element 1.1.1g Prior Abuse Reports decreased from 97% to 92%. The primary reason for decrease is that investigators are not always completing FSFN individual person searches and as a result, they are not obtaining all of the prior reports. Review element 1.5 Interviews with Caregivers: o Sub-element 1.5.1Interview with mother decreased from 98% to 92%. The main basis for decrease is that investigators are not always interviewing incarcerated mothers, or they are not addressing all of the report allegations. Review element 1.6 Observations and Interactions of the Children decreased from 86% to 76%. Review element 1.12 Children s Legal Services Staffing, decreased somewhat from 100% to 96%. o Sub-element A dependency petition was filed or a valid reason for not pursuing dependency was documented, when the CLS staffing documented legal sufficiency decreased from 100% to 87%. Review element 1.18 Maltreatment Findings decreased from 98% to 93%. The following chart displays the negative overall trends in Circuit 18 between the June 2008 review, and the December 2008 review (See Charts 18 and 19). Chart 18 Circuit 18 CPI QA Review Page 32

33 Chart 19 Recommendations Circuit 18 needs to focus their improvement strategies on the following recommendations that present opportunities for qualitative improvement across the circuit. Administrative and operations staff, in conjunction with the Family Safety Program Office staff, will develop action plans and conduct in-service training and supervisory oversight to address the following recommendations: If the investigative record reflects that the family resided in another state, the CPI must complete a Child Welfare Out of State check in accordance with the requirements of that other state. The CPI is to determine if the family has been involved with any other child welfare agency, and document the circumstances of the involvement. The CPI must consider any information obtained from the other state s child welfare agency in the assessment and include the results in the implications for child safety section. Reference: ss (9)(b)3, F.S.; & 65C (j) & 65C , F.A.C. For each initial and additional abuse or neglect report received, the CPI shall request a call history check from local law enforcement. Reference: ss (9) (b)3, F.S.; & 65C (j) & 65C , F.A.C. Service centers must develop strategies to ensure that supervisors and investigators are familiar with the requirements for documenting specific physical, developmental and behavioral observations of children found in ss (10)(b), F.S.; & 65C (3)(c) Florida Administrative Code. The CPI must notify the assigned Case Manager within one workday when there is an active service case at the time of report receipt. This is more than a notification; there must be evidence in the case file of meaningful communication between the CPI and the Case Manager or Case Management Supervisor regarding the specific circumstances of the family. This communication is necessary for the CPI to know Circuit 18 CPI QA Review Page 33