As the Department of Human Services rolls out its new service model — called Improving Outcomes for Children — DHS Commissioner Anne Marie Ambrose is spreading the word about the changes, aimed at streamlining case management and bolstering oversight in situations when children are at risk.
“A private provider is going to be providing real service and DHS is stepping back and taking more of a monitoring, oversight role,” Ambrose said during a Tribune editorial board meeting on Tuesday August 14.
Ambrose wants to be sure that the community is aware of the change in agency’s practices as it embarks on a reform drive that will occupy it for the next four years.
DHS recently awarded contracts to its first two Community Umbrella Agencies: Northeast Treatment Centers (NET) and Asociación Puertorriqueños en Marcha (APM). The two organizations are the first named as DHS moves to change its operations. They will take over case management under the new system. Ultimately, 10 agencies will be given contracts, down from 240 under the old system.
All case management would be handled by those 10 service providers with DHS oversight, monitoring of cases and support in a unified case plan for each child. Each CUA will operate within a specific geographic area of the city.
Ambrose assured the Tribune that should private providers fail in their duties to the city’s children, they face the possibility of losing DHS contracts.
“We won’t have any problem with terminating the contract,” she said.
Hopes are that the change will benefit the children under DHS supervision in two ways.
The first is a new emphasis on community involvement. By giving CUA’s a stronger role in a specific geographic area, Ambrose hoped that communities would be drawn into the effort to help children. Stronger geographic ties are intended to help provide the resources to keep children at home or with family, as much as possible, in the city and their communities.
“This is intended to build a community around children whose parents are struggling,” she said. “If you can’t work it out with parents, then what are the other family or community resources that can be brought to bear?”
Secondly, Ambrose said the new simpler system should be easier for families to navigate.
Under the old system, children under DHS supervision had two case workers, one from DHS and one from a provider agency.
“It really provided lots of opportunities for kids to get lost in the cracks,” Ambrose said. “When everyone’s responsible, no one is responsible. Really tragic things happen as a result of that.”
Under the new model, DHS will streamline case management into a single-case management system. Children will now have one case manager through the CUA, and DHS will provide oversight — including home visits from DHS staff to make sure CUA case workers are providing the necessary care.
Though the changes could save DHS a chunk of its $629 million annual budget, Ambrose said, the agency had not done a cost analysis and expected the shift to be cost neutral. Staffing levels were expected to remain similar under the new plan, though employees would be in new roles.
The reforms are part of a sweeping program of change implemented after the death of Danieal Kelly. The 14-year-old, who suffered from cerebral palsy, died in August 2006 from starvation. Her parents, her DHS and service provider caseworkers and others connected with her death were arrested and prosecuted.
In that case, social workers from the provider agencies and DHS each shifted the blame back and forth.
Her father, Daniel Kelly Sr. 40, was found guilty of endangering the welfare of a child. Dana Poindexter, the DHS caseworker, was found guilty of child endangerment, recklessly endangering another person, and perjury. Her mother, Andrea Kelly, 42, pleaded guilty to third-degree murder in 2009 and is serving a 20-to-40-year prison sentence. Mickal Kamuvaka, head of the service provider agency, was found guilty of involuntary manslaughter, child endangerment, reckless endangerment, perjury and criminal conspiracy.
DHS case management gradually shifting to regional agencies
Mayor Michael Nutter and DHS Commissioner Anne Marie Ambrose announced on Wednesday that the agency would be starting the implementation of a major shift in how its cases are handled — a change designed to streamline case management and provide more oversight in situations when children are at risk.
Over the next four years, the Department of Human Services will transition into what is called the Improving Outcomes for Children model. All case management would be handled by ten service provider agencies called Community Umbrella Agencies or CUAs. DHS personnel would take over oversight, monitoring of cases and training. The CUAs will be chosen and contracted by DHS, and each will manage cases within a specific geographic region.
“DHS has seen some tremendous improvements under the leadership of Commissioner Ambrose,” said Mayor Nutter. “But no matter how much we have done, there is still more work to do. ‘Improving Outcomes for Children’ is another opportunity for our administration and DHS to put first the welfare, safety and best interest of Philadelphia’s children.”
The contracting of the Community Umbrella Agencies will take place over a period of four years, at the end of which, all direct case management will be handled by them. Under the old system, DHS-involved children had two case workers, one from DHS and one from a provider agency. Under IOC, DHS will streamline case management into a single-case management system. This allows for children in the DHS system to have a consistent case manager from the provider agency with the experience and knowledge of DHS staff to account for the care and services given to DHS children and families by the provider agencies. The first two CUAs are Northeast Treatment Centers (NET) and Asociación Puertorriqueños en Marcha (APM).
“APM has a long record of serving eastern North Philadelphia, building affordable housing, helping reunify hundreds of families and providing behavioral health and foster care services,” said Ambrose. “It is an agency truly, as its name says, on the march. NET has also performed very well with its school-based programs, parenting classes, and adult drug and alcohol treatment program. Both APM and NET have a documented record of more than 40 years of commitment and involvement in the communities they serve.”
DHS spokesperson Alicia Taylor said the shift to the IOC model clarifies responsibilities.
“There would be several people overseeing a case. DHS would provide direct oversight, support and monitoring. There would be a much clearer clarification of responsibilities,” said Taylor.
“NET is known to many people as a national leader in the field of recovery. But we started as a youth services organization more than 40 years ago,” said Regan Kelly, vice president of Northeast Treatment Centers. “We’ve always maintained a strong connection to supporting youth and families in their own communities. We’ve developed very successful home- and community-based programs for youth and families and support more than 400 families every year. We look forward to partnering with the local community and DHS to make this a nationally recognized child welfare system.”
APM and NET will begin training with former DHS case management workers as early as next week. DHS will still be responsible for the children within its care and will still operate the DHS Hotline, continue to perform intake and will still conduct investigations.
One of the problems the change to IOC is meant to address is that during the Danieal Kelly case, the social workers from the provider agencies and DHS each shifted the blame back and forth. Kelly, a 14-year-old who suffered from cerebral palsy, died in August 2006 from starvation. Her parents, her DHS and service provider caseworkers and others directly connected with her death were arrested and prosecuted.
Last year Kelly’s father, Daniel Kelly Sr., 40, was found guilty of endangering the welfare of a child. Dana Poindexter, the DHS caseworker, was found guilty of child endangerment, recklessly endangering another person and perjury. Her mother, Andrea Kelly, 42, pleaded guilty to third-degree murder in 2009 and is serving a 20-to-40-year prison sentence. Mickal Kamuvaka, head of the service provider agency was found guilty of involuntary manslaughter, child endangerment, reckless endangerment, perjury and criminal conspiracy.