DHHS head says DCYF staffing concerns driven by growing caseload

  • Department of Health and Human Services Commissioner Jeffrey Meyers speaks during the Executive Council meeting at the State House on Wednesday, June 29, 2016. The Council voted 3-2 to restore a Planned Parenthood contract during the meeting. (ELIZABETH FRANTZ / Monitor staff) Elizabeth Frantz

Monitor staff
Published: 9/30/2017 11:39:43 PM

Months after an independent review recommended staffing increases at New Hampshire’s Division for Children, Youth and Families, the Department of Health and Human Services is still struggling to fill its open positions.

Data provided by the department shows that while the overall number of child protection safety workers at DCYF has grown, the increases have failed to meet hiring targets, despite internal position reassignments and increased funding from the Legislature.

Meanwhile, the staffing gains have been matched by a proportionate increase in caseloads, increasing burnout and driving continual turnover, the department said.

The conclusions come from a comparison of staffing levels in 2016 – from June to August – and figures in 2017 over the same period. Last summer, the department had an average of 61 workers carrying out assessments in the field; this summer that average was 75. But the rate has fluctuated; this summer alone, 14 child protection safety workers dropped out over the three months analyzed.

“Staffing continues to be an issue in New Hampshire,” said DHHS Commissioner Jeffrey Meyers at a meeting with the Monitor editorial board earlier this month. “And it’s driven, I think in large part by the sheer number of calls that come into DCYF reporting potential abuse and neglect, as well as the number of assessments that are open.”

Staffing DCYF has taken on urgency in the past year, after two high-profile child deaths connected to abuse cases by the agency sparked an independent review by the Center for the Support of Families and multiple legislative commissions. A preliminary report from that review concluded in October 2016 that the department needed 35 additional positions to cope with its caseload.

Over the last 12 months, DHHS has moved to grow its workforce in response to the concern. In October, the agency reassigned non-frontline, unfilled positions in other departments to the division, allowing it to stay within budget, according to Jake Leon, director of communications in the department. Then, in January, the agency’s 24-hour call center for child abuse cases came online, which brought with it a second shift for DCYF caseworkers and a need to fund more employees. By June 2017, the number of open positions at the agency had increased from 84 in mid-2016 to 115.

An appropriation in the 2018 budget created 10 more positions in July; the total number in the division is presently 125.

But while job openings have grown, the agency has struggled to fill all positions, particularly those for assessment workers, who work to substantiate reports of abuse and recommend new cases. During the summer months of 2016, 86 percent of positions were filled on average, but only 71 percent of those workers had completed the training necessary to carry out the work. Summer 2017 saw an average 84 percent of positions filled, with 73 percent of those workers trained.

Assessment workers carry a critical role in the DCYF’s work – they’re one of the first points of contact for those approaching the agency, and their evaluations shape the caseload down the line. But the strain can be exhausting. And due to the necessary qualifications, the training period for new employees is lengthy: between four to six months, Leon said.

Those factors, Meyers said, create the perfect conditions for turnover. When employees do leave the system, he noted, the long training period makes quick restaffing a challenge.

To Meyers, fixing the staffing problem starts with tackling the caseload. Despite dozens of newly hired assessment workers, the corresponding increase in assessments has meant that each employee still tackles about the same number as last summer, according to figures. An assessment worker in August 2016 faced an average of 16 potential cases to investigate per month; 12 months later that number remained the same.

“Until we get the caseloads down, the whole system is overloaded, and that’s something I recognize,” Meyers said.

Some of the increased workload is likely the result of the 24-hour call center, which is manned by an outside agency that directs reports to caseworkers.

But Meyers said inefficiency in the digital tools used for assessment plays a predominant role in the backlog. In its December report, The Center for the Support of Families found that the risk assessment tools used by caseworkers were completed “timely and accurately in about two-thirds of the open cases.” In surveys, many employees complained the tools are cumbersome, slowing down the response process and adding to the overall load.

The Seattle-based Casey Family Programs is working with DHHS to evaluate the assessment tools presently used, Meyers said.

And the Florida-based nonprofit Eckerd Kids has a state contract to train DCYF employees in “Rapid Safety Feedback” software the organization developed to flag high-risk cases that deserve more follow up. A representative did not respond to a request for comment Friday.

To Meyers, fixing the reporting system needs to accompany a broader cultural change within the agency as a whole.

“We’ve got to transform,” he said. “We are transforming – this is ongoing, we’re not waiting for anybody to show up. We’ve been doing this now since I’ve been commissioner, and I think we’re starting to make some progress, and I think the staff understands that we are building a different program.”

(Ethan DeWitt can be reached at edewitt@cmonitor.com or on Twitter at @edewittNH.)

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