DCYF Leader: More Workers Needed to Keep up with Caseload

Sep 22, 2017

Credit Department of Human Health and Services

The state Division of Children, Youth, and Families, or DCYF, has been criticized for its handling of child abuse cases.

The division came under scrutiny following the deaths of two young girls whose cases were under review.

Now, legislative action is being taken to try and resolve those issues.

Christine Tappan was confirmed as the associate commissioner of Health and Human Services last week. Her hire is part of a reorganization of DCYF. She’ll oversee the agency where she actually worked before, from 2008 to 2012.

Morning Edition Host Rick Ganley spoke with Tappan about her goals for reform.

This transcript has been edited lightly for clarity.

State legislators have been open in saying the reform that's been passed so far is just scratching the surface. They say there's a lot of work left. Now I know you're new to the role, but what's your first priority?

So I do agree that we're at the beginning of the change that we're all trying to create. I think that as we've looked across the country and child welfare, there have been calls for reform in many states. And one of the things that I've shared as I've come back to New Hampshire again, I am native here, is that I really believe at this point in time that what we're all talking about, what so many people have come forth with ideas that I think really can truly help us to transform the system. I think that's what we're really looking for.

Let's kind of recap a little bit what New Hampshire has not been doing well and what it is doing well.

Sure. So when I left New Hampshire in 2012, we were considered at the time one of the best child welfare agencies in the country. I think at that point though what has happened is we had begun in the state to have gradually begin some reductions.

Are you talking about staffing levels or resources? What was the cause of that?

Of several different areas. So yes there had been reductions in staffing. And with that also came things like in 2010 there was a cut to what we called incentive funds, which were funds that went out to communities to actually help to prevent child abuse and neglect. I took a look at some data from 2010 when that first occurred, and what I could see is that we've actually had a 26 percent increase in our calls to central intake.

And on top of that you had an opioid epidemic in the state, which obviously has a large effect on these numbers I imagine.

Absolutely. In 2012 we were a fairly stable organization. I think in many ways we were able to be flexible and responsive to some of the cuts that had taken place. Because at the time we had what were potentially some increases in caseload, but not so much that we couldn't handle that by flexing our system. But by the time you added the opioid crisis on top of it, it was really the element that I think tipped the system over.

So the state had an independent consulting group conduct in-depth review of DCYF last year. What were the most pressing issues in that review, and how do you plan to address those recommendations? Where do you start, and what are some of the steps you're going to take?

We have workforce issues across the entire division and across the department for that matter.

This means from attrition or people leaving? Are you talking about you can't recruit? What are the issues there?

It's all of the above. When we have an unemployment rate of 2.7 percent in the state, the reality is that all employers, and when you then drill that down into a particular area like health and human services, we're all competing for the same quality people. And then I think when the caseloads began to increase, and frankly when portions of our system like our training system didn't evolve as they needed to, really adapting to what were the new and pressing needs for workers to number one be able to assess and understand substance use disorders and how that should impact the way that they conduct their assessments and safety planning with families, then the workers began to be very concerned about their ability to do the job well.

So you've got a problem here with staffing. You've got just too many cases for too few workers. On top of that you've got workers that maybe aren't well enough trained for the conditions that they were facing. So where do you start? How do you how do you change this?

So before I came, there was opportunity for overtime for staff who had the ability to put in some additional time and close cases. And they've tried to do that. And we have had many cases closed. Additionally, I can't say enough about our juvenile justice staff. Many who were prior child protection workers, who moved over to the juvenile justice side of our division, who have stepped up and been now engaged, been retrained and are helping to close those assessments. And then we're also looking at options to potentially bring back staff who've left in good standing with the division, who are good child protection staff, and contract with them to come back and help us to close those cases.

Have you had luck with that recruitment effort?

We are we are, but my concern is we're not making traction fast enough. And so we are in the process of exploring other options in the near future that we could undertake to close those. But because we've continued to get over a thousand new assessments per month throughout June, July and August, we're now at the same level. We are over 3,000 overdue assessments still.

I have got to say that's got to be rather disheartening, I think, for you and the staff in general to see those numbers, to know that they're there. And it's just you just don't physically have the time and staff to go through all of these in a timely manner.

Absolutely. Many states have looked towards developing a culture of safety where you know that you need in an organization to have a high level of an ability for staff to feel safe to talk about what they're concerned about, what they don't feel like is working right in the system, what the breakdowns in the system are. We're going to be hiring a safety specialist to help us look across our safety practices and help us build the safety culture.

This sounds like whistleblower protection really is what it is if somebody wants to kind of put their head up and say there's something wrong in the organization.

Right. And I don't want it to become all the way to have someone feeling like they have to be a whistleblower. I want people to feel safe to be able to say I'm really concerned, or frankly, I have a new idea. I want to test a new idea, because I'm seeing families having different needs than they had six months ago so that we can be an evolving system. That's the direction we really need to go in.