How Arizona Fixed Its Broken Child Welfare System in 2 Years

The state attracted national attention for its failure to prevent and address child abuse and neglect. Since then, massive changes have led to massive improvements.
by | April 27, 2017
Greg McKay has been director of the Arizona Department of Child Safety since 2015. (AP/Ross D. Franklin)

For much of the past decade, Arizona’s child welfare agency has been in crisis. The number of children entering the state's foster care system grew 92 percent from 2005 to 2015.

At one point, caseworkers were handling more than seven times the recommended caseloads; investigators had failed to look into more than 6,500 cases of abuse and neglect; and it took more than an average of 10 minutes to speak to a person on the child abuse hotline.

It was such a mess that in 2014, then-Gov. Jan Brewer created an agency dedicated to child welfare -- something only 10 other states had done at the time.

Today, things are looking a lot better.

The backlog of cases used to be about 16,200. Now it’s under 700 and shrinking.

The average caseload used to be 145. Now it’s 22 -- just slightly above the recommended national standard of 20.

And the time it typically takes to connect with the child abuse hotline, which used to be more than 12 minutes, is now 28 seconds.

“The journey over the last two years has been nothing short of extraordinary,” says Shalom Jacobs, deputy director of Arizona’s relatively new Department of Child Safety.

What’s changed most, says Jacobs, is a new management system under Gov. Doug Ducey, a former businessman, that borrows from "lean" practices in the business world to speed up the way they do things. In the past, the agency relied on ad hoc groups that would study an issue for a few months and recommend solutions. Jacobs, who started with the agency as a case specialist in 1999, says that previous leadership never focused on the processes and systems that kept breaking down. Now it's the staff themselves who diagnose problems, propose solutions and then try out their ideas.

But even with the eye-popping improvements in performance, people inside and outside the agency think it remains challenged.

"I would describe the system as still in crisis," says Dana Naimark, president and CEO of Children's Action Alliance, a child welfare advocacy group in Arizona.

Calls suspecting abuse and neglect come in at roughly the same rate. The agency is entangled in a two-year class-action lawsuit that alleges the state is guilty of "deliberate and systemic neglect" of foster care children. And audits in the past few years have criticized the agency's coordination with juvenile courts, inadequate compensation for caseworkers, lack of family and prevention services, poor relations with outside advocacy groups and low success rates at finding permanent placements for children within a year of entering the system.

"We still have a long way to go," says Jacobs, "but I would definitely say we’re on the mend."

The improvements largely coincided with the appointment of a new agency director, Greg McKay, a former foster parent and police officer who previously oversaw the state's child welfare investigations unit.

Governing spoke with McKay about the agency's progress in the past two years. The following transcript has been edited for clarity and length.

How do you explain the turnaround?

Historically in Arizona, and in every state around the country, child welfare is riddled with events that cause constituencies to react heavily. They're usually followed by public outcry, knee-jerk policymaking, funding swings, priority swings and failure.

We put in systems of standard work and visual management. Now this place, which was crisis-driven every day for decades, has become a very stable and calm organization that responds to the demands but does it with a certain process in place, and it’s working.

People used to say social workers don’t like data or structure; they’re about hearts and minds and dealing with people. They are, but they absolutely love the fact that they now know what to do, how to manage what they’re doing and how to take counter measures and deploy things when they’re going the wrong way.

What led you to use lean management techniques?

Gov. Ducey’s direction for the state of Arizona is to implement a statewide management system where government operates at the speed of business. It’s not a downsizing of your staff but more about efficiencies, processes, standardization and adherence.

This is something that every state should be looking at in terms of child welfare. We’re going to stop seeing the constant degradation that happens cyclically around the country in child welfare. I hope this way of doing business can travel.

And please don’t get me wrong, we’re far from saying we’re victorious. We still have a lot of problems. Societally, there’s a lot of problems involving children and families -- from drug addiction to poverty to behavioral health. I don’t think we’ll ever be able to say that we’re victorious in child welfare because there’s always something bad happening to a child somewhere. But we can be the best we possibly can at being a government-mandated response agency. We’re farther ahead in doing that now than we’ve ever been in this state.

Does it help that you held prior roles in the agency?

Most of my executive team consists of grunts who understand the work. You need people who know what it's like to deal directly with drug houses, autopsies and hospitals, and who know what it’s like to have a caseload in the 80s, 90s or 100s. I know personally what all those things feel like.

When I interviewed your predecessor a few years ago, he had brought up the difficulty of retaining employees. What have you been doing to try address that problem?

When my team took the lead, the turnover rate in Arizona was about 35 percent. And that’s for a variety of reasons. This job has a lot of civil, moral and physical risk to it. It doesn’t pay very well, considering the educational requirements to get here. The scrutiny and criticism on people doing this work is intense and very thankless. And you had an organization with no accountability across the board and a line-level workforce that was destined for failure because of mismanagement from the top.

We’ve brought in a culture of support rather than leadership condemnation. When children suffer abuse or are killed in Arizona, fingers no longer immediately point at the line-level worker who should have done something to prevent that death. You don’t see us casting this person out to the masses anymore; you don’t see the firing; you don’t see me acting like a bureaucrat and sacrificing the people down under to keep the heat off of me.

We’ve implemented what we call “a safety culture." We’re not going to talk about people as failures as much as the systemic and process failures that lead to outcomes that we would like to be different. That’s had a huge impact. Our turnover rates are now in the mid-20s.

When we used to put out surveys to find out why people were quitting, it was high caseloads, poor supervision and a lack of training. Now when you ask why they're quitting, it’s almost inevitably pay. So now, we're trying to confront the pay issue. We only do three major initiatives a year, and employee retention is our number two strategic initiative again this year.