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Human Services

Reforming in a Whirlwind

A new book on how a troubled agency was turned around is a testimony to perseverance and determination.

There's a problem with most of the books on social services written by top scholars and published by respected think tanks. Most of the time, they're a deadly combination of boring and out of date--even if they might be important contributions to scholarly research.

Which is why it was such a pleasure to open Reforming Child Welfare by Olivia Golden, just published by the Urban Institute. The book is not only timely and topical, but eminently readable.

The book's narrative is enriched substantially by Golden's real-world experience, including her tenure working on a wide variety of children, youth and families issues at the U.S. Department of Health and Human Services from 1993 to 2001. But what really informs Reforming Child Welfare is the three years, 2001 to 2003, that Golden spent working to turn around the District of Columbia's famously and disastrously dysfunctional Children and Family Services Agency, which had experienced nearly 250 child fatalities from 1993 to 2000.

At turns harrowing, appalling and inspiring, Golden's personal account of her tenure at CFSA — and CFSA's efforts to stay out of federal receivership — is a page-turner. It includes stories of battling absolutely brutal odds, odds that ranged from a hostile media (she singles out the Washington Post in particular), to a demoralized, dispirited staff (many of whom were carrying caseloads beyond insane), to lousy relationships with key stakeholders (including the courts), to dealing with the routine and tragic calamities that come with trying to keep thousands of kids safe from harm day in and day out.

She describes, for example, the scene at CFSA — one that was routine at the time of her arrival — that involved turning the agency's offices into emergency shelter for as many as 20 kids on any given night, due to the inability to find them emergency shelter in more appropriate settings.

Especially familiar is the pattern that Golden paints of trying to get in front of and lead reform, while at the same time dealing with the daily brushfires that seemed to consume everyone's time and energy. "Figuring out what lay before me meant untangling a knot of crises, emergencies, demands and requirements," writes Golden.

For example, CFSA had a state-of-the-art case-management system that worked well in other states but that was largely dismissed within CFSA as useless. As a result, "agency decision making felt like a 'data free zone,'" writes Golden. Even getting basic information such as current caseload numbers was a challenge. It was a fundamental systems fix that just had to be made. (Golden eventually found a first-rate data hound who figured out that the problem pretty much revolved around deep-seated conflicts between caseworkers and information technology staff that prevented them from cooperating on fixing the problems.)

Fragmentation and a lack of clear accountability also dogged the agency. For example, both the police department and the local court system — along with CFSA — had responsibility for responding to abuse and neglect reports, which meant that follow up on reports was fragmented and lacked any credible accountability system.

At the same time, there was no special family court to hear child welfare cases, so caseworkers were forced into the same interminable queue along with every other case, working with judges who may or may not have much expertise in children and family law. Entire days were consumed as caseworkers sat idly in court waiting for hearings; CFSA caseworkers were attending 1,500 hearings a month. The tension between the agency and the courts, meanwhile, was so bad that at one point early on in Golden's tenure a judge actually sent a CFSA caseworker to jail for contempt — the caseworker had missed filing deadlines.

The Crush of Cases

Underlying all of the problems at the agency: crushing caseloads. Some front-line staff had dockets of 90 to 100 kids. In one of the most telling passages in the book, Golden describes a syndrome that will be familiar to anyone who has spent 10 minutes in the child welfare business: "With burdens this large, social workers spent their time mainly on court appearances and on emergencies. Of course, failure to have regular contact with children, families and foster parents only made emergencies worse and more frequent, creating a cycle of failure, more emergencies and, in the end, higher caseloads as cases got worse rather than closing."

Finding and hiring additional staff was lagging badly, while a deadline from federal court overseers loomed for documented improvements in 20 areas, ranging from boosting rates of adoption to responding in a timely fashion to neglect and abuse reports, lest the agency go back into federal receivership. In the midst of it all, a high-visibility sexual abuse scandal erupted at one of the District's congregate care facilities.

Other distractions, major and minor, also intervened. For example, the state of Maryland, where foster parents were hosting 1,000 D.C. kids, was threatening to throw them all back into the District due to arguments over foster care reimbursement levels.

Through all of this — and thanks to the high-level and consistent support of then-Mayor Anthony A. Williams, himself a former foster child — Golden and her staff persevered and progressed: Child and neglect response were unified. The District created a family court. The data-system problems get ironed out. And to great relief, the CFSA's secondary function as an emergency shelter was phased out.

Golden's chronicle a troubled agency's transformation is really a story of dogged persistence that helps set up the ultimate message of the book: that while this kind of fundamental change isn't easy — it takes almost superhuman patience and perseverance — it is possible.

To help make that case, Golden also chronicles child welfare system turnarounds in Alabama and Utah, and what made those possible, as a setup to the later chapters in the book. Those chapters get into such topics as the importance of research and data in helping channel and fuel change; lessons learned about turning large rule- and hide-bound organizations around; and how to drive that change down through the organization by building the capacity of front-line staff, along with how to deal with the politics of it all.

Ultimately, though, the book is a vivid chronicle of the challenges that those working in children and family services face day in and out, and the superhuman — even heroic work — that those in the field do almost as a matter of routine to help the kids and families who have tumbled into the system get back out.