Performance Audit Report

Department of Human Resources

Social Services Administration
Certain Aspects of Child Welfare System

Reported Staffing Levels Were Unreliable

A Number of Issues Impacting the Timeliness, Adequacy and Documentation

Of Child Protective Services Investigation Were Noted

DHR Automated System Could Not Track Caseworker Assignments

Certain Baltimore City Foster Care Performance Measures Were Unreliable

December 2005

OFFICE OF LEGISLATIVE AUDITS

DEPARTMENT OF LEGISLATIVE SERVICES
MARYLAND GENERAL ASSEMBLY
• This report and any related follow-up correspondence are available to the public through the
Office of Legislative Audits at 301 West Preston Street, Room 1202, Baltimore, Maryland
21201. The Office may be contacted by telephone at 410-946-5900, 301-970-5900, or 1-877-
486-9964.

• Electronic copies of our audit reports can be viewed or downloaded from our website at
http://www.ola.state.md.us.

• Alternate formats may be requested through the Maryland Relay Service at 1-800-735-2258.

• The Department of Legislative Services – Office of the Executive Director, 90 State Circle,
Annapolis, Maryland 21401 can also assist you in obtaining copies of our reports and related
correspondence. The Department may be contacted by telephone at 410-946-5400 or 301-
970-5400.
 December 29, 2005

Delegate Charles E. Barkley, Co-Chair, Joint Audit Committee

Senator Nathaniel J. McFadden, Co-Chair, Joint Audit Committee
Members of Joint Audit Committee
Annapolis, Maryland

Ladies and Gentlemen:

We conducted a performance audit of certain aspects of the Department of Human

Resources’ (DHR) child welfare system. The purpose of this audit was fourfold, and
included the review of: a February 2005 DHR child welfare staffing report for accuracy
and completeness, DHR’s process for investigating reported child abuse and neglect,
the timely assignment of caseworkers to foster care cases, and the reliability of select
information reported semi-annually by DHR in accordance with a longstanding
Baltimore City Department of Social Services (BCDSS) foster care consent decree.
This audit was requested by the President of the Senate and the Speaker of the House
of Delegates.

We found that the caseworker and supervisor staffing levels included in the February
2005 DHR child welfare staffing report were unreliable. DHR did not consider all
pertinent factors affecting staffing, including the impact of all relevant industry staffing
standards. For example, by not considering leave usage in developing its staffing
standards, we estimated under one scenario that DHR understated its required
staffing level by 130 caseworkers and 26 supervisors statewide. Also, DHR did not
use the most current data available; however, because of certain data limitations, a
reliable determination of staffing levels was not possible.

During our review and testing of Child Protective Services (CPS) investigations, which
were limited to three specific local departments of social services (LDSS), we identified
a number of issues impacting the timeliness, adequacy and documentation of
investigations. For example, investigations of reported child abuse or neglect were not
always initiated or completed timely, and supervisors frequently did not document
their review and approval of decisions not to investigate allegations of abuse or
neglect. We also found inconsistencies between critical CPS data recorded in case
files and DHR’s automated records, casting doubts on the reliability of the record
keeping.
DHR’s automated system was not capable of tracking foster care case assignments to
help management ensure that cases were continually assigned to active employed
caseworkers. Although our testing of caseworker assignments to 111 foster care
cases active from January to June 2005 disclosed that during that period the cases
were assigned to valid DHR employees, case oversight was not consistent. We noted
at all three LDSS that documentation in the respective case file of required monthly
face-to-face meetings between the worker and the child was frequently lacking. Fifty-
four cases were noted where at least one month’s visit during the six month period
was not documented in the files. Some caseworkers acknowledged that monthly visits
did not always occur due to extended employee leave and unavailability of the child
during unscheduled visits. In some cases, telephone contact was made in lieu of face-
to-face meetings.

Our fourth objective dealt with testing the reliability of certain BCDSS foster care
performance results reported semi-annually by DHR in compliance with a consent
decree from a 1988 lawsuit. Our test of 20 of the 71 foster care results included in
the December 31, 2004 report disclosed that 8 results were reliable but 11 other
results were deemed to be unreliable and the remaining result was unauditable due to
a lack of documentation. Finally, we found that for a specific result we were requested
to review, dealing with the timely transfer of cases when caseworkers leave
employment or transfer, DHR did not track or report this information as required.

An executive summary of our results can be found on page 5 and our objectives, scope
and methodology of the audit are explained on page 7.

We wish to acknowledge the cooperation extended to us during our audit by DHR

Social Services Administration and the staffs of the three LDSS selected for review.

Respectfully submitted,

Bruce A. Myers, CPA

Legislative Auditor

2
Table of Contents
Executive Summary 5

Audit Scope, Objectives, and Methodology 7

Background Information 11

Baltimore City Consent Decree 11

Reports Addressing Services to Children 11
Caseload Standards 12
Statistical Information 13

Findings and Recommendations 17

Objective 1: Child Welfare Staffing

Conclusion 17
Background 18
Finding 1 – February 18, 2005 Child Welfare Staffing Report 19
Was Not Reliable

Objective 2: Child Protective Services (CPS) Investigations

Conclusion 23
Background 24
Finding 2 – Required Supervisory Review of Decisions to Not 26
Formally Investigate Allegations of Neglect and Abuse Was
Often Not Documented
Finding 3 – CPS Cases Were Sometimes Closed Without Making 28
Contact With the Alleged Victim
Finding 4 – Two Local Departments Did Not Comply With 28
Certain Processing and Documentation Requirements
Finding 5 – Investigations Were Often Not Initiated or 29
Completed Within the Legally Required Timeframes
Finding 6 – Evidence of CPS Investigation Results Being 31
Forwarded to State’s Attorney Offices Was Frequently Lacking
Finding 7 – CPS Data In the Client Information System Were Not 32
Always Accurate

Office of 3
Legislative
Audits
 Finding 8 – Reasons for Decline in Continuing Services Cases 33
Were Not Adequately Assessed
Finding 9 - Reported Managing For Results Data On 34
Maltreatment Recurrence Might Be Overstated

Objective 3: Assignment of Foster Care Cases to Active

Caseworkers

Conclusion 37
Background 38
Finding 10 – The Automated System Did Not Have the 38
Capability to Identify the Historical Assignment of Caseworkers
Finding 11 – Case File Often Did Not Contain Documentation of 39
Required Monthly Contacts

Objective 4: Baltimore City Consent Decree – Department

of Human Resources Data Reports

Conclusion 43
Background 43
Finding 12 – Data Underlying Reported Measures Reviewed 46
Were Sometimes Found to Be Unreliable
Finding 13 – BCDSS Compliance With Timely Transfer of Foster 48
Care Cases Between Workers Was Not Reported

Exhibits
Exhibit A – Audit Request Letter From the President of the 51
Senate and the Speaker of the House of Delegates and
Follow-up Letter Granting Time Extension
Exhibit B – Child Welfare Staffing Report as of February 18, 55
2005
Exhibit C – OLA Recalculation of DHR’s February 2005 Staffing 57
Report
Exhibit D – Analysis of Questionable Allegations “Screened Out” 61
Exhibit E – Comparison of 31st, 32nd and 33rd 6-Month 63
Compliance Report Performance Measures (Baltimore City
Consent Decree)

Agency Response Appendix

Office of
4 Legislative
Audits
Executive Summary
At the request of the leadership of the Maryland General Assembly, the
Office of Legislative Audits has conducted a performance audit of various
child welfare issues. The audit had four stated objectives and the following
are summaries of the findings in those areas.

Child Welfare Staffing (see pages 17 through 22)

Our audit disclosed that the Department of Human Resources (DHR)
February 18, 2005 report on child welfare staffing was unreliable, as it did
not include a comprehensive consideration of all pertinent factors affecting
staffing, such as all relevant Child Welfare League of America staffing
standards, the use of the most current data available and factors for
employee leave. We estimated under one scenario that DHR understated
the required staffing level by 130 caseworkers and 26 supervisors by not
considering leave usage. Because certain data were missing from the files
or were not being accumulated, we were unable to determine the actual
staff levels and ratios.

Child Protective Services Investigations (see pages 23 through

36)

The results of our reviews and testing in this area disclosed a number of
problems impacting virtually every facet of Child Protective Services (CPS).
For example, we found that CPS investigations tested were often not
initiated or completed within the time frames required by State law, and
certain documents were not always completed during the investigation as
required. Problems were also found with the preliminary screening of the
allegation of neglect or abuse. Our tests disclosed numerous cases where
required supervisory review of decisions not to accept allegations of neglect
or abuse for formal investigation were not documented. For some cases, we
also found evidence that when efforts to contact the alleged victim were
impeded, the cases were closed without pursuing available legal means to
gain access. Finally, we found that critical CPS data recorded in the
automated DHR Client Information System (CIS) were not always complete
and accurate.
Office of
Legislative 5
Audits
Assignment of Foster Care Cases to Active Caseworkers
(see pages 37 through 41)

DHR’s automated system was not capable of tracking foster care case
assignments to help management ensure that cases were continually
assigned to active employed caseworkers. Therefore, we conducted
statistical samples at three local departments of social services (LDSS) to
determine, based on case file documentation and personnel records,
whether caseworkers for these particular cases were active DHR employees.
We found that all 111 cases tested (active during the period of January to
June 2005) were assigned to active caseworkers. However, caseworker
contact with the foster care children was inconsistent. In 54 cases there
was no documentation that required monthly visits occurred in each of the
six months tested. Missed or undocumented visits ranged from 26 cases
where one month was missed to 2 cases for which there was no
documented visit for the entire 6-month period. Although there is no way to
know if a visit actually occurred in these 54 cases, as compared to the
failure to document a visit, caseworkers did acknowledge to us that monthly
visits in fact do not always occur for a number of reasons. This situation has
now been commented upon in several of our previous audit reports starting
with the May 2002 Performance Audit Report on the Out-of-Home Care
Program.

Baltimore City Consent Decree – DHR Data Reports (see

pages 43 through 49)

We tested certain information contained in the 6-month DHR compliance

report on the Baltimore City Department of Social Services (BCDSS) for the
period ending December 31, 2004 to determine its reliability. The report
included 72 performance measures (of which 37 related to foster care and
35 related to kinship care). For these measures, DHR reported 146
separate results of which 71 related to foster care, 64 to kinship care and
11 included combined results. Our test of 20 reported results for foster care
determined that the reliability of the data underlying 11 results was deemed
unreliable. We also noted that one additional measure could not be tested
due to a lack of documentation to support how the measure was calculated.
Although we were also specifically requested to determine if BCDSS
complied with a Consent Decree requirement to transfer foster care cases
within five days of a foster care caseworker leaving or transferring, we could
not test this measure because DHR has not tracked or reported the results
of this specific requirement in the 6-month reports.
Office of
6 Legislative
Audits
Audit Scope, Objectives,
and Methodology
Scope
We performed an audit of certain aspects of the Department of Human
Resources (DHR) child welfare system. This audit was conducted in
response to a May 2005 request from the President of the Senate and
Speaker of the House of Delegates (see Exhibit A). We conducted the audit
under the authority of the State Government Article, Section 2-1221 of the
Annotated Code of Maryland, and performed it in accordance with generally
accepted government auditing standards.

Objectives

Our specific audit objectives as completed were to determine whether:

(1) the methodology used in preparing the February 18, 2005 DHR Child
Welfare Staffing table (as reported to the General Assembly) was
consistent with appropriate industry standards (for example, the Child
Welfare League of America or CWLA) and the reported staff-to-
caseload ratios were reliable.

(2) DHR performed investigations of reported child abuse and neglect in

accordance with State law.

(3) children in foster care were assigned to active case workers and that
case workers made monthly contact with children as required by
State law.

(4) certain information contained in the DHR 6-month compliance report,

for the period ending December 31, 2004, filed in accordance with
the September 1988 L.J. v. Massinga Baltimore City foster care
Consent Decree was accurate. We were also requested to determine
whether DHR complied with certain Consent Decree requirements
related to the timely assignment and transfer of cases when a worker
leaves or transfers.

Office of
Legislative 7
Audits
 Our audit objectives did not include other aspects of child welfare not
specifically requested (such as adoption services). In addition, since the
audit request specifically requested we evaluate Baltimore City, and Prince
George’s and Anne Arundel Counties, we did not include other local
departments of social services (LDSS) with respect to performing Objectives
2 and 3. Furthermore, our testing of compliance with the Consent Decree
(Objective 4) was necessarily limited to the Baltimore City Department of
Social Services (BCDSS).

Methodology

To accomplish our objectives, we reviewed applicable State laws and

regulations and the 1988 Consent Decree, as well as policies and
procedures established by DHR and the three local departments. We also
reviewed and obtained an understanding of the recommended practices and
guidelines related to staffing and caseloads issued by the CWLA. We
interviewed personnel responsible for processing and supervising child
protection investigations and foster care cases, including employees of DHR
and the respective LDSS. We also reviewed relevant independent studies
and reports on the adequacy of child welfare services. Finally, we
interviewed other stakeholders as we deemed appropriate under the
circumstances.

We performed tests to determine the reliability of February 18, 2005 staff-

to-caseload information reported to the General Assembly. We also
conducted separate statistically valid tests of child protection and foster
care cases from the Baltimore City, Anne Arundel and Prince George’s
County LDSS to determine if 1) child protection investigations were
conducted timely in accordance with State law and 2) foster care children
were contacted on a monthly basis as required by State law, and hence
assigned to active DHR caseworkers.

We used statistical sampling for certain tests to be able to project the results
to the entire population subject to testing. In each test, we tested the source
records (such as DHR’s automated Client Information System) to ensure that
the source was reliable for use in selecting test items. We found that we
could rely on the selected source(s) when selecting our test items. All
statistical sampling test results are projected based on a 95% level of
confidence.

Office of
8 Legislative
Audits
 To test the accuracy of performance measures reported by DHR for
compliance with the Consent Decree, we selected certain measures
contained in the 33rd compliance report (distributed in February 2005, for
the 6-month period ending December 31, 2004) and obtained and tested
documentation supporting the reported performance. Specifically, we
interviewed DHR and BCDSS personnel, reviewed performance measure
calculations for reliability, and determined whether these calculations were
appropriate for the data being reported. We used sampling techniques or
other methods as deemed appropriate to test the related source documents.
We also analyzed BCDSS measurement data collection and reporting
activities to evaluate whether proper controls existed.

Finally, we concluded if the reported data were reliable or not reliable

(defined as 3 or more errors having been noted in our sample). Our testing of
the performance measurement data required by the Consent Decree was
similar in nature to that performed during our audits of the State of Maryland
Managing for Results performance measures. Specifically, we determined if
the data were reliable or unreliable using industry accepted sampling
methods. This method states that for randomly selected tests, the
reliability/accuracy of the selected attribute being tested is based on the
number of errors found in a predetermined number of test items. If less
than 3 errors are found in a test of 61 randomly selected items, the attribute
tested is deemed to be reliable or accurate. If, however, the testing
discloses three (or more) errors, the attribute or data was deemed
unreliable.

After our audit fieldwork started, we were requested by staff of the General
Assembly leadership to compile a summary of the results of the past three 6-
month compliance reports (the 31st, 32nd and 33rd). This information is
included in Exhibit E, and was not audited by us or subjected to any other
verification procedures, except as described in Objective 4 for the 33rd
request. Accordingly, the summary information is included for informational
purposes only, and we have drawn no conclusions on its accuracy or
reliability of the presented results.

Fieldwork and DHR Response

We conducted our fieldwork from May 2005 to October 2005. The DHR
response to our findings and recommendations is included as an appendix
to this report.

Office of
Legislative 9
Audits
 Office of
10 Legislative
Audits
Background Information
The Department of Human Resources’ Social Services Administration (SSA)
supervises child welfare social service programs provided through the 24
local departments of social services (LDSS). These programs include
services intended to prevent or remedy neglect, abuse or exploitation of
children, preserve, rehabilitate or reunite families and provide appropriate
placement and permanency services for children requiring out-of-home care
(such as foster care).

Baltimore City Consent Decree

Over the past 20 years, the State and DHR have been parties to a lawsuit
regarding various aspects of the quality of care provided to foster children in
Baltimore City, which serves approximately 50% of the State’s foster care
caseload (L.J. v. Massinga). In 1988, the State entered into a Consent
Decree with a plaintiff to the lawsuit, which required DHR, in conjunction
with the Baltimore City Department of Social Services (BCDSS), to provide
certain services and functions. The Consent Decree has been modified over
time, but still maintains provisions related to care provided to foster children
in the City. To demonstrate compliance with the Decree, DHR files 6-month
compliance reports covering various aspects of services provided by BCDSS.

Reports Addressing Services to Children

In addition, to the above noted lawsuit, there have been a number of reports
and studies concerning the quality of care provided to children requiring
services in the State. These include:

• Review of the Maryland Child Welfare System (January 1997) – issued

by the Child Welfare League of America (CWLA). This report noted that
decision making for child protective services was inconsistent, caseloads
were too high or not evaluated and that worker training was inadequate.

Office of
Legislative 11
Audits
• Department of Human Resources Social Services Administration Out-of-
Home Care Program performance audit report (May 2002) – issued by
the Office of Legislative Audits. This report included a number of
significant concerns about the delivery and monitoring of critical services
to the then 11,000 children in the State’s out-of-home care program,
administered by SSA and the local departments of social services.
Additional comments were included regarding the adequacy of DHR
resources devoted to the program.

• Citizen Review Board for Children Annual Report (2002 and 2003) –
indicated the need for stable funding and adequate human resources. It
also noted concerns regarding adequacy of investigations of child abuse
and neglect.

• Maryland Child and Family Services Review (June 2004) – prepared by

the United States Department of Health and Human Services. The
review noted that the State was not in substantial conformity with a
number of child welfare outcomes including ensuring permanency and
stability of living situations. The report identified a number of barriers to
compliance.

• Report of the Task Force on Child Welfare Accountability (December

2004) – prepared by the Maryland Task Force on Child Welfare
Accountability. The report noted that Maryland has yet to achieve the
basic system needed to ensure accountability and quality in the child
welfare system. Attention to overall quality was deemed to be “hit or
miss”, rather than systematic. The task force made a number of
recommendations to improve accountability including meeting CWLA
caseload standards, stable funding, and a fully functional information
system.

Caseload Standards

The General Assembly has statutorily mandated that DHR hire additional
child welfare caseworkers and supervisors in order to achieve the staff-to-
caseload ratios recommended by the CWLA. In fiscal year 2005, the
General Assembly restricted funds in the DHR budget unless certain position
targets were met. In February 2005, DHR reported that it was close to
achieving the recommended staffing levels, and subsequently $3.5 million in
restricted funds was released to DHR.

Office of
12 Legislative
Audits
Statistical Information

During the audit, DHR provided us with various statistical information. Table
1 provides fiscal year 2005 information for selected child welfare services
included in the scope of our audit.

Table 1
Selected Case Data for Fiscal Year 2005
Foster/Pre-
CPS Investigations Kinship Care
Adoptive Care
Local
June June June
Department FY 2005 FY 2005 FY 2005
2005 2005 2005
Average Average Average
Caseload Caseload Caseload

Anne Arundel 215 247.1 217 214.7 24 30.2

Prince George’s 252 286.7 505 507.6 39 42.2

Baltimore City 491 543.2 5,059 5,134 1,611 1,562.5

Other 21 Local
1,402 1,548.3 2,588 2,576.2 283 265
Department

State Totals 2,360 2,625.3 8,369 8,432.5 1,957 1,899.9

Source: June 2005 DHR Monthly Management Report and CIS Data Extracts

Charts 1 to 3 show five-year trend information for the above categories

(Child Protective Services Investigations, Foster / Pre-Adoptive Care, Kinship
Care) based on fiscal year average cases. The source for the information in
all three charts is the June 2005 DHR Monthly Management Report.

Office of
Legislative 13
Audits
 Chart 1
Average Monthly CPS Investigations Conducted
(Statewide)
Fiscal Year 2001 to 2005

2,800
2,726 2,741

2,700
2,629 2,625

2,600
2,520
2,500

2,400
2001 2002 2003 2004 2005
Fiscal Year

Chart 2
Average Number of Foster and Pre-Adoptive Care Cases
(Statewide)
Fiscal Year 2001 to 2005
10,500
10,177
9,999
10,000
9,682

9,500
9,132

9,000
8,795

8,500

8,000
2001 2002 2003 2004 2005
Fiscal Year

Office of
14 Legislative
Audits
 Chart 3
Average Number of Kinship Care Cases
(Statewide)
Fiscal Year 2001 to 2005
2,500
2,221
1,910 1,803 1,823 1,900
2,000
1,500
1,000
500
0
2001 2002 2003 2004 2005
Fiscal Year

(Note: The average number of foster and pre-adoptive care cases reported
in Chart 2 for each year erroneously counts certain data. That is, CIS counts
certain cases twice when compiling the data for inclusion in the
Management Report. DHR personnel could not accurately restate the data
for those years. The number of cases in Table 1 accurately reflects the fiscal
year 2005 average case count. Chart 2 is included for trend comparative
purposes only.)

Office of
Legislative 15
Audits
 Office of
16 Legislative
Audits
 Findings and
Recommendations
Objective 1
Assessment of DHR Calculated Child Welfare
Staffing at February 18, 2005
Conclusion
Our first audit objective was to determine if the February 18, 2005 DHR
Child Welfare Staffing report was consistent with industry standards and if
the reported staff-to-caseload ratios were reliable. Our audit disclosed that
the February 18, 2005 DHR report on child welfare staffing was unreliable,
as it did not include a comprehensive consideration of all pertinent factors
affecting staffing, such as all relevant Child Welfare League of America
(CWLA) staffing standards and the most current data available. Although we
were unable to recalculate the actual staffing levels and ratios with any
confidence, due to missing or unavailable information, we believe the nature
and extent of questionable DHR assumptions and practices noted are
sufficient to conclude that the report is unreliable. For example, we noted:

• that current CWLA caseload standards were not used,

• employee leave usage was not taken into account as recommended by
CWLA,
• the most recently available caseload data were not used,
• the impact of caseworker and supervisor vacancies was not considered,
and
• there was no verification that individuals in caseworker positions
actually functioned in areas related to child welfare service delivery or
supervision.

Office of
Legislative 17
Audits
Background
To prepare the February 18, 2005 report of caseload staffing ratios
submitted to the General Assembly (see Exhibit B), DHR performed a two-
step process. First, DHR determined the number of caseworkers needed.
Second, DHR determined the number of existing staff. This information was
used to calculate the staffing ratios. The process worked as follows:

DHR Determination of Caseworkers Needed (CWLA Standard)

1. Obtain the 12-month case averages for fiscal year 2004 as contained
in the June 2004 Monthly Management Report for all child welfare
service categories.1

2. Divide the case averages by the CWLA standards for the type of
service provided. When no standard existed (such as for child
protective service intake screening), DHR developed an internal
standard based on their best estimates.

3. Total the number of caseworkers needed from each category to

obtain the total caseworkers needed based on CWLA standards.

4. Divide the number of total caseworkers needed by five to determine

the number of supervisors needed in accordance with CWLA
supervisory standards.

(Note: All calculations were performed separately by LDSS and then

accumulated by DHR to provide a statewide total.)

DHR Determination of Existing Filled Positions

DHR determined the number of actual filled positions starting with a
Department of Budget and Management (DBM) listing of caseworkers and
supervisors according to personal identification number (PIN). The DBM
listing showed all related PINs including vacant positions by LDSS. Since a
delay exists between filling vacant positions and posting the information to
DBM records, DHR used reports of new hires prepared by each LDSS and
compared this information to determine any new staff not reflected on the
DBM report. This adjusted total, by LDSS, was then compared to the
number of caseworkers and supervisors needed according to the CWLA

1 There are seven service categories: adoptive services, child protective services, family preservation
services, foster care, intensive family services, kinship care and services to families with children.
Office of
18 Legislative
Audits
 standards to determine the adequacy of the number of staff employed by
DHR for child welfare services.

Finding
1. DHR Child Welfare Staffing report dated February 18, 2005 was
not prepared in accordance with recognized standards nor
based on reliable or current information – The Child Welfare Staffing
report (see Exhibit B) presented by DHR to the Maryland General Assembly in
February 2005 was not reliable. Certain assumptions were made by DHR
that were not verified, were inconsistent with the standards of the CWLA, or
were based on data of questionable accuracy. Additionally, we noted that
the most current data were not always used.

We attempted to recalculate the February 2005 report using more timely

and complete data. When we adjusted DHR’s calculation for known errors
(such as accurate staff counts and current caseload standards), we found
that the number of caseworkers and supervisors needed and employed as
reported by DHR was reasonable. Exhibit C includes a restated report
including as much correct information as available. However, we believe
that factors we could not quantify would result in a significant increase in the
number of staff needed to meet the current caseload. For example, because
leave usage (such as annual, sick and personal leave) was not considered in
determining the required staff size, we estimated, under one scenario, that
DHR would have needed to hire 130 additional caseworkers and 26
additional supervisors to adequately address staffing needs based on
caseloads during November 2003 to October 2004.

The following is a summary of the issues we found when reviewing the

underlying assumptions and supporting documentation of the February 18,
2005 Child Welfare Staffing report.

Noncompliance with CWLA standards:

• Current CWLA caseload standards were not used when determining the
number of required caseworkers. For example, DHR used a standard of
6 cases per worker for both family preservation and intensive family
services, even though the CWLA recommended standards are 12 and 4,
respectively.

Office of
Legislative 19
Audits
• CWLA recommended practices include a consideration of employee leave
usage on staffing and caseload ratios (to arrive at annual workdays
available). DHR did not calculate the effect of leave, which could have
been significant. In fact, we estimated that if all employees included in
the February 2005 Staffing Report took 20 days off annually (from all
leave sources), DHR would need approximately 130 additional
caseworkers and 26 additional supervisors to meet existing staffing
standards. Because leave usage, especially among employees with
longevity, tends to be higher than 20 days per year, we believe these
estimates are conservative.

Comprehensiveness and Accuracy of Underlying Data:

• DHR did not verify that staff included in the report actually functioned in
areas related to the delivery or supervision of foster care services.
During our field visits to three LDSS, it came to our attention that at least
7 supervisors included in the DHR calculation of available staff did not
directly supervise caseworkers (as assumed), but performed other
managerial duties. These three LDSS had a total of 192 supervisors.

• Although DHR used January 2005 DBM employee position information to

quantify the number of employees, it did not take newly vacant positions
into account that had not been reflected in the DBM data. Our review of
the DBM data and DHR recruiting reports indicated that 20 caseworker
and 2 supervisor positions reported as filled on the report were actually
vacant at the time DHR prepared its calculations.

• The most current caseload averages2 (a key component of staffing ratios)

were not used. DHR used the 12-month caseload averages for the
period ending June 30, 2004 when assembling the report. While the use
of a 12-month average is reasonable; at the time the report was being
prepared, a more current 12-month average for the period ending
October 31, 2004 was available.

• Questionable data from the automated Client Information System (CIS)

were used for certain components of the reported results. We noted that
the child protective services (CPS) case count was unreliable. Our testing
(see Objective 3 findings) disclosed that the number of active or open

2 Actually several different caseload averages were used, as the generic term “Child Welfare”
includes a number of different categories.
Office of
20 Legislative
Audits
 cases included cases that were actually closed, and included cases
mistakenly opened for the sibling(s) of a child under CPS (that is, LDSS
personnel opened cases for multiple children in a family when only one
child was alleged to have been abused or neglected).

As a final check on the DHR-calculated results from the report, we also

reviewed manual records maintained at three LDSS. Supervisors
maintained monthly manual caseload assignment reports, which identified
the caseworkers under their oversight and the number of cases each
caseworker was assigned that month. Although our analysis was only for
January and February 2005 (months that were not specifically covered by
the report), it highlighted issues that DHR should pursue further before
attempting to republish the staffing report. For example,

• Supervisor caseloads generally appeared to be higher than reported

and were above the CWLA recommended ratio of one supervisor for
every five caseworkers. The February 18, 2005 report to the
legislature indicated that two (Anne Arundel Department of Social
Services or AADSS and Prince George’s Department of Social
Services or PGDSS) of the three LDSS were adequately staffed with
supervisors, while the third (Baltimore City Department of Social
Services or BCDSS) was short only three positions based on the five
caseworker per supervisor ratio used in calculating the February
staffing report. Manual supervisor reports indicate that for the two
months reviewed, on average, a supervisor in PGDSS supervised 6
caseworkers; while in BCDSS, on average about 5.5 caseworkers
were supervised, with over 60 percent of those supervisors of
foster/kinship/adoptive services assigned at least 6 caseworkers.

• Actual caseloads for certain caseworker categories were higher than

recommended. For example, CPS caseloads significantly exceeded
the CWLA standard of 12 active cases per employee. In BCDSS, CPS
caseworkers averaged about 17.5 cases per month, while in PGDSS
the average was around 24 cases per month. Three caseworkers in
the PGDSS had caseloads exceeding 60 cases. These findings do
correlate somewhat with the reported staffing results in the February
report, where these two LDSS were shown to be short 15 and 31.5
caseworkers.3

3 It should be remembered that the February 18, 2005 report is an amalgamation of all categories of
child welfare services.
Office of
Legislative 21
Audits
Recommendation
1. We recommend that DHR revise its methodology for calculating child
welfare staffing. CWLA standards should be utilized, the most current
information used, and the reliability and comprehensiveness of the
underlying data should be tested or otherwise verified.

Office of
22 Legislative
Audits
Objective 2
Child Protective Services Investigations
Conclusion
Our second audit objective related to determining the adequacy of several
aspects of Child Protective Services (CPS) at three LDSS. CPS is a
specialized social service for children who are believed to be neglected
and/or abused, and to their parents, other caregivers or to household or
family members to decrease the risk of continuing physical, sexual or mental
abuse or neglect. The results of our reviews and testing in this area
disclosed a number of issues impacting virtually every facet of CPS, including
the timeliness, adequacy and documentation of the investigative effort
related to child abuse and neglect allegations reported to the LDSS.
Although every issue may not have been found at each of the three LDSS
audited, we nevertheless believe that the frequency of occurrences was
sufficiently broad, and coupled with the sensitive nature of the CPS mission,
suggests that DHR should evaluate the CPS activity statewide.

Our tests found that CPS investigations at the 3 LDSS were often not
initiated or completed within the time frame required by State law, and
certain documents were not always completed during the investigation as
required. Problems were also found with the preliminary screening of the
allegation of neglect or abuse. Specifically, our tests disclosed that
frequently there was no documentation of the required supervisory review of
decisions to not accept allegations of neglect or abuse for formal
investigation. We also found evidence that when contact could not be made
with the alleged victim, cases were sometimes closed, without pursuing all
available means to get access. Preliminary findings and final dispositions of
neglect and abuse allegations were not routinely forwarded to the State’s
Attorney Office as required. Furthermore, we found problems with the
posting of critical CPS data to the automated DHR Client Information System
(CIS), including the posting of incomplete and inaccurate data, plus untimely
postings. We also found a lack of uniformity between the three LDSS in
determining actual case closure dates, and several instances of allegation
receipt dates (a key date that begins the timing of other actions) not
agreeing between CIS and the case file records.

Office of
Legislative 23
Audits
 Additionally, our review of a recent downward trend in continuing service
case activity disclosed no predominant cause, although several plausible
explanations were noted based on discussions with LDSS personnel and our
review of the case files. These include the increased intervention of non-
government entities, removal of children into kinship care and
parents/caretakers declining offered services. We also found that reported
maltreatment recurrence rates might be slightly overstated, based on our
limited testing of some of the underlying data for the annual DHR reported
MFR performance measure of the percentage of children with recurrence of
maltreatment within six months of a first occurrence.

Background
Child abuse and neglect allegations are reported to the local departments of
social services (LDSS). Each LDSS provides staffing to accept these reports
24 hours a day, 365 days a year (either directly or in conjunction with other
local agencies such as local law enforcement officials). In some instances, a
person reporting alleged abuse or neglect may choose to contact DHR
headquarters directly where they will be referred to the appropriate LDSS.
Allegations can be oral (either in-person or over the phone), in writing or by e-
mail, and can be made anonymously.

Each LDSS screens allegations to determine whether or not sufficient

information exists to investigate the claim and if the reported situation(s)
meets the legal definitions of abuse or neglect. If the allegation does not
meet the criteria for further investigation, the LDSS “screens out” the
allegation and documents the decision in a case file. Examples of
allegations not accepted for further investigation include school attendance
problems, preventive health care and parental chemical dependency (unless
it interferes with parenting ability or poses a significant risk to the child).
State law and regulations, plus DHR administrative procedures, guide
workers in making these determinations. All records (hardcopy case files)
related to “screened out” cases are eventually destroyed or expunged after
120 days in accordance with State law.

If a LDSS accepts the case for further investigation, it makes a

determination of whether or not the child is in immediate danger and
contacts local law enforcement officials, if warranted. The intake worker
(screener) also completes various documents, and the case is assigned to a
CPS caseworker for formal investigation.

Office of
24 Legislative
Audits
State law requires an on-site investigation to begin within 24 hours of
receiving a report of child abuse and within 5 days for neglect allegations.
These investigations may include work performed by the local law
enforcement agency and usually include interviews with the alleged victim
and any other children in the care of the suspected caregiver.

During the formal investigation, CPS workers must gather appropriate

information to assess the immediate safety of the child and the risk of
maltreatment. Safety assessments4 and risk assessments5 are documented
by CPS workers on forms developed by DHR for use at each LDSS. The
investigation is considered complete when the LDSS (and the local law
enforcement agency, if applicable):

1) determines the nature, extent and cause of any abuse or neglect;

2) determines the condition of other children in the caregiver’s custody;
3) assesses the safety of all children in the custody of the caregiver;
4) evaluates factors related to risk of future abuse or neglect; and
5) identifies any services needed by the children/caregiver/family.

State law requires that investigations be completed within 10 days, if

practicable, but no later than 60 days, unless the LDSS is waiting for an
assessment from an outside party (such as a physician or psychologist) to
determine the nature and extent of the abuse. State law also requires that
LDSS inform the applicable State’s Attorney Office of preliminary findings
(including the allegation and any findings to date) within 10 days of when the
allegation is first received, to be followed by a written report within 5 days
after the completion of the investigation. Final determinations are to be
documented in the case file, recorded in CIS and approved by supervisory
personnel. One of three final determinations can be reached:

4 The Safety Assessment is a tool used to support the determination of the child’s level of safety
while receiving child welfare services. Children found to be in unsafe living arrangements may be
moved to safer environments.
5 The Risk Assessment is a formal consideration of factors that determine the risk that maltreatment
will recur. It includes child specific factors (such as the capability to protect oneself), caregiver
factors (such as substance abuse and level of functioning) and family factors (such as resources).
Office of
Legislative 25
Audits
 Ruled-Out – the reported abuse or neglect did not occur.
Unsubstantiated – there was insufficient evidence to either prove or
disprove a finding of abuse or neglect.
Indicated – there was credible evidence, which has not been
satisfactorily refuted, that abuse or neglect occurred.

Records for “ruled-out” cases are maintained for 120 days after receipt of
the allegation then expunged, unless another allegation for the same
caregiver is received during that time frame. In these instances, record
retention is guided by the nature and outcome of the subsequent
investigation. Case files for unsubstantiated allegations are maintained for
five years unless another allegation concerning the same caregiver is
received. In these instances, the files are maintained for five years after
receiving the report for the original unsubstantiated finding or the expunged
date related to the subsequent investigation, whichever is later. It is DHR
policy to maintain case file records of indicated determinations for 25 years,
although State law is silent on this specific issue.

The Social Services Administration (SSA) performs quality assurance reviews

of each LDSS. Annually, SSA selects CPS cases for review and determines if
LDSS staff 1) investigated each case timely in accordance with legal
requirements, 2) notified law enforcement when appropriate and 3)
completed the required risk and safety assessments. SSA did not perform
these reviews in fiscal year 2005 as it was in the process of modifying the
quality assurance review process in response to comments contained in the
June 2004 federal Child and Family Services report. That report
recommended that SSA improve its review process to include the quality of
services offered in addition to compliance requirements. SSA has modified
its quality assurance process and is conducting a pilot project in several
LDSS.

Findings
2. Documentation of the required supervisory review of initial
screening determinations was often missing and several
instances were noted where the decisions to screen out neglect
or abuse allegations appeared questionable – Our test of child
protective services investigations at the three LDSS disclosed that required
supervisory review and approval of initial screening determinations was

Office of
26 Legislative
Audits
frequently not documented. Additionally, the testing disclosed five cases at
two LDSS where the referral was not accepted for formal investigation (that
is, referral was screened out) although, in our opinion, the details from the
allegation appeared to meet the State definition of neglect or abuse. The
decisions to screen out these allegations appeared questionable.

Our test of 90 randomly selected CPS referrals from the period from April 1,
2005 to June 30, 2005 (30 selected from each LDSS) disclosed 58 referrals
lacking a documented supervisory review and approval of the screening
determinations, see Table 2. Additionally, out of the 90 cases tested, we
believe that the proper determinations were made for 85 cases. However,
we noted 5 that had been “screened out” by the LDSS, even though, in our
opinion, the assertions presented in the allegations appeared to meet the
legal definition of neglect or abuse established in the Annotated Code (for
the circumstances surrounding these five cases, see Exhibit D). Although
State law and the applicable State regulations describe the general
situations meeting the definitions of neglect and abuse, there can be an
inherent degree of subjectivity in interpreting a reported event (allegation),
which is often based on sketchy or less than complete information.
According to LDSS personnel, the five cases were “screened out” since in
their opinions, the information provided in the allegations did not include
enough information or other evidence that the abuse or neglect occurred. In
four of the five cases, we also found that there was no documented
supervisory review and approval of the decision not to formally investigate
the allegation. Since such decisions require sound judgment, the required
supervisory review is extremely important to help ensure that appropriate
decisions affecting a child’s welfare are made.

Table 2
Test Results – Child Protective Services Investigations
Cases With:
Local Cases No Documented
Questionable
Department Tested Supervisory
Determination
Approval
Anne Arundel 30 3 30
Baltimore City 30 0 6

Prince George’s 30 2 22

Totals 90 5 58

Office of
Legislative 27
Audits
3. CPS cases were sometimes closed without making contact with
the child or family – DHR had not developed formal guidance to aid CPS
workers on closing cases of reported neglect or abuse when access to the
child in question had been denied or the caseworker could not locate the
family. Although DHR policy provides specific guidance for CPS workers
when the victim and family relocate during the investigation, there was no
such guidance when the worker could not initially obtain access to the child.
In our testing of closed CPS investigation cases, we noted 7 of 192 closed
cases where the final disposition was noted as unsubstantiated (that is,
abuse or neglect may have occurred but there was a lack of evidence to
prove it) because the family or the caregiver refused the caseworker access
to the alleged victim or the caseworker could not locate the family. In
several of these cases, with at least one occurring at each of the three LDSS
tested, the caseworker made multiple unsuccessful attempts to contact the
victim or family.

Without physical access to the child or caregiver in question, legitimate

cases of neglect or abuse could go undetected. We did note that State law
permits a LDSS to obtain the assistance of local law enforcement and the
local SAO in abuse investigations with the implication that such officials can,
through appropriate legal channels, obtain the required access to a child. In
the seven cases cited, there was no evidence that law enforcement agencies
or local SAO were contacted in an attempt to gain access to the child, prior
to the caseworker closing the case.

4. Two local departments reviewed did not comply with certain

requirements related to processing or documenting CPS
investigations – At the PGDSS, certain required documentation was not
completed when the investigation determined the disposition of the case to
be “ruled-out.” Specifically, the LDSS did not require its CPS workers to
complete risk assessment documentation or final disposition forms for these
cases. DHR policy requires the completion of a risk assessment for all
investigations regardless of the final disposition, and we were advised by a
DHR official that it was intended for final disposition forms to serve as the
basis for the submission of final dispositions to the SAO. In addition, BCDSS
and PGDSS maintained summary statistical records of cases “screened out”
(since case files are expunged after 120 days) for supervisory and statistical
purposes. However, AADSS did not maintain any such information. State

Office of
28 Legislative
Audits
 regulations provide that LDSS may accumulate and maintain statistical data
about “screened out” cases.6

5. Investigations were often not initiated or completed within the

time frame required by law – Although State law requires that
investigations of reports of child abuse and neglect be initiated within 1 day
and 5 days, respectively, after the date the allegation is received, our
statistical sample of 192 closed cases (64 cases from each of three LDSS)
disclosed that investigations were not initiated timely in 48 cases (including
the 7 cases identified in Finding 3). From this same test we also found that
investigations were not completed timely (within 60 days as required by law)
in 42 instances, see Table 3.

Table 3
Results of Test of Timeliness of CPS Investigations
Number of Cases Where
Number
Local CPS Investigation Was:
of Cases
Department Initiated Completed
Tested
Untimely Untimely
Anne Arundel 64 17 8

Baltimore City 64 13 12
Prince George’s 64 18 22

Totals 192 48 42

In 29 of the 48 cases of untimely initiations, the related files did include

documentation that the CPS worker attempted to see the child within the
required timeframe. The most common reasons for not being able to
contact the victim timely included the child’s caretaker refusing access or
the CPS worker not being able to contact the child/family. We noted several
examples where the caseworker could not obtain access and did not
perform additional follow-up procedures prior to closing the case (see
Finding 3 for additional comment on this situation). In 39 of the 48 cases,

6 The retention of this record does not appear to be contrary to the 120 day document destruction
requirement for “screened out” case documentation as it only contains non-identifying data, such
as a summary of the allegation, and is used for statistical and management purposes.
Office of
Legislative 29
Audits
we were able to readily determine the delay between the report of the
allegation and when the investigation was initiated, see Table 4.

Table 4
Number of Cases With Delays in Initiating CPS
Investigations
Number of Days Delayed
Local Department
1 to 5 6 to 10 Over 10
Anne Arundel 11 1 2
Baltimore City 8 1 2
Prince George’s 10 2 2
Totals 29 4 6

Regarding the untimely completions of investigations, for 42 of the 192

cases tested the related investigations were not completed until 61 to 334
days after the allegation was reported without documenting the required
justification for the delay (such as waiting for outside expert evaluations).
Table 5 shows the distribution of cases where the investigations were not
completed timely.

Table 5
Number of Cases With Delays Between Receipt of Allegation and
Completion of Investigation
Number of Days
Local Department 61 to 81 to 121 to Over Totals
80 120 240 240
Anne Arundel 5 2 1 0 8
Baltimore City 6 2 4 0 12
Prince George’s 6 6 6 4 22
Totals 17 10 11 4 42

Projection of Results
Our statistical sample consisted of tests of a random selection, from CIS, of
closed child protective investigation cases with closing dates between
February 1 and June 7, 2005. In Table 6, we projected our test results

Office of
30 Legislative
Audits
 related to untimely CPS investigation initiation and completion based on a
confidence level of 95%. As an example of how to interpret the Table, we
are 95% confident that between 233 to 661 CPS investigations in the
BCDSS were not initiated timely (out of 2,201 total cases).

Table 6
Projection of Test Results for Untimely CPS Investigation Initiation and Completion
(based on 95% confidence)
Cases With Cases With
Population Untimely Initiation Untimely Completion
Local Percent (%) Quantity (#) Percent (%) Quantity (#)
subject to
Department Range Range Range Range
testing
Low High Low High Low High Low High
Anne Arundel 750 16.2 36.9 122 277 4.8 20.3 36 152
Baltimore City 2,201 10.6 30.0 233 661 9.3 28.2 205 620
Prince George’s 831 17.5 38.7 146 322 23.2 45.6 193 379

Since we only tested from these three local departments, the results of
these tests cannot be projected to other local departments or for other time
periods. Although we found CIS to be a reliable source for test selection
purposes, we found that we could not rely on CIS to accurately identify the
case closing date since each local department tested used different criteria
to record the closing date in CIS (see Finding 7). Consequently for the
purposes of our test, we obtained closing dates directly from the CPS case
files.

6. The case files routinely lacked evidence that preliminary findings

and final dispositions of abuse and neglect allegations were
forwarded to the State’s Attorney Offices – Although State law
requires each LDSS to submit to the respective State’s Attorney Office (SAO)
preliminary findings for abuse investigations within 10 days of receipt of an
allegation and a final report on the disposition of the allegation within 5 days
after the completion of the investigation, this was not routinely done. At two
of the three LDSS we reviewed, preliminary findings were not routinely
submitted to the SAO. Specifically, our testing of 128 closed CPS cases in
Anne Arundel and Baltimore City LDSS disclosed 30 and 31 cases,
respectively, where the LDSS should have referred preliminary findings to
the SAO but did not. Although officials at the PGDSS advised us that it sent
preliminary findings to the SAO, our testing disclosed this was not
Office of
Legislative 31
Audits
documented in the case files. Regarding, the submission of final reports to
the SAO, we noted that PGDSS did comply while the other two LDSS claimed
to have made these submissions, but did not document the submissions.
We confirmed this lack of documentation in our test of closed CPS cases.
Specifically, case files for 30 and 31 cases in AADSS and BCDSS,
respectively, where reports should have been submitted did not contain
documentation that the final reports were submitted to the SAO although
agency personnel stated that the reports were submitted as required.
Ultimately, the failure to submit required findings and reports to a SAO may
hinder its ability to initiate any subsequent prosecution in a timely manner.

7. CPS data entered into CIS were not always accurate or

complete – From both our review of CIS data entry procedures and related
tests of CIS, we found that for a number of cases tested, CPS case closure
information was incorrect and that policies addressing the completeness or
accuracy of CPS data entered in CIS were generally lacking. We
judgmentally selected 25 CPS cases from each of three LDSS (for a total of
75), which according to CIS had been open for at least five months as of
May 31, 2005. Our tests disclosed that 29 of the cases, involving all three
LDSS, had actually been closed prior to May 31, 2005, but the closing date
or case disposition had not been recorded accurately or timely in CIS. For
32 of the remaining 46 cases, we could not locate the related hard copy
case file, because we were advised by officials that the cases had been
expunged (since a “ruled-out” determination had been reached). Since a
case needs to be closed before being expunged, we could not determine
whether the open case status in CIS was an error (that is, a closed date was
not recorded) or the case files were inappropriately expunged. Finally, we
noted four cases where the allegation receipt date (a critical date from
which all LDSS actions are measured) recorded in the hard copy case file
did not agree to CIS. In all four cases the receipt date per the case file was
earlier than the date recorded in CIS.

BCDSS did not any have process in place to review the completeness or
accuracy of CPS data entered into CIS by data entry personnel. AADSS had
a policy to review CPS data entered into CIS. However, at 2 of 3 AADSS field
locations reviewed, we found that no procedures were in place to ensure the
accuracy of any CPS data entered into CIS, while the third location claimed
that there was an undocumented independent supervisory review of data
input. Additionally, DHR had not provided any guidance to ensure the
consistency of CPS case closure dates in CIS or the accuracy of CPS data
posted to CIS. We found a lack of uniformity in the case closure date
process between the three LDSS reviewed. Specifically, we found three

Office of
32 Legislative
Audits
 different dates were used. The CPS case closure date recorded in CIS was
either:

• the date the supervisor signed off on the case disposition form (the
proper date according to SSA personnel),
• the date the supervisor reviewed the entire investigation file for
completion or
• the date the caseworker signed the case disposition form (prior to
supervisory review and approval).

8. Reasons for the decline in continuing service cases were not

adequately assessed - During this audit we were asked to determine why
cases opened for continuing services7 after CPS investigations had
decreased over the past several years. Continuing services cases include
both continuing CPS cases and family preservation services cases.
According to DHR statistics, these cases had decreased 32% from 1999 to
2004 as shown in Chart 4. Although complete fiscal year 2005 data were
not available during the course of our audit fieldwork, there were indications
that the average number of cases for continuing CPS cases had increased
from around 1,250 in fiscal year 2004 (included in the 1,971 below) to
about 1,500 in fiscal year 2005.8 The number of family preservation
services cases during fiscal year 2005 was not known at the time of our
review.

DHR did not have a formal process for assessing caseload trends. Our
interviews with administrative and LDSS employees, as well as our review of
cases filed, brought to light several potential causes for the past decline in
continuing services cases. For example, DHR central office staff indicated
that improved tools for risk and safety assessments may now lead
caseworkers to draw different conclusions on the level of services needed
(meaning they determined that families did not need continuing services,
while they may have decided otherwise in the past). Local department
personnel on the other hand, indicated that much of the decrease could be
attributed to reductions in staffing and placing more priority on higher risk
cases that take more time. This means spending more resources (such as

7 Continuing services includes cases where an LDSS provides assistance to the child/family to help
ensure the safety of the child and may include medical assistance (both physical and mental), in-
home aide services and transportation among the types of assistance provided.
8 DHR could not readily provide an explanation for the apparent increase in the average fiscal year
2005 caseload, which reverses the trend of the previous five years.
Office of
Legislative 33
Audits
 staff time) on cases where a child was at the greatest risk of neglect and
abuse and the child/family needed more services and supervision.

Chart 4
Average Number of Cases for Child Protective Services
and Family Preservation Services
3500
2,913 2,800
3000
2,488
2500 2,332
2,156
1,971
2000

1500

1000

500

0
1999 2000 20001 2002 2003 2004
Fiscal Year

Source: DHR Monthly Management Report, June 2005

While the previously noted reasons could explain some of the decline, we
noted three further plausible causes which, depending on their frequency,
could also impact the number of cases. Our review of the case files noted
that community and other non-State providers of services were being used
instead of State services. In addition, we noted in many instances, children
were being removed from the home and being placed with relatives (that is,
kinship care), lessening the need for continuing services. Finally, we noted
that in some instances, when formally offered, parents refused DHR
services.

9. DHR reported Managing For Results (MFR) performance

measure on the percentage of children with recurrence of
maltreatment within six months of a first occurrence might be
overstated - DHR calculates this measure to comply with federal reporting
requirements and includes it in its annual MFR submissions. The measure is
to be calculated using a methodology consistent with that recommended by
the federal government. The reported statewide recurrence rates for fiscal
Office of
34 Legislative
Audits
 years 2004 and 2005, were 7.9 percent and 8.4 percent, respectively. Our tests of
the combined fiscal year 2005 reported recurrence rates of 7.3 percent applicable
to the three LDSS reviewed during this audit, disclosed that the reported results
may be overstated since certain cases were misclassified as recurrences. In a
randomly selected sample of 37 cases classified as recurrences, we found that 5 of
those cases did not meet the federal definition of a recurrence. In each case, the
child was listed as a victim in CIS for a subsequent case, when the child was
actually a sibling of the victim (this is not a recurrence under the federal
methodology). We also randomly tested 37 cases not classified as recurrences and
determined that these cases had been properly classified.

Since these three LDSS collectively account for a significant number of the
cases in the population from which the measurement is taken, the impact of
this test suggests that the statewide recurrence rate might be slightly lower
than the reported 8.4 percent.

Recommendations
2. We recommend that DHR ensure that all screening determinations of
neglect and abuse referrals be subject to a documented and timely
supervisory review and approval to confirm the propriety of the
determinations.

3. We recommend that DHR, in conjunction with the appropriate law

enforcement agencies, develop a comprehensive policy that includes the
appropriate steps to be taken to gain access to all children reported to
be victims of potential abuse or neglect.

4. We recommend that DHR ensure that each LDSS complies with all legal
requirements regarding case documentation. In addition, DHR should
consider requiring each LDSS to maintain summary records of all
screened out cases for management oversight purposes.

5. We recommend that DHR ensure that all child protective services

investigations are initiated and completed in a timely manner as required
by State law.

6. We recommend that DHR enforce the legal requirements to report

preliminary findings and final dispositions of abuse and neglect
allegations to the SAO and implement a policy requiring periodic
monitoring of compliance.

Office of
Legislative 35
Audits
 With regard to the above recommendations, DHR should ensure that its
CPS quality assurance review process includes steps, as appropriate, to
ensure LDSS compliance with the specific areas where we noted
weaknesses and errors during the audit.

7. We recommend that DHR require a periodic review of CPS investigation

cases open for extended periods of time and take appropriate action to
ensure that information reflected in CIS is complete and accurate. We
also recommend that DHR develop and distribute guidance to each LDSS
on recording key dates in CIS.

8. We recommend that DHR monitor trends in the number of continuing

service cases and determine the reasons for significant changes. DHR
should consider this information when making policy decisions related to
providing continuing services.

9. We recommend that DHR review for accuracy, at least on a test basis, its
calculation of the performance measure of percentage of children with
recurrence of maltreatment within six months of a first occurrence to
ensure compliance with federal reporting standards.

Office of
36 Legislative
Audits
Objective 3
Assignment of Foster Care Cases to Active
Caseworkers
Conclusion
Our third audit objective was to assess if all children in foster care were
continually assigned to an active caseworker. We were ultimately unable to
design a comprehensive test for this attribute due to DHR and LDSS data
limitations. We had intended to conduct a match of automated case file and
personnel records to ensure that all foster care cases at a certain date were
assigned to active caseworkers, but were unable to for several reasons such
as CIS not retaining historical information on foster care caseworker
assignments. Instead, we conducted statistical samples of the critical
requirement of monthly caseworker contact with the children, while at the
same time ensuring the applicable caseworkers for these particular cases
were active DHR employees.

Using hard-copy case file data and DHR personnel files, we found that during
the 6-month period tested (January to June 2005), the 111 cases selected
for review of monthly face-to-face meetings were assigned to 92 different
individuals who were valid employees of DHR and the LDSS. That is, an
active employee was assigned to each case throughout the period tested.
We conducted this combined test since the intent of verifying that assigned
caseworkers are active DHR employees is to help ensure that caseworkers
are in a position to provide children with all required services. Since a key to
service delivery is the monthly face-to-face meeting with a child, one
objective of our test was to determine the documented existence of this
requirement. Our tests at all three local departments disclosed that out of a
total of 111 active cases tested during the period of January to June 2005,
in 54 cases there was no documentation that the visits had occurred for at
least one month during the 6-month period. Findings ranged from 26 cases
where one month was lacking to 2 cases for which there was no
documented visit for the entire 6-month period. Because the visits may not
have been documented, there is no way to know whether a visit actually
occurred in these 54 cases. However, caseworkers did acknowledge to us
that monthly visits in fact do not always occur due to extended employee

Office of
Legislative 37
Audits
 leave or the child not being available during an unscheduled visit. In some
cases, caseworkers substituted phone contacts instead of the required face-
to-face visits.

While the lack of an adequate automated database makes it impossible to

estimate the frequency or duration of cases not being assigned to active
caseworkers, we found that even when cases were assigned to active
caseworkers, monthly monitoring was not being performed or documented
as required by DHR regulations. This situation is not a recent event, but has
now been commented upon in an number of our audit reports dating back to
our May 2002 Performance Audit Report on the Out-of-Home Care Program,
wherein we commented that 48 percent of the cases tested statewide
lacked documentation that monthly face-to-face contact with the child had
occurred.

Background
As previously noted, we were originally requested to determine if children in
foster care were under the supervision of active caseworkers. We
determined that due to a lack of available information, we could not design a
test to categorically provide this information. As the intent of the assignment
of active caseworkers is to ensure that children in foster care ultimately
receive required timely monitoring and services, we conducted a statistical
sample of cases to determine if children were receiving documented,
monthly visits from a caseworker. We sampled 37 cases active during the
period of January 2005 to June 2005, from each of the three LDSS for a
total of 111 cases. Since these tests were statistically valid, the results can
be projected to the LDSS in question, but not statewide or to other LDSS.

Findings
10. There was no system to identify caseworkers assigned to foster
care cases over the history of the case – Our review of CIS data files
and discussions with DHR and LDSS personnel revealed that CIS did not
include adequate information to ensure that foster care cases were
consistently assigned to active employed caseworkers. That is, CIS did not
maintain a historical record of past caseworker assignments which could be
used to ensure continuous active monitoring. We also determined that the
three LDSS did not maintain manual records documenting the same
information. Although we were advised that some supervisors kept a
manual record of caseworker assignments, upon review of these records we

Office of
38 Legislative
Audits
 found these records included just the number of cases assigned. As a
result, DHR and the three LDSS lack critical information to use in monitoring
staff levels and caseworker assignments. However, our tests disclosed that
foster care cases were assigned to valid employees of DHR and the
respective LDSS. Specifically, we tested 111 foster care cases (37 from
each of the three LDSS) during the period from January to June 2005. These
111 cases were assigned to 92 different individuals. All employees tested
were valid employees of DHR and the LDSS for the entire period tested.

10. DHR could not document that foster care caseworkers met with
children monthly as required by regulations in almost 50
percent of the cases tested over a 6-month period - Our test of
foster care case files disclosed that frequently caseworkers either did not
visit children or there was no documentation that foster care children were
visited by caseworkers as required by State regulations. State regulations
generally require that caseworkers have a monthly, face-to-face meeting with
children, except under certain specified circumstances (such as placement
in a treatment facility or out-of-state). Our tests related to a statistical
sample of 111 foster care cases (37 selected from each local department
included in our audit), disclosed that there was no documentation that
children in 54 of the cases received all required visits for the period from
January through June 2005, see Table 7.

Table 7
Test Results – Caseworker Visits of Foster Children
Number of Months with Undocumented Caseworker Visits
Local Cases Between January and June 2005
Department Tested One Two Three Four Five Six
Total
Month Months Months Months Months Months
Anne Arundel 37 13 1 2 0 0 0 16
Baltimore City 37 6 1 0 2 1 0 10
Prince George’s 37 7 10 4 2 3 2 28

Totals 111 26 12 6 4 4 2 54

Office of
Legislative 39
Audits
As can be seen from Table 7, 28 of the foster children in our test either had
undocumented visits or did not receive visits from their caseworker for 2 or
more months during a 6-month period. Based on our review of the case files
and discussions with LDSS employees, the reasons given for not conducting
visits included extended employee leave (an issue raised in CWLA staffing
guidelines in Finding 1) and, the child not being available during an
unscheduled visit. Also, in some cases, phone contacts instead of in-person
contact were used and, there may have been instances in which the
caseworker had not yet documented a visit in the file when we conducted
our test in August 2005.

This situation is similar to a finding in our May 2002 Performance Audit

Report on the DHR Out-of-Home Care Program, where a statewide sample
disclosed that in 48 percent of the case files tested, monthly face-to-face
meetings between the caseworker and the child could not be documented.
This situation continues to occur even though DHR quality assurance
processes have periodically disclosed this same problem.

Projection of Results
As these three tests were conducted on a statistical basis, we can project
the results to the populations of the respective LDSS. Our statistical sample
consisted of tests of a random selection, from CIS, of children in foster care
as of April 30, 2005 (who were also in foster care during the entire period of
January to June 2005). While we found CIS to be a reliable source for our
test selection based on our preliminary testing of judgmentally selected
foster care cases, we did note that we could not rely on CIS to accurately
identify the current caseworker so we obtained this information directly from
the hard-copy case files. In Table 8, we projected our test results related to
documented monthly visits to foster care children based on a confidence
level of 95%. As an example of how to interpret the Table, we are 95%
confident that between 302 to 431 children at PGDSS did not receive at
least one documented monthly visit over the 6-month period tested (out of
484 total children).

Office of
40 Legislative
Audits
 Table 8
Projection of Test Results for Monthly Visits to Foster Care Children
(based on 95% level of confidence)
Cases Where There was Either No Evidence
of Required Caseworker Contact
or No Contact for at Least One Month
Test
Local Department during January to June 2005
Population
Number of Cases in
% Range
the Range
Low High Low High
Anne Arundel 227 28.6% 57.9% 65 131
Baltimore City 5,117 12.8% 41.3% 653 2,113
Prince George’s 484 62.4% 89.0% 302 431

Since we only tested these three local departments for visits during the
previously mentioned six-month period, the results of these tests cannot be
projected to other local departments or for other time periods.

Recommendations
10. We recommend that DHR determine the feasibility of developing
system capabilities to monitor foster care caseworker assignments,
including historical caseworker assignment information.

11. We recommend that DHR ensure that all children in foster care receive
the required monthly face-to-face meeting with their assigned
caseworker, as required by State regulations. Additionally, DHR should
assess why visits have not occurred and take additional steps
necessary to ensure such visits are made as required (such as
reallocating caseworker resources or hiring additional staff as
necessary) and are documented.

Office of
Legislative 41
Audits
 Office of
42 Legislative
Audits
Objective 4
Reliability of Selected Data Reported as
Required by the Consent Decree
Conclusion
Our fourth audit objective was to determine if 1) certain information
contained in the 6-month DHR compliance report applicable to Baltimore
City for the period ending December 31, 2004 was reliable, and 2) BCDSS
complied with requirements related to the timely transfer of foster care
cases when a worker leaves or transfers. The report was filed in accordance
with requirements established under the September 1988 L. J. v. Massigna
Consent Decree. The report included 72 performance measures (37 related
to foster care and 35 related to kinship care). For these measures, DHR
reported 146 separate results of which 71 related to foster care, 64 to
kinship care and 11 included combined results. Our test of 20 reported
results for foster care determined that 8 results were reliable but the
reliability of the supporting data underlying 11 other results were deemed
unreliable. We also noted that another result could not be tested due to a
lack of documentation to support how the related measure was calculated.

We were also specifically requested to determine if BCDSS complies with a

Consent Decree requirement to transfer foster care cases within five days
when a foster care caseworker leaves or transfers. We could not test the
reliability of this measure because DHR did not track or include the results
in the 6-month reports.

Background
In September 1988, DHR entered into a Consent Decree to settle a class
action lawsuit regarding the administration of foster care cases by the
BCDSS. The Court found overwhelming evidence of serious systematic
deficiencies in Baltimore City’s foster care program such that foster children
would suffer irreparable harm. The Consent Decree established a number of

Office of
Legislative 43
Audits
requirements for the improved provision of foster care services by BCDSS
including such areas as caseworker caseload, staff training, foster care
placement resources (that is, homes, shelters, etc.) and health care, among
others. To determine compliance with these requirements, the Decree
required that DHR file semi-annual reports with the Court containing specific
data such as assigned caseworkers and supervisors, caseload statistics,
complaints of abuse and neglect, number of homes approved and other
data. The Consent Decree was modified in December 1991 to remove
certain requirements as well as to add kinship care services to those
included in the Decree to be monitored and reported by DHR.

We reviewed and tested selected data from the 33rd report covering the
period from July to December 2004 (the most recent report filed at the time
of our audit).

The DHR Monitoring Process

BCDSS quality assurance unit tests foster and kinship care cases to
determine if BCDSS provides the services required by the Decree. The unit
uses a monthly random case selection process to measure compliance. For
each month included in a six-month reporting period, the unit samples 22
new entrant cases and 38 continuing care cases (for a total of 360 cases
per reporting period). New entrant cases represent those that entered foster
care in the three months prior to the test month and were in care for at least
60 days. Based on its internally developed Consent Decree Review Guide,
the unit evaluates each case for compliance based on documents in the
case file. The findings for each required element can be either “Yes” (the
required documentation exists and was completed timely if required), “No”
(the case files does not include the required documentation or the element
was not completed timely) or “n/a” (the element does not apply for the case
file under review). Case review results are documented and reviewed and
approved by supervisory personnel. The percentage of compliance equals
the number determined as compliant divided by the total of compliant and
non-compliant cases tested. Case elements noted as “n/a” are not included
in the calculations.

The unit compiles the results for each month into a spreadsheet. At the end
of the six-month reporting period, the monthly results are accumulated to
determine compliance for the entire period included in the compliance
report. Other data not contained in the case files, such as available foster

Office of
44 Legislative
Audits
care home placements, are based on various management reports
generated by supervisory staff and data systems as appropriate.

The OLA Audit Process

Based on our review of required reporting elements and discussion with

various stakeholders, we selected 20 measures under the following
categories for testing:

1. Weekly Parental Visits – If the case plan specifies that the

permanency goal includes returning the child to the family, the parent
shall have weekly visits with the child while in foster care as long as
the court doesn’t object.
2. Monthly Caseworker Visits – Monthly face-to-face visits with the child.
3. Maintain an Abbreviated Health Record – Documentation of various
health care attributes including immunizations, consent forms for the
release of medical records and required health visits.
4. School Aged Child Placed in School – A child should be attending
school within five days of being placed in non-emergency foster care.
5. Continuum of Sufficient and Appropriate Placement – Establish and
maintain a continuum of foster care placement resources to ensure
that there is appropriate foster care placement for children who come
into care. That is, obtaining new foster care homes and measuring
new approved homes and those homes closed.

For the first four selected categories, we obtained the documentation

prepared by the quality assurance unit related to the sample foster care
cases they tested for the period. This included 132 new entrant cases and
228 continuing cases. We reviewed 51 cases from each type from the
cases included in the quality assurance unit’s sample. We reviewed the
case file documents for each case selected and compared our findings to
those previously documented by the unit.

We evaluated the test results using the methodology developed for our
Office’s periodic audits of the State’s Managing for Results (MFR)
performance measures. In those audits, we test the data underlying
reported MFR measures and reach a conclusion regarding the reliability. For
purposes of this audit the corresponding conclusions would be reliable or
unreliable. The nature of audit testing of this type of reported information is
not to determine the true value or result of the information under
examination, but rather to assess the reliability of the underlying data.

Office of
Legislative 45
Audits
 For the fifth category, we attempted to review the documentation used by
BCDSS to calculate new foster care homes approved and the number of
homes closed during the report period. BCDSS was not able to provide us
with documentation to support the figures reported. After obtaining other
documents, we were able to recreate the number of new homes approved
but could not develop the number of homes closed. As a result, we were
only able to test and report on new homes approved.

Findings
12. The reliability of the data underlying the reported measures
tested was questionable with several being judged unreliable –
Our testing of 51 new entrant cases and 51 continuing cases included in the
quality assurance unit’s sample for the period from July to December 2004
disclosed that the underlying data supporting selected measures were not
always reliable (that is, the reported compliance was either over or
understated). Tables 9 and 10 show the specific results of our testing and a
comparison to the equivalent BCDSS results.

Table 9
Test of Foster Care Cases for Consent Decree Compliance – New Entrants Cases
(Source: 33rd 6-Month Report)
Comparative Conclusions from OLA OLA
DHR
Test of Identical 51 Cases Assessment
Measure Reported
BCDSS Results OLA Results of DHR
Compliance
Yes No n/a Yes No n/a Results
Weekly Parental Visits 65% 28 19 4 7 41 3 Not Reliable
Monthly Caseworker Visits 56% 25 26 0 34 17 0 Not Reliable
Medi-Alert 94% 48 3 0 48 3 0 Reliable
Health Record

Health History 94% 49 2 0 48 3 0 Reliable

Abbreviated

Developmental Status 99% 28 1 22 24 2 25 Not Reliable

Initial Health Visit 90% 45 6 0 46 5 0 Reliable
Health Care Consent 90% 44 7 0 45 6 0 Reliable
Health Passport 92% 46 5 0 47 4 0 Reliable
School Aged Child Placed in
62% 20 10 21 16 10 25 Not Reliable
School within 5 days
“Yes” means the case complied with the Consent Decree requirement.
“No” means the case did not comply.
“N/A” means that the requirement did not apply to the case tested.
If the variance between BCDSS results and OLA results was 3 or more, we considered the
DHR result to be “Not Reliable”.

Office of
46 Legislative
Audits
 Table 10
Test of Foster Care Cases for Consent Decree Compliance – Continuing Cases
(Source: 33rd 6-Month Report)
Comparative Conclusions from OLA OLA
DHR
Test of Identical 51 Cases Assessment
Measure Reported
BCDSS Results OLA Results of DHR
Compliance
Yes No n/a Yes No n/a Results
Weekly Parental Visits 74% 29 5 17 4 7 40 Not Reliable
Monthly Caseworker Visits 79% 40 11 0 43 8 0 Not Reliable
Medi-Alert 93% 48 3 0 47 4 0 Reliable
Health Record

Health History 93% 48 3 0 47 4 0 Reliable

Abbreviated

Developmental Status 90% 27 2 22 22 5 24 Not Reliable

Initial Health Visit 83% 44 7 0 41 10 0 Not Reliable
Health Care Consent 90% 45 6 0 42 9 0 Not Reliable
Health Passport 85% 43 8 0 42 9 0 Reliable
School Aged Child Placed in
56% 12 14 25 9 17 25 Not Reliable
School within 5 days
“Yes” means the case complied with the Consent Decree requirement.
“No” means the case did not comply.
“N/A” means that the requirement did not apply to the case tested.
If the variance between BCDSS results and OLA results was 3 or more, we
considered the DHR result to be “Not Reliable”.

We also attempted to evaluate two other measures: the number of “new

foster care homes approved” and “homes closed” for the report period. DHR
indicated that 117 homes were approved and 218 homes were closed for
the 6-month period. As noted previously, BCDSS could not provide us with
documentation to support the reported numbers for either measure, but we
were ultimately able to test “new foster care homes approved.” Specifically,
we recreated the new homes added during the period with reasonable
accuracy, using documentation that was available. Based on these
documents, we calculated that DHR added 119 new homes for the period.
We then tested for approvals using a random sample of 22 homes added,
which disclosed 3 errors. Two of the three homes had been approved and
added prior to the start of the report period and the remaining home,
although reevaluated by DHR during the period, had also been added prior
to the start of the period. As a result these homes were incorrectly classified
as new homes added by DHR during the period. This leads us to conclude
that the documentation used to record new foster care homes added is
unreliable.
Office of
Legislative 47
Audits
13. DHR did not report the BCDSS level of compliance regarding the
timely transfer of foster case cases between caseworkers and
the method of calculating this measure may not be appropriate -
We were requested to specifically review BCDSS compliance with the
Consent Decree’s requirement that BCDSS must transfer foster care cases
to other caseworkers within five days when a caseworker leaves BCDSS
employment or transfers to another unit. However, as of September 30,
2005, DHR had not reported the BCDSS degree of compliance with the
requirement. Although the Consent Decree required DHR to comply with this
requirement within two years of the date of the Decree (September 1988),
BCDSS officials could not document if compliance had ever been measured
or reported. We did verify that the level of compliance for this applicable
requirement had not been included in the last three six-month compliance
reports.

BCDSS has decided to report future compliance based on its existing

statistical sampling of individual cases for compliance with a number of
requirements directly affecting children that are also contained in the
Consent Decree. As previously described, this process randomly tests cases
for a number of attributes generally affecting the services rendered to
children. Since legal requirements, such as health and dental care, therapy,
schooling and periodic caseworker visits, are fairly consistent among all
children in foster care (the population from which the cases are selected),
such sampling will usually result in meaningful results.

Testing an attribute such as timely reassignment of cases from the general

population of all foster care cases may not provide meaningful results for
monitoring purposes as intended by the Consent Decree. For example, if
none of the cases in the sample involve a transfer, DHR will report
compliance as “Not Applicable” for the reporting period. A more meaningful
result would be obtained if the population tested only contained those cases
involving transfers.

We attempted to specifically test compliance with this requirement as we

believe was intended by the Consent Decree and objective 4 of this audit,
using existing BCDSS data and documents, but were unsuccessful due to
current limitations with the data. Specifically, neither DHR nor BCDSS could
provide us with a listing of caseworkers who either left the BCDSS

Office of
48 Legislative
Audits
 employment for a given time period or transferred to another non-foster care
unit. Although we subsequently were able to manually create at least a
partial record of caseworkers who left BCDSS from October 2004 through
February 2005 using Department of Budget and Management and DHR
personnel records, we could not obtain a listing of the foster care cases
handled by these caseworkers prior to leaving BCDSS. We were informed
that CIS, which records caseworker assignments, does not include a
historical record of caseworker assignments (see Finding 10). In addition,
CIS overwrites the previous caseworker of record in the system as soon as a
new caseworker is assigned to the case without retaining a history of prior
assignments. Finally, BCDSS did not maintain any internal documentation
regarding the historical assignment of specific cases for each caseworker.

Recommendations
12. We recommend that DHR periodically test the reliability of the
information reported to it by BCDSS for inclusion in the 6-month
compliance reports. In addition, we recommend that DHR ensure that
appropriate steps are taken by BCDSS to provide reliable results in the
future and that BCDSS retain adequate documentation to support all
data included in the report.

13. We recommend that DHR and BCDSS establish a process for

measuring compliance with the requirement to timely transfer foster
care cases. Specifically, we recommend that BCDSS maintain records
of historical caseworker assignments, including terminated employees
and their related assigned cases and use these records as the source
for selecting cases to test the timely transfer of cases.

Office of
Legislative 49
Audits
 Office of
50 Legislative
Audits
 Exhibit A
Audit Request Letter From The President of the Senate
and the Speaker of the House of Delegates
Page 1 of 3

Office of 51
Legislative
Audits
 Exhibit A
Audit Request Letter From The President of the Senate
and the Speaker of the House of Delegates
Page 2 of 3

Included as Exhibit B

52 Office of
Legislative
Audits
 Exhibit A
Audit Request Letter From The President of the Senate
and the Speaker of the House of Delegates
Page 3 of 3

Office of 53
Legislative
Audits
54 Office of
Legislative
Audits
 Exhibit B

Child Welfare Staffing Data Presented by DHR

to Maryland General Assembly Budget Committees in February 2005

Child Welfare Staffing

As of February 18, 2005
Workers Supervisors
Local
CWLA Filled Over/ CWLA Filled Over/
Department
Standard Positions (Under) Standard Positions (Under)
Allegany 39.5 43.3 3.8 7.9 6.0 -1.9
Anne Arundel 88.0 98.8 10.8 17.6 17.0 -0.6
Baltimore 124.5 110.1 -14.4 24.9 17.0 -7.9
Calvert 14.0 18.5 4.5 2.8 3.0 0.2
Caroline 9.0 12.5 3.5 1.8 4.0 2.2
Carroll 21.0 26.0 5.0 4.2 7.0 2.8
Cecil 31.0 33.5 2.5 6.2 8.0 1.8
Charles 36.0 37.5 1.5 7.2 4.0 -3.2
Dorchester 9.5 15.0 5.5 1.9 3.0 1.1
Frederick 46.0 51.0 5.0 9.2 7.0 -2.2
Garrett 10.0 17.0 7.0 2.0 2.0 0.0
Harford 45.0 43.1 -1.9 9.0 10.0 1.0
Howard 29.0 32.0 3.0 5.8 9.0 3.2
Kent 3.0 6.0 3.0 0.6 2.0 1.4
Prince George’s 132.5 117.5 -15.0 26.5 27.0 0.5
Queen Anne’s 6.5 9.8 3.3 1.3 3.0 1.7
St. Mary’s 22.6 22.6 0.0 4.5 6.0 1.5
Somerset 12.0 15.5 3.5 2.4 3.0 0.6
Talbot 9.0 10.0 1.0 1.8 4.0 2.2
Washington 56.0 63.5 7.5 11.2 11.0 -0.2
Wicomico 37.0 36.0 -1.0 7.4 7.0 -0.4
Worcester 17.0 19.5 2.5 3.4 4.0 0.6
Baltimore City 754.5 723.0 -31.5 150.9 148.0 -2.9
Total 1552.6 1561.7 9.1 310.5 312.0 1.5

Note: The above schedule does not include Montgomery County. The County receives a grant for operations
from DHR and all employees are county employees, not State employees.

Office of 55
Legislative
Audits
56 Office of
Legislative
Audits
 Exhibit C
OLA Recalculation of DHR’s February 2005 Staffing Report

Page 1 of 3

As noted in Finding 1, we attempted to restate the February 18, 2005 caseload report by
substituting those variables where more reliable data were available. Specifically, we made
the following adjustments to DHR’s calculations:

1. We used 12-month case averages for the period from November 2003 to October
2004 which represented the most current data available at the time of the February
2005 report.
2. We adjusted staffing for both new hires and terminations.
3. We used current CWLA recommended caseload standards for determining the
number of workers needed.

Nevertheless certain required adjustments/corrections were not possible, which could

significantly impact the true results. For example, we did not attempt to determine the
number of supervisors not actually engaged in supervising line staff or if caseworkers listed
were exclusively assigned to work child welfare cases due to time limitations, as this
information was not readily available and there was no reasonable basis for estimation.
Furthermore, testing related to other areas of this audit, disclosed that Client Information
System (CIS) data (used by DHR as the source for certain information in the February report,
including all the numerical counts of all cases for the measured categories) were not always
accurate.

The following partial restatement shows that, although statewide totals are close, staffing
among individual local departments often varies significantly from the original DHR report.
For example, according to the restatement, Anne Arundel County appears to have almost 20
caseworkers in excess of those needed based on current CWLA standards and Baltimore
City is short 49 staff to meet those same standards, while the original DHR report noted only
10.8 and (31.5), respectively (see Exhibit B).

Office of 57
Legislative
Audits
 Exhibit C
OLA Recalculation of DHR’s February 2005 Staffing Report

Page 2 of 3
Recalculation of Estimated
Total Caseworkers and Supervisors Needed to Meet CWLA Standards
(the accompanying notes and comments are integral to interpreting this table)

Workers Supervisors
Local
Department CWLA Over / CWLA Over /
Standard Filled (Under) Standard Filled (Under)

Allegany 36.8 43.3 6.5 7.4 6.0 (1.4)

Anne Arundel 79.9 99.8 19.9 16.0 18.0 2.0
Baltimore 123.1 113.6 (9.5) 24.6 18.0 (6.6)
Calvert 13.1 18.5 5.4 2.6 3.0 0.4
Caroline 9.8 12.5 2.7 2.0 4.0 2.0
Carroll 19.6 26.0 6.4 3.9 7.0 3.1
Cecil 29.3 33.5 4.2 5.9 8.0 2.1
Charles 38.6 37.5 (1.1) 7.7 4.0 (3.7)
Dorchester 9.0 15.0 6.0 1.8 3.0 1.2
Frederick 43.8 48.0 4.2 8.8 8.0 (0.8)
Garrett 9.1 17.0 7.9 1.8 2.0 0.2
Harford 45.2 43.1 (2.1) 9.0 10.0 1.0
Howard 30.7 27.0 (3.7) 6.1 9.0 2.9
Kent 4.0 6.0 2.0 0.8 2.0 1.2
Prince George's 123.7 117.5 (6.2) 24.7 27.0 2.3
Queen's Anne's 6.7 9.8 3.1 1.3 3.0 1.7
St. Mary's 23.9 21.6 (2.3) 4.8 6.0 1.2
Somerset 12.6 15.5 2.9 2.5 3.0 0.5
Talbot 8.0 10.0 2.0 1.6 4.0 2.4
Washington 55.6 65.5 9.9 11.1 11.0 (0.1)
Wicomico 38.0 35.0 (3.0) 7.6 7.0 (0.6)
Worcester 15.9 19.5 3.6 3.2 4.0 0.8
Baltimore City 761.9 713.0 (48.9) 152.4 149.0 (3.4)

Total 1,538.3 1,548.2 9.9 307.6 316.0 8.4

Original Totals
from February 18,
1,552.6 1,561.7 9.1 310.5 312.0 1.5
2005 DHR Report
(see Exhibit B)

Potential Impact of Employee Leave on Staffing Levels

Taking employee leave into account was found to have a profound impact on the adequacy
of current staffing levels. Although detailed leave usage data were not readily available, if
the average child welfare employee is assumed to earn leave at the rate of a new State

58 Office of
Legislative
Audits
 Exhibit C
OLA Recalculation of DHR’s February 2005 Staffing Report

Page 3 of 3

employee (annual earning rate of 10 days annual leave, 15 days sick leave and 6 personal
leave days) and take the equivalent of one month’s leave per year (or about 20 working
days), the number of staff required would increase. If each employee in the February 2005
report annually used 20 days of leave, DHR would have required approximately 130
additional caseworkers and 26 additional supervisors to help ensure an appropriate number
of staffing for the average caseloads during November 2003 to October 2004.

Office of 59
Legislative
Audits
60 Office of
Legislative
Audits
 Exhibit D

Analysis of Questionable Allegations “Screened Out” (Finding 2)

Referred Reason provided

Local
# Allegation Description of Allegation for
Department
Type “Screening Out”
Reporter claimed a video surveillance tape showed Since there was no
mother grabbing hold of child’s arm and hitting child on evidence of injury,
Physical the chest with the other hand after leaving a 3rd party information given
1
Abuse community service case worker’s office. does not meet
child maltreatment
definition ®

Reporter claimed that mother is drug abuser who has Information given
been removed several times for crack overdose. does not meet
Reporter claimed neighbor advised that mother was child maltreatment
2 Neglect seen hitting the child (10 years old), but did not know if definition ®
injuries were sustained. Reporter said that his wife and
others had fed child in past because child claimed to
Anne
be hungry.
Arundel
Reporter, who was a CPS screener at another LDSS, Information of
claimed that mother had called the other LDSS to injuries not
report abuse of 8 year old child by father at a provided.
restaurant. Father allegedly hit child on side of head Accordingly,
and then hit the back of the head causing child’s information given
Physical forehead to hit the table. Mother reported that father does not meet
3
Abuse was in treatment for domestic abuse, was aggressive child maltreatment
toward children and had a temper. Reporter gave definition ®
mother Anne Arundel County DSS phone number and
mother suddenly began to make excuses for father.
Reporter made referral as reporter felt mother
ultimately would not.

Reporter (grandmother) claimed 7 year old girl has Per file notation –
been abused by older brother and mother refuses to Case
Sexual
4 take action. Reporter claimed child is scared and that recommended for
Abuse
she told reporter of the alleged abuse. A prior report of screen out by a
sexual abuse was found to be unsubstantiated. supervisor
Prince
George’s Reporter (Department of Juvenile Services worker) No explanation
claimed that 16 year old child’s mother died and child provided ®
has no known guardian (father does not want child).
5 Neglect
Since mother’s death the child has lived with a 70 year
old woman who it is claimed can no longer care for the
child.

® - required supervisory review of determination not documented

Office of 61
Legislative
Audits
62 Office of
Legislative
Audits
 Exhibit E
Comparison of 6-Month Compliance Report Performance Measures
(31st, 32nd, and 33rd Compliance Reports)

At the beginning of this audit, we were requested to summarize the reported results from
the last three 6-month compliance reports, which are required by the 1988 Consent
Decree. The decree required DHR to periodically report certain child welfare goals and
performance indicators of the Baltimore City Department of Social Services. The
information presented in Exhibit E was complied by us from the applicable reports
published by DHR and was not subject to audit verification by us (accept as indicated in
Finding 11).
Items shaded in gray represent ones selected for testing during the audit.

Page 1 of 13

31st Report
32nd Report 33rd Report
July 2003 to
Consent Decree Reference & Requirement January 2004 July 2004 to
December
to June 2004 December 2004
2003

Worker Caseload Ratios

5A, M7 Maintain caseload averages of 1 continuing foster care
worker for 20 children and their families.
Average during 6 month period 1:23.3 1:22.9 1:22.4
As of December 31, 2003 (31st), June 30, 2004 1:23.2 1:21.9 1:20.5
(32nd), December 31, 2004 (33rd)
5B Maintain caseload averages of 1 intake foster care
worker for 14 children and their families.
Average during 6 month period 1:18.1 1:18.2 1:20.6
As of December 31, 2003 (31st), June 30, 2004 1:17.2 1:22.3 1:16.5
(32nd), December 31, 2004 (33rd)
5C Maintain caseload averages of 1 foster home worker for
40 foster families.
Average during 6 month period 1:45.7 1:38.2 1:36.4
As of December 31, 2003 (31st), June 30, 2004 1:42.7 1:36.1 1:40.5
(32nd), December 31, 2004 (33rd)

Supervisor to Worker Caseload Ratios

5D, M8 Maintain caseload averages of 1 supervisor for 6 1:5.5
workers.
Average Intake and Assessment during 6 month period No Data no data 1:4.8
Intake and Assessment as of December 31, 2004 No Data 1:4.6 1:5.7
Average Continuing Services during 6 month period No Data 1:5.6 1:5.3
Continuing Services as of December 31, 2004 No Data 1:5.8 1:5.6

Office of 63
Legislative
Audits
 Exhibit E
Comparison of 6-Month Compliance Report Performance Measures
(31st, 32nd, and 33rd Compliance Reports)

Page 2 of 13

31st Report
32nd Report 33rd Report
July 2003 to
Consent Decree Reference & Requirement January 2004 July 2004 to
December
to June 2004 December 2004
2003

Assignment and Transfer of Cases

5E, M9 When worker leaves or transfers, supervisor will No Data No Data No Data
reassign the case within 5 working days of the transfer
and have a conference with the new worker within 10
working days of the reassignment.

Caseworker Credentials and Training

M10 All caseworkers of children placed with relatives will All 13 new All 33 new All 64 new hires
have at least a BA or BS degree. hires hires
7A, All caseworkers will receive at least 4 days of All 13 new 25 of 29 new All 64 new hires
M11 orientation and training within 60 days of beginning hires hires attended;
employment. Other 4 were
reinstatements
7B, All caseworker will receive 20 hours of training annually Does not Does not Does not provide
M12 beginning in the second year of employment. provide hours provide hours hours of training
of training for of training for for each worker
each worker or each worker or or the number of
the number of the number of applicable
applicable applicable workers
workers workers

Specialized Support Unit

M13 The Specialized Support Unit shall be a resource for From 7/1/03 From 1/1/04 From 7/1/04 to
case-workers and supervisors serving children placed to to 6/30/04, 12/31/04, the
with relatives. 12/31/2003, the Specialized Specialized
the Specialized Support Unit Support Unit
Support Unit provided 56 provided 62
provided 95 consultations consultations to
consultations to BCDSS staff. BCDSS staff.
to BCDSS staff.

Continuum of Sufficient and Appropriate Placements

9 Establish and maintain a continuum of foster care Does not Does not Does not provide
placement resources to ensure that there is appropriate provide total provide total total available
foster care placement for children who come into care. available available placements to
placements to placements to total children
total children total children who enter care.
who enter care. who enter care.

Approved homes during report period 84 90 117

Homes closed during report period 386 264 218

64 Office of
Legislative
Audits
 Exhibit E
Comparison of 6-Month Compliance Report Performance Measures
(31st, 32nd, and 33rd Compliance Reports)

Page 3 of 13

31st Report
32nd Report 33rd Report
July 2003 to
Consent Decree Reference & Requirement January 2004 July 2004 to
December
to June 2004 December 2004
2003

Net Loss of homes 302 174 101

New Specialized Placements beds 19 no data 28
Caretaker Supports and Funds for Supportive Services
M14 Assist relative caretakers in obtaining services.
Compliance rate for Continuing Kinship Care cases 89% 91% 89%
Compliance rate for New Entrant Kinship Care cases 92% 95% 89%
M16 Seek funds for the purchase of special services to
prevent removal from relative placement, promote
reunification, and/or prevent institutionalization.
Total Funds Spent on Kinship Care Program $99,759.70 $637,447.13 $309,423.21

Licensure of Relative Caretakers as Restricted Foster Parents

M15 Send a letter to relative caretakers about licensure as a
restricted foster parent within 10 days of commitment
to DSS.
Compliance rate for Continuing Kinship Care cases 83% 64% 51%
Compliance rate for New Entrant Kinship Care cases 83% 77% 76%

Foster Parent Training

13 All foster parents must complete at least 6 hours of
training a year.
Foster families not trained at end of reporting period 188 394 356

Relative Caretaker Training

M17 Inform relative caretakers of provider training on an Caretakers are Caretakers are Caretakers are
annual basis. notified and notified and sent training
receive some receive some calendars. No
training. No training. No specifics
specifics specifics provided
provided provided

Office of 65
Legislative
Audits
 Exhibit E
Comparison of 6-Month Compliance Report Performance Measures
(31st, 32nd, and 33rd Compliance Reports)

Page 4 of 13

31st Report
32nd Report 33rd Report
July 2003 to
Consent Decree Reference & Requirement January 2004 July 2004 to
December
to June 2004 December 2004
2003

Information on Foster Children

M19 Provide relative caretakers with necessary information
about the child at time of placement, or within 10 days
if emergency placement.
Compliance rate for Continuing Kinship Care cases 92% 85% 87%
Compliance rate for New Entrant Kinship Care cases 90% 91% 80%
Reasonable Efforts to Prevent Placement and Reunify Families
15A, Reasonable efforts will be made to prevent foster care
M20 placement or eliminate the need for removal of the
child.
Compliance Rate for Continuing Cases 99% 98% 86%
Compliance Rate for New Entrant Cases 98% 100% 92%
Compliance rate for Continuing Kinship Care cases 99% 99.56% 79%
Compliance rate for New Entrant Kinship Care cases 98% 98% 73%

Intensive Family Services

15B Seek sufficient funds to provide a program of intensive
family services to reduce the number of children who
need to be removed from their parents.
Total Flex Fund Expenditures During Report Period $54,292.15 $111,408.17 $145,334.48
Total families served for report period 232 198 177

Case Plan
M21 Each child placed with a relative shall have a written
case plan within 60 days.
Compliance Rate for Continuing Cases 92% 93% 88%
Compliance Rate for New Entrant Cases 94% 95% 84%

Weekly Visits for Parents

16, When the goal is to return a child in foster care home,
M23 reasonable efforts shall be made to facilitate weekly
visits with the parent.
Compliance Rate for Continuing Cases 98% 94% 74%
Compliance Rate for New Entrant Cases 92% 90% 65%
Compliance rate for Continuing Kinship Care cases 85% 91% 79%
Compliance rate for New Entrant Kinship Care cases 93% 94% 82%

66 Office of
Legislative
Audits
 Exhibit E
Comparison of 6-Month Compliance Report Performance Measures
(31st, 32nd, and 33rd Compliance Reports)

Page 5 of 13

31st Report
32nd Report 33rd Report
July 2003 to
Consent Decree Reference & Requirement January 2004 July 2004 to
December
to June 2004 December 2004
2003

Weekly Visits for Siblings

M32 Provide regular visitation among siblings in the legal
custody of BCDSS, except when not in the best interest
of one of the children.
Compliance rate for Continuing Kinship Care cases 88% 94% 83%
Compliance rate for New Entrant Kinship Care cases 88% 89% 88%
Service Agreement

17, In the plan is to return a foster child home, a service

M22 agreement will be developed with the parent within 60
days of the child's placement.

Compliance Rate for Continuing Cases 33% 63% 62%

Compliance Rate for New Entrant Cases 86% 91% 72%
Compliance rate for Continuing Kinship Care cases 87% 91% 87%
Compliance rate for New Entrant Kinship Care cases 89% 94% 79%
M24 Existing guidelines will be followed when the plan is
changed from "return home" to another permanency
goal.
Compliance rate for Continuing Kinship Care cases 74% 61% 72%
Compliance rate for New Entrant Kinship Care cases 96% 95% 92%

Termination of Parental Rights

18 A petition for the termination of parental rights of a All 99 cases All 218 cases All 149 cases
child placed in foster care shall be filed within 120 days
of establishing a goal of adoption.

M25 A petition for the termination of parental rights of a child All 9 cases All 12 cases All 12 cases
placed with relatives shall be filed within 120 days of
establishing a goal of adoption

Education Enrollment, Screening and Monitoring .

19A, A foster child will be enrolled in school within 5 working
M26 days of being placed in non-emergent foster care,
unless school attendance within the time frame is
unattainable

Compliance Rate for Continuing Cases 77% 71% 56%

Compliance Rate for New Entrant Cases 86% 88% 62%

Office of 67
Legislative
Audits
 Exhibit E
Comparison of 6-Month Compliance Report Performance Measures
(31st, 32nd, and 33rd Compliance Reports)

Page 6 of 13

31st Report
32nd Report 33rd Report
July 2003 to
Consent Decree Reference & Requirement January 2004 July 2004 to
December
to June 2004 December 2004
2003

Compliance rate for Continuing Kinship Care cases 86% 78% 70%
Compliance rate for New Entrant Kinship Care cases 82% 79% 62%
M27 All educational screenings will be requested, in writing,
if there is reason to believe that the child placed with
relatives may be educationally handicapped.
Compliance rate for Continuing Kinship Care cases 89% 91% 80%
Compliance rate for New Entrant Kinship Care cases 77% 86% 75%
M28 The caseworker shall monitor the child's progress in
school and shall encourage the relative caretaker to
have contact with the child's school.
Compliance rate for Continuing Kinship Care cases 87% 77% 69%
Compliance rate for New Entrant Kinship Care cases 81% 73% 69%

Special Education Training for Caseworkers

19C, All foster care caseworkers shall receive training A performance A performance Report does not
M29 regarding the special education process and notify the improvement improvement address whether
child's attorney if the services are not provided timely. plan to address plan to address ALL related
requirement requirement caseworkers
will be was received the
recommended recommended related training
under next
report.

Parent Surrogate Appointments

M30 If BCDSS holds guardianship with the right to consent to
adoption and the child placed with relatives is
suspected of being educationally handicapped,
appropriate documentation of the child's legal status
must be provided to the local educational agency so
that the school can apply for the appointment of a
parent surrogate.
Compliance rate for Continuing Kinship Care cases 97% 100% 90%
Compliance rate for New Entrant Kinship Care cases 91% 90% 90%

68 Office of
Legislative
Audits
 Exhibit E
Comparison of 6-Month Compliance Report Performance Measures
(31st, 32nd, and 33rd Compliance Reports)

Page 7 of 13

31st Report
32nd Report 33rd Report
July 2003 to
Consent Decree Reference & Requirement January 2004 July 2004 to
December
to June 2004 December 2004
2003

Comprehensive Health Care System

21A, Develop and maintain a medical care system System System System
M31 reasonably calculated to provide comprehensive health developed and developed and developed and
care services to foster children maintained. maintained. maintained.
Performance of Systematic Systematic
System to be changes made changes made
addressed as deemed as deemed
during next necessary. necessary.
report.

Initial Health Screenings

21B, Provide an initial health care screening before
M31 placement but not later than 5 working days following
placement.
Compliance rate for Foster Care cases 96% Average 93.5% Average 98% Average
over Report over Report over Report
Period Period Period
Compliance rate for Kinship Care cases 92% Average 92% Average 92% Average
over Report over Report over Report
Period Period Period

Comprehensive Health Assessment

21C, A child will be referred for a comprehensive health
M31 assessment within 30 days of entering placement. The
assessment must be completed with in 60 days.
Compliance Rate for Continuing Cases 80% 80% 77%
Compliance Rate for New Entrant Cases 89% 90% 88%
Compliance rate for Continuing Kinship Care cases 93% 95% 90%
Compliance rate for New Entrant Kinship Care cases 95% 92% 91%

EPSDT Standards
21D, Provide medical care in accordance with EPSDT
M31 Standards.
Compliance Rate for Continuing Cases 99% 96% 83%
Compliance Rate for New Entrant Cases 98% 99.56% 90%
Compliance rate for Continuing Kinship Care cases 98% 99.56% 79%
Compliance rate for New Entrant Kinship Care cases 98% 98% 97%

Office of 69
Legislative
Audits
 Exhibit E
Comparison of 6-Month Compliance Report Performance Measures
(31st, 32nd, and 33rd Compliance Reports)

Page 8 of 13

31st Report
32nd Report 33rd Report
July 2003 to
Consent Decree Reference & Requirement January 2004 July 2004 to
December
to June 2004 December 2004
2003

Health Care Record, Case File Documentation and Case Plan

21E, Develop and use an abbreviated health care record,
M31, i.e., medical passport, for each foster child and make
M34 reasonable efforts to place in the case files the results
of the pre-placement screening, 60 day assessment,
any mental health evaluation, any hospital discharges,
or any other assessment.
Compliance Rate for Continuing Cases
Medi Alert form (631A) 91% 84% 93%
Child's Health History (631B) 95% 93% 93%
Developmental Status (631C) 98% 95% 90%
Health Visit Report (631E) 99% 96% 83%
Consent to Health Care and Release of Records 92% 85% 90%
(631F)
Receipt for Health Passport (631G) 87% 90% 85%
Compliance Rate for New Entrant Cases
Medi Alert form (631A) 96% 89% 94%
Child's Health History (631B) 97% 98% 94%
Developmental Status (631C) 97% 98% 99%
Health Visit Report (631E) 98% 100% 90%
Consent to Health Care and Release of Records 90% 94% 90%
(631F)
Receipt for Health Passport (631G) 95% 94% 92%

Compliance rate for Continuing Kinship Care cases

Medi Alert form (631A) 98% 99% 95%
Child's Health History (631B) 98% 99% 95%
Developmental Status (631C) 98% 99% 93%
Health Visit Report (631E) 98% 99% 79%
Consent to Health Care and Release of Records 93% 99% 92%
(631F)
Receipt for Health Passport (631G) 92% 92% 93%

70 Office of
Legislative
Audits
 Exhibit E
Comparison of 6-Month Compliance Report Performance Measures
(31st, 32nd, and 33rd Compliance Reports)

Page 9 of 13

31st Report
32nd Report 33rd Report
July 2003 to
Consent Decree Reference & Requirement January 2004 July 2004 to
December
to June 2004 December 2004
2003

Compliance rate for New Entrant Kinship Care cases

Medi Alert form (631A) 98% 98% 96%
Child's Health History (631B) 98% 98% 96%
Developmental Status (631C) 98% 98% 97%
Health Visit Report (631E) 98% 98% 97%
Consent to Health Care and Release of Records 98% 98% 96%
(631F)
Receipt for Health Passport (631G) 90% 93% 83%

Health Services Management Unit

21F Establish and maintain a Health Services Management Maintained and Maintained Maintained and
Unit currently and currently currently
employs 9 staff employs 9 staff employs 9 staff
and 1 and 1 and 1
coordinator coordinator coordinator

Worker Home Visits with Children

22 At least monthly visits by caseworker for each child
placed in foster home
Compliance Rate for Continuing Cases 78% 78% 79%
Compliance Rate for New Entrant Cases 89% 89% 56%
M18 At least monthly visits for the first 6 months after
placement with a relative visits every other month
thereafter
Compliance rate for Continuing Kinship Care cases 73% 88% 82%
Compliance rate for New Entrant Kinship Care cases 81% 79% 68%
Compliance Rate for bi-monthly continuing Kinship Care 76% 94% 82%
cases

6 Month Administrative Reviews and Periodic Court Review

Hearing for Kinship Cases
25B A child placed with a relative shall have a case plan and
six-month administrative reviews and 18-month juvenile
court review. DSS shall request that the Foster Care
Review Board conduct the 6 month reviews.

Office of 71
Legislative
Audits
 Exhibit E
Comparison of 6-Month Compliance Report Performance Measures
(31st, 32nd, and 33rd Compliance Reports)

Page 10 of 13

31st Report
32nd Report 33rd Report
July 2003 to
Consent Decree Reference & Requirement January 2004 July 2004 to
December
to June 2004 December 2004
2003

Compliance Rate for Case Plan Completion Within 60

Days for Continuing
Kinship Care cases 92% 93% 67%
Compliance Rate for Case Plan Completion Within 60
Days for New Entrant
Kinship Care cases 94% 95% 69%
M33 A copy of the administrative review form shall be made Not Specifically Not Specifically Not Specifically
available to the child's attorney Noted Noted Noted
% Kinship Care Cases Reviewed by the Citizen's Review 40% 40% 53%
Board
% Kinship Care Cases Reviewed by BCDSS Care Review 60% 60% 38%
Panels

Other Data Required by the Consent Decree

33A The number of BCDSS continuing foster care workers
and intake foster care workers, the number of
immediate supervisors of these workers and the
average number of cases for these workers.
Continuing Service Workers 218 290.5 285.6
Intake Workers 22 30.7 33.8
Supervisors for Continuing Service Workers 41 51.5 54
Supervisors for Intake Workers 5 8.3 7
Cases per Continuing Service Worker 22.2 22.9 22.4
Cases per Intake Worker 16.8 18.2 20.6
33B The number of BCDSS foster home caseworkers, the
number of immediate supervisors for these workers and
average number of cases for these workers.
Foster Home Caseworkers 51 53 49.7
Foster Home Supervisors 7 8 8
Average Caseload 45.7 38.2 36.4

72 Office of
Legislative
Audits
 Exhibit E
Comparison of 6-Month Compliance Report Performance Measures
(31st, 32nd, and 33rd Compliance Reports)

Page 11 of 13

31st Report
32nd Report 33rd Report
July 2003 to
Consent Decree Reference & Requirement January 2004 July 2004 to
December
to June 2004 December 2004
2003

33C The number of restricted and general foster homes

approved.
Restricted Foster Homes and Homes Approved 39 63 65
Regular Foster Homes 45 27 52
33D The number of children's and home caseworkers that
have been hired.
Children's Caseworkers Hired 13 31 64
Foster Home Caseworkers Hired 0 2 0
33E Schedule of the rates of reimbursement available to Included Included Included
foster parent.
33F The number of emergency foster homes and children No homes No homes No homes
that can be served by each home. specifically specifically specifically
designated as designated as designated as
emergency emergency emergency
(2176 regular (1948 regular (1784 regular
resource resource resource homes)
homes) homes)

33G The number of current foster parents who have

completed the requisite pre-service and/or continuing
training.
Families Completing Pre-service Training 114 150 127
Families Completing Continuing Training 885 515 706
33H The number of foster children receiving after care 16 14 14
services who are placed with a relative.
The number of foster children who are placed with a 1171 1413 1413
relative in a restricted foster home.
The number of children who are committed by the 1485 1525 1532
juvenile court to DSS and placed in a relative home,
which is not a licensed foster home.

Office of 73
Legislative
Audits
 Exhibit E
Comparison of 6-Month Compliance Report Performance Measures
(31st, 32nd, and 33rd Compliance Reports)

Page 12 of 13

31st Report
32nd Report 33rd Report
July 2003 to
Consent Decree Reference & Requirement January 2004 July 2004 to
December
to June 2004 December 2004
2003

33I The number of complaints of abuse and/or neglect of

children in foster homes received and the disposition of
such complaints
The number of abuse complaints received. Disposition 43 complaints 42 complaints 44 complaints
is as follows: for 54 children for 49 children for 46 children
Indicated 7 7 3
Unsubstantiated 5 6 12
Ruled Out 40 36 28
Pending 2 0 3
The number of neglect complaints received. Disposition 20 complaints 10 complaints 11 complaints
is as follows: for 31 children for 14 children for 26 children
Indicated 6 5 0
Unsubstantiated 5 3 7
Ruled Out 17 6 18
Pending 3 0 1
33J Commencing with the second semiannual report, the
number of complaints of abuse or neglect of children
placed with relatives received and the disposition of
such complaints
The number of abuse complaints received. Disposition 12 complaints 15 complaints 18 complaints
is as follows: for 13 children for 15 children for 18 children
Indicated 1 1 5
Unsubstantiated 4 3 2
Ruled Out 6 11 11
Pending 2 0 0
The number of neglect complaints received. Disposition 10 complaints 10 complaints 12 complaints
is as follows: for 16 children for 15 children for 19 children
Indicated 5 7 4
Unsubstantiated 0 3 1
Ruled Out 10 5 14
Pending 1 0 0

74 Office of
Legislative
Audits
 Exhibit E
Comparison of 6-Month Compliance Report Performance Measures
(31st, 32nd, and 33rd Compliance Reports)

Page 13 of 13

31st Report
32nd Report 33rd Report
July 2003 to
Consent Decree Reference & Requirement January 2004 July 2004 to
December
to June 2004 December 2004
2003

33K The number of children entering foster and/or kinship

care and the status of the first medical assessment for
each child
Total # of Children Entering Foster Care 523 641 618
Total Completed Medical Assessments 304 377 342
Medical Assessments Not required 96 135 157
Total Cases with no Medical Assessments 123 129 119
Total # of Children Entering Kinship Care 362 403 394
Total Completed Medical Assessments 282 312 284
Medical Assessments Not required 22 23 65
Total Cases with no Medical Assessments 58 68 45
33L The number of foster/kinship care children for whom a 1866 1098 2235
goal of return home has been established
The number for whom a plan of adoption has been 1365 310 1090
established
The number for whom a petition to terminate parental 6150 6368 149
rights has been filed
The number for whom a petition to terminate parental 4946 5164 161
rights have been granted
33M A report on expenditures for support services and Included Included Included
reunification funds as of the most recent end of fiscal
year or mid-fiscal year.
33N The number of foster homes reassessed. 29 9 3
33O A summary of quality assurance forms used by BCDSS. Included Included Included
33P The number of workers who have attended training and Included Included Included
the nature of the training provided.

Office of 75
Legislative
Audits
II. Child Protective Services

The narrative section of the report contains some misunderstandings of the Child
Protective Services investigation process. The process begins with receiving and
evaluating a community concern, generally in the form of a telephone call to a local
department of social services. The audit report indicates that a function of an intake
worker (screener) is to complete a safety assessment prior to the report being assigned to
a CPS worker for investigation (pages 24 – 25). That misrepresents the role of a
screener. The screener applies established criteria to determine if the referral alleging
child abuse or neglect contains sufficient information to allow a CPS worker to initiate an
investigation. It is the role of the CPS caseworker (investigator) to determine if a child is
safe as part of their responsibility during initial and subsequent contacts with a child and
his/her caretakers.*

The narrative also indicates that “records for “ruled out” cases, as with the earlier
“screened out” cases, are maintained for 120 days after the final determination is reached
then expunged (Page 26).” Family Law requires that expungement take place “within
120 days after the date of the referral if the report is ruled out, and no further reports of
child abuse or neglect are received.” If the Department takes 60 days to conclude it’s
finding, the audit report suggests that the Department has 120 days from that point to
expunge the record. This interruption extends the timeframe for expungement from 4 to
6 months for ruled out investigations. The statute is clear that the Department has 120
days from receipt of the allegation to expunge the record when the finding is ‘ruled out’.*

Finding2: Documentation of the required supervisory review of initial screening

determinations was often missing and several instances were noted where the decisions to
screen out neglect or abuse allegations appeared questionable.

Recommendation2: We recommend that DHR ensure that all screening determinations

of neglect and abuse referrals be subject to a documented and timely supervisory review
and approval to confirm the propriety of the determinations.

Response: Agree. The Department did not review each of the cases that the auditors felt
should have been investigated however, agrees with the general finding. It would have
been useful to see the actual screened-out reports to see if the Department concurred with
the auditor’s clinical assessment of what should be investigated. In the narrative of the
audit it was noted that Anne Arundel Co. DSS screened out cases because “the reporter
did not indicate if the child incurred physical injury”. Local departments are instructed
not to investigate allegations when it is clear that the child in question did not sustain an
injury. If the reporter reports that no injury occurred as a result of the incident, it is
correct to screen the report out from investigation. If, however, the LDSS was screening
out cases from investigation because the reporter did not know if the child sustained an
injury or if they suspected that there was an injury, the procedure is incorrect.

Planned Corrective Actions: The Department’s new automated case record contained
in MD CHESSIE requires supervisory review and approval of all screening decisions.

Auditor’s Comments:
*Changes were made to the Background Information to address the Department’s
concerns.

2
This feature is part of both early and major release of the new electronic case record. The
electronic system requires that all cases be approved (screened in or out for investigation)
prior to any action being taken.

Finding 3: The CPS cases were sometimes closed without making contact with the child
or family.

Recommendation 3: We recommend that DHR, in conjunction with appropriate law

enforcement agencies, develop a comprehensive policy that includes the appropriate steps
to be taken to gain access to all children reported to be victims of potential abuse or
neglect

Response: Agree. The Department agrees with the recommendation but cautions that
law enforcement also has statutory limits as to how aggressive a report can be pursued.
For example, law enforcement can only forcibly enter a home if they believe a child to be
in imminent danger from child abuse or neglect.

Planned Corrective Actions: Current statute requires each local jurisdiction to establish
Memorandum of Agreements between local law enforcement and child protective
services as to how investigations will be conducted. This item will be incorporated into
the agreements where lacking.

Finding 4: Two local departments reviewed did not comply with certain requirements
related to processing or documenting CPS investigations.

Recommendations 4: We recommend that DHR ensure that each LDSS complies with
all legal requirement regarding case documentation. In addition, DHR should consider
requiring each LDSS to maintain summary reports of all screened out cases for
management oversight purposes.

Response: Agree. Local departments have built their own data files and each is
cautioned concerning maintaining identifying information on screened out reports beyond
120 days. CIS contains no information on screening activity; therefore there has been no
central office guidance on the subject.

Planned Corrective Actions: The Department agrees that maintaining information on

screened out reports is useful and planned for its incorporation into MD CHESSIE from
the beginning phases of development. MD CHESSIE will maintain non-identifying
information on screened out cases for managerial and statistical use. It is part of both
early and major MD CHESSIE release. In those situations where auditors determined
that risk assessments were not conducted on ‘ruled out’ cases, the Department followed
up immediately to correct the situation. All local departments conduct both safety and
risk assessments on situations accepted for investigation.

Finding 5: Investigations were often not initiated or completed within the time frame
required by law.

3
Recommendation 5: We recommend that DHR ensure that all child protective services
investigations are initiated and completed in a timely manner as required by State law

Response: Agree. The Department’s compliance review; CAPS, generally found

compliance rates for investigation initiation higher than that identified in this report.
During CAPS reviews local departments were credited for attempts to see children if it
appeared that appropriate action was taken (visit both home and school for school age
children). DHR understands that it is not in a position to ‘forgive’ a statutory
requirement but also appreciates the reality of an investigation. Workers are required to
clearly document their failed attempts to gain access to a child. Maryland’s results in the
federal Children and Family Service Review conducted in November of 2002 found a
compliance rate for case initiation at a much higher rate than that suggested in this audit
report.

Additionally, the Department considers the determination of whether child abuse or

neglect is ‘indicated’, ‘unsubstantiated’ or ‘ruled out’ and whether an individual is
identified as responsible of child abuse or neglect to signify the conclusion of the
investigation. Investigating is one component of the CPS assessment process.

Determining safety, risk of future maltreatment and service needs of the family are part
of the process but have not historically been considered the investigation as those items,
while part of the statute, have not been of interest to the other investigating entities (law
enforcement and State’s Attorney). When the Department conducts its own review of
child protection records, completion of the report to the State’s Attorney (form DHR/SSA
181 which is also used for neglect investigations) signified by the program supervisor’s
signature and date on the document, marks the completion of the investigation. This can
only be determined by a record review as the date on the DHR/SSA 181 is not captured
in the Department’s current data file (Client Information System). There is a business
rule in MD CHESSIE that will allow DHR to track the date of supervisory approval of
DHR/SSA 181. This interpretation of when an investigation is complete is in keeping
with the Department’s rules regarding notification of an individual of their opportunity to
appeal the dispositional finding of a Child Protective Services worker. Those determined
to be responsible for ‘indicated’ or ‘unsubstantiated’ child abuse or neglect are notified
once the determination is reached, not when all activities related to risk and service
determination are concluded.

Finally, local department directors are at times faced with determining how to best use
their staff resources to ensure safety of children. That has at times had a negative impact
on completion of paper reports associated with an investigation.

Planned Corrective Actions: Maryland’s soon to be implemented electronic case record

will enable local and state program managers to track the actual date that the DHR/SSA
181 was signed by a supervisor and sent to the local SAO. The need to complete the
investigation within specified timeframes will be reinforced.

4
Finding 6: The case files routinely lacked evidence that preliminary finding and final
dispositions of abuse and neglect allegations were forwarded to the State’s Attorney
Offices.

Recommendation 6: We recommend that DHR enforce the legal requirements to report

preliminary findings and final dispositions of abuse and neglect allegations to the SAO
and implement a policy requiring periodic monitoring of compliance.

Response: Agree. The requirement for producing a preliminary report has been in
Family Law for many years. Operationally, the practice of sending a preliminary report
to the local SAO has diminished as the information provided is often incomplete and of
little use. In one of the audit sites it was pointed out that the local SAO requested that the
local department of social services stop sending the preliminary reports because of the
limited information the reports provided and the time it takes to review each and
everyone of them. Law enforcement provides information to the SAO that is more useful
for determining when to prosecute an individual for crimes related to an alleged incident
of child abuse. The form DHR/SSA 181 is the tool designed for reporting the outcome of
the investigation to the SAO. It should be noted that Departmental case record reviews
(CAPS) have included checking for the presence of the DHR/SSA 181 (report of
disposition to the local SAO) and have found high compliance for the document in the
records. The Departmental review has not looked for documentation of mailing the
DHR/SSA 181 to the SAO and concluded that its presence in the record suggested that it
was shared with the local SAO.

Planned Corrective Actions: The Department plans to re-emphasis the need to forward
both the preliminary and final reports of the investigation to the SAO. MD CHESSIE
will allow the Department to monitor when reports are forwarded. Additionally, DHR
will consult with law enforcement and the SAO to evaluate the usefulness of the
preliminary report and consider proposing a change in statute if deemed appropriate.

Finding 7: CIS data entered in CIS were not always accurate or complete.

Recommendation 7: We recommend that DHR require a periodic review of CPS

investigation cases open for extended periods of time and take appropriate action to
ensure that information reflected in CIS is complete and accurate. We also recommend
that DHR develop and distribute guidance to each LDSS on recording key dates in CIS.

Response: Agree. Presently, caseworkers complete forms that are submitted to data
entry personnel who then enter data into CIS. Caseworkers will enter their own
information into MD CHESSIE and an electronic interface will post information to CIS.
The Department will be in a much better position to monitor casework activity once case
records are maintained electronically in MD CHESSIE.

Planned Corrective Actions: MD CHESSIE will eliminate the need to enter CPS
investigation information directly into CIS. Business rules for case opening, case
closure, case transfer, etc. are established for MD CHESSIE and supervisors will be in a

5
position to monitor the work of their caseworkers. Additionally, managers will be in a
better position to monitor casework activity, as they will have access to MD CHESSIE
and the management reports that it will generate.

Finding 8: Reasons for the decline in continuing services cases were not adequately
assessed.

Recommendation 8: We recommend that DHR monitor trends in the number of

continuing service cases and determine the reasons for significant changes. DHR should
consider this information when making policy decisions related to providing continuing
services.

Response: Agree. Local directors were faced with diminishing staff resources in the
recent past and made choices as to how to best provide ongoing and family preservation
services. Priority was given to the mandated services - child protective services and
foster care. Multiple variables, such as the economic conditions and the availability of
community services, impact the child welfare case loads.

Planned Corrective Actions: The Department is moving towards a casework system

driven by risk of child maltreatment versus one where the presence of an incident of
maltreatment determined case direction. This move requires that casework staff address
all risk factors identified during assessment prior to closing a case. This change in
casework process will increase the numbers of families served by Continuing CPS and
Family Preservation staff in the local departments with the plan of reducing the
recurrence rate. Moving to a risk based service-planning model is one component of the
Departments Program Improvement Plan submitted to our Federal partners.

Finding 9: DHR reported Managing for Results (MFR) performance measure on the
percentage of children with recurrence of maltreatment within six months of a first
occurrence might be overstated.

Recommendation 9: We recommend that DHR review for accuracy, at least on a test

basis, its calculation of the performance measure of percentage of children with
recurrence of maltreatment within six months of a first occurrence to ensure compliance
with federal reporting standards.

Response: Agree. The Department noted in its Program Improvement Plan to the
Federal Child and Family Service Review that the percentage of recurrence was not
accurate (actually an over count) and that better measures for that outcome needed to be
developed.

Planned Corrective Actions: MD CHESSIE allows the Department to identify the date
of a maltreatment incident that will allow for much more accurate counting of recurrence.
Incidents that occur prior to an initial contact with a family but are not reported until after
the investigation episode is complete will not be counted as recurrence. CIS does not
contain a data field for ‘date of incident’ which prevents an accurate count.

6
III. Assignment of Foster Care Cases to active Caseworker

Finding 10: There was no system to identify caseworkers assigned to foster care cases
over the history of the case.

Recommendation 10: We recommend that DHR determine the feasibility of developing

system capabilities to monitor foster care caseworker assignments, including historical
caseworker assignment information.

Response: Agree. The audit report recommended that DHR consider using CIS to record
caseworkers and track visits. DHR has assessed CIS’s capability to record active
caseworkers and track visits. Unfortunately, CIS would not be able to appropriately
provide for such tracking.

Planned Corrective Actions: MD CHESSIE will be able to perform this function.

Finding 11: DHR could not document that foster care caseworkers met with children
monthly as required by regulations in most 50 percent of cases tested over a 6 month
period.

Recommendation 11: We recommend that DHR ensure that all children in foster care
receive the required monthly face-to-face meeting with their assigned caseworker, as
required by State regulations. Additionally, DHR should assess why visits have not
occurred and take additional steps necessary to ensure such visits are made as require
(such as reallocating caseworker resources or hiring additional staff as necessary) and are
documented.

Response: Agree. Regulations and policy currently dictate that all children in foster care
receive a monthly face-to-face meeting with their assigned caseworkers. There must be
documentation in the record of the meetings. In this audit review there was some
disagreement about the format the documentation of visits and whether documentation
other than contact sheets was valid. The documentation by the local department can
include contact sheets, visitation logs or other narratives. The documentation of the visit
with the child must be maintained in the child’s records. Although DHR agrees that there
were instances where the visitation requirement was not met, it also notes that some visits
were not included as completed due to the discrepancy in the format of visit
documentation. There were also instances where, as noted in the audit report, a visitation
waiver was utilized. As long as there is a valid waiver in the record and regular reports
from the placement facility indicating visits with the child according to policy, the local
department should be considered in compliance with visitation requirements.
As this was an issue in the previous audit and there is still a need for improvement
despite training and policy efforts implemented by DHR, another solution has to be
pursued.

7
Planned Corrective Actions: For the jurisdictions reviewed in this audit, a corrective
action plan regarding visitation will be required and monitored for compliance. DHR
will monitor monthly visits in the form of written report submissions from all
jurisdictions. The reports will include the name of the child, visits made and explanations
of why the visitation requirement was not met. A corrective action plan will be required
to address the issue of non-compliance with the visitation requirement. After four
quarters of reports, the Social Services Administration will assess whether there has been
any significant change in compliance with the visitation requirement. The assessment
will include any barriers to meeting the visitation requirement statewide and
recommendations to DHR Executive administration for removing said barriers. DHR
will also issue policy publications emphasizing face-to-face visitation as opposed to other
types of contacts, what is expected from visitations, and the importance of prompt and
complete documentation.

DHR continues to actively recruit staff to meet the caseworker resource needs of the local
jurisdictions. Caseworker resources are currently allocated as judiciously as possible
according to children population and caseload.

IV.Baltimore City Consent Decree – DHR Data Reports

Finding 12: The reliability of the data underlying the reported measures tested was
questionable with several being judged unreliable.

Recommendation 12: We recommend that DHR periodically test the reliability of the
information reported to it by BCDSS for inclusion in the 6-month compliance reports. In
addition, we recommend that DHR ensure that appropriate steps are taken by BCDSS to
provide reliable results in the future and that BCDSS retain adequate documentation to
support all data included in the report.

Response: Disagree. Consistent with the philosophy of managing for Results (MFR)
BCDSS/DHR periodically reviews all data in order to inform management decisions.
Universally accepted sound management practices encourage periodic review and
validations of data capture and methodologies used to analyze the data.

Planned Actions: Spring 2005 the Department authorized the hire of a nationally
recognized data consultant to: Validate LJ performance indicators/elements; Determine
whether the LJ data capture instruments ask the right and best questions to measure both
quantitative and qualitative compliance with each paragraph of the decree; Validate
methodologies used to measure and report LJ compliance and progress; and Validate
statistical soundness of LJ reporting format. The data consultant is expected to submit a
written report Spring 2006.

Finding 13: DHR did not report the BCDSS level of compliance regarding the timely
transfer of foster care cases between caseworkers and the method of calculating this
measure may not be appropriate.

8
 AUDIT TEAM

Edward L. Shulder, CPA

Audit Manager

Shawnielle D. Predeoux, CPA

Senior Auditor

Keonna M. Carter
David R. Fahnestock
Roger E. Jaynes, III
David S. Propper
Staff Auditors

Office of
Legislative
Audits