Investigative Aid

Mobile computing devices boost the efficiency of social workers, leaving them more time to protect at-risk children.
Chris Pantaleon, acting CIO of the Florida Department of Children and Families, wants social workers in his agency to be able to spend less time on paperwork and more time interacting with clients.

Two-year-old Courtney Clark was abducted from a Florida foster home in October 2006 by her troubled mother, despite a court order barring her from custody. When Courtney was found in June 2007 in a Wisconsin home along with several other endangered children, investigators discovered the Florida Department of Children and Families (DCF) contract agency that was monitoring her had failed to report her disappearance for several months.

The Florida Office of Inspector General faulted the contract agency for, among other things, failing to enter Courtney into a statewide child welfare database quickly enough. Headline- grabbing stories such as Courtney’s often prompt states to re-evaluate their child welfare policies and procedures. In Florida’s case, it led DCF’s acting CIO, Chris Pantaleon, to explore mobile technology to quicken data entry into state systems, avoid redundancy and increase the time spent interviewing families.

Earlier this year, the DCF partnered with agencies in Miami-Dade, Monroe and Hillsborough counties on proof-of-concept pilots with handheld devices and customized software that allowed caseworkers to capture visit information without returning to the office. The agency would also like to add GPS mapping capability to help get caseworkers to the appropriate location, to provide digital cameras to document visits and to create a date and time stamp to verify where and when meetings occurred.

“What we are looking for is efficiency gains so that caseworkers can spend more time interacting with families,” says Pantaleon. “We need to increase the number of children who are seen by caseworkers every 30 days.”

He also wants the portable devices to offer benefits beyond more convenient note-taking. “We’re looking at decision-support software to lead them through structured steps to develop a case-management plan for a family,” he explains, adding that predictive analytics software could use clients’ past behavior to forecast their future actions.

Outfitting Employees

Child welfare administrators across the country are tapping mobile computing tools to boost overburdened caseworkers’ efficiency. From Texas to Wisconsin to New York, states have begun offering notebook and tablet PC access to Statewide Automated Child Welfare Information Systems (SACWIS) databases, as well as systems designed to track adult protective services.

Three years ago, the Texas Department of Family and Protective Services (DFPS) outfitted all 900 caseworkers in Adult Protective Services with Motion Computing tablet PCs with broadband cellular service.

Employees began documenting their cases in the field rather than jotting down notes and typing them in later. The agency now sends new cases to caseworkers electronically, and workers use a mapping feature to plot their route to the next destination. If a home visit elicits a particular concern, a caseworker can take a picture with the tablet and send it to a supervisor for consultation, says Barbara Purnell, a DFPS program administrator in San Angelo. And with some workers responsible for covering counties the size of Rhode Island, “the ability to pull over at a Dairy Queen and transmit case notes or consult with a supervisor has made a huge difference,” she says.

Mobility speeds the services that families receive, says Joseph King, a DFPS field trainer based in Abilene. A few years ago, after meeting with a family, a caseworker would leave a card and tell them that service providers would call in a day or two, he says. “Now, from contact information stored on the tablet, they can find the right person to help that family and even make that call for them, so a meeting is set up before they leave the house.”

One unit in Purnell’s office is involved in a state pilot project to move beyond mobility and toward being completely office-free. Caseworkers are given a state cell phone, a mobile printer with scan and fax capability, a power strip and a cart to hold all their tech gadgets and act as a mobile desk. “We have found during this pilot that it definitely increases their time with clients in the field,” she says. “We’ve seen improvement in client outcomes across the board.” Retention and job-satisfaction measures are also improving, Purnell adds.

Mobility computing options can also prove valuable in a crisis situation. Purnell notes that as DFPS workers began the Fundamentalist Church of Jesus Christ of Latter Day Saints compound child-abuse investigation, the fact that many of its employees had notebooks and mobile access to their files helped the department respond quickly.

Increased Efficiency

William Travis sees a big part of his job as allowing caseworkers to spend more time with people and less time in an office entering data. “Our motto is ‘more casework, less mouse work,’” says the deputy commissioner and CIO for the New York State Office of Children and Family Services (OCFS).

For the past two years, OCFS has been piloting mobile technology. “We were hearing from county social services commissioners that caseworkers wanted to get administrative work done while they were waiting in court or at home at night,” Travis explains.

In 2006, the state legislature allocated $1 million to test mobile technology in the field. Early pilot projects involved notebook and tablet PCs with wireless broadband connections, personal digital assistants, voice recognition software, cell phones and dictation equipment. “The notebooks with broadband provided the most bang for the buck,” Travis says, noting the caseworkers’ satisfaction with other technologies didn’t match that of notebooks with broadband. In 2007, with additional state funding, 23 social-service districts participated in a demonstration project using notebooks and HP Compaq tc4400 tablet PCs.

Erin Gessini, a child protective services investigator in Onondaga County, N.Y., says using a notebook has helped her stay on top of her paperwork. Investigators are supposed to file safety assessments on children within seven days of a case being open. But Gessini says that with three or four new cases each week, and 15 to 20 pages of progress notes on each case, she sometimes fell behind in entering them into the SACWIS system, which made the safety assessments late. “The notebook helps keep my stress level down because I can catch up on my work at home at night or on weekends.”

Travis’ office worked with researchers at the Center for Technology in Government (CTG) at the State University of New York at Albany to measure the caseworkers’ efficiency gains and perceptions of the technology. CTG found an increase in the number of case-progress notes entered per day and an increase in the number of cases closed within 60 days. Here are some findings:

  • 63 percent of surveyed caseworkers said notebook use improved their ability to access case information;
  • 55 percent said it improved timeliness of documentation;
  • 32 percent said it improved their ability to do work in court;
  • 28 percent said it improved the service they provided clients; and
  • 20 percent said it aided communication with supervisors.

Based on these results, the state is expanding the pilot this year. “We made these changes to how they worked, and 80 percent said they would recommend using a notebook to a colleague,” Travis says. “These are people who a few years ago were doing most of this work on paper. I think that’s remarkable.”

Efficiency is only the half of it, says Anthony Cresswell, interim director of CTG. “A more complete story would include the reports we saw of reduced stress and improvements in morale in this highly stressful and demanding profession. The full public value of deploying this technology will not be known until we can assess the impacts on the lives of children at risk and overall improvements in the quality of life in the community.”

Investment Obstacles

Many states and counties that have expressed interest in mobile technology are finding it difficult to fund the projects. For instance, Florida Gov. Charlie Crist has recommended the state invest $10 million to expand its efforts from proof-of-concept to pilot projects. But because the state is facing budget deficits, it is unlikely the project will get funded in the next fiscal year’s budget.

Tracy Whitaker, director of the Center for Workforce Studies at the National Association of Social Workers in Washington, D.C., says that despite budget challenges, states and counties should consider investing in technology if it has the potential to help caseworkers assist families. “All the people working in this field have good intentions, but sometimes they are too reactive. We do not need to wait for something horrible to happen before taking action.”

Although it may be difficult to calculate a return on investment, Whitaker says, “If the worker is spending more time with children and less time writing at a computer, there’s real value in that.”

Rocky Mountain Roaming

At the Colorado Department of Human Services, employees who inspect and license child-care centers and foster-home facilities have become true road warriors. For the past three years, they have been using HP tablet PCs and web-based forms they can access from anywhere.

“They used to go to the facility and do everything on paper. It was very labor-intensive,” recalls Kelley Eich, the department’s chief technology officer.”They would fill the data in by hand and then later scan the forms into an imaging system. They had to come back into the office much more often.” Now they return to the office about once a month to upload that information into a state database.

Users like the tablet’s handwriting recognition feature, which allows care facility owners to provide signatures on forms. “When licensing specialists walk away from the encounter,” Eich says, “the facility has copies of everything that was created for that visit.”

Lessons Learned

The Center for Technology in Government gleaned good insight from the New York State Office of Children and Family Services’ pilot of mobile computing.

  • Worker-driven programs are most likely to succeed.
  • Organizational and political commitment is vital to success.
  • In-depth pilots are necessary to draw accurate conclusions about a device’s suitability for social work.
  • Elimination of double entry is crucial to workers’ satisfaction.
  • Wireless connectivity is essential but problematic.
  • Adequate IT support and training are crucial for successful implementation.

Stress-busting System

New York City’s Administration for Children’s Services’ pilot of mobile computing helped reduce job-related stress, according to the Center for Technology in Government. Of the caseworkers surveyed after the pilot, 63 percent said having a notebook computer reduced their overall job stress. Those respondents said their ability to catch up on work, submit reports on time, work on documentation outside of the office and have the device available all contributed to reducing their overall job stress.

Task Tally

A report from the Oregon Department of Human Services shows caseworkers allocate only 29 percent of their time with clients because of other required activities. In New York’s first pilot deployment of mobile technology for child protective services, here is how social workers used the notebooks:

  • Progress notes: 65%
  • Safety assessment: 65%
  • To-do list: 55%
  • Searches of person, address, case, resource and staff: 53%
  • Investigation conclusion: 50%
  • E-mail: 38%
  • Risk assessment profile: 45%
  • Event list: 33%
  • Review intake information: 25%
  • Adding/relating person: 20%

COUNT IN THE COUNTIES

In many states, child welfare systems are “federated” — that is, overseen by the state government, but administered by counties. In those states, it’s often up to the counties to invest in mobile devices.

Federal guidelines are prompting Wisconsin counties to closely examine mobile computing. The Child and Family Services Improvement Act of 2006 sets new requirements for caseworker visits and new procedures to track and report monthly caseworker-visit data. By this June, states were to provide an outline of steps they will take to ensure that 90 percent of the children in out-of-home care are visited once a month.

Jason Wutt, a program analyst with the Wisconsin Department of Health and Family Services, says 10 of the state’s 72 counties are already taking advantage of the mobile version of its statewide automated child welfare information systems (SACWIS) system, dubbed eWiSACWIS Anywhere. For instance, more than 100 caseworkers in Dane County, which includes the state capital of Madison, currently use notebook and tablet PCs to access the mobile version of the software.

“Where wireless access is available, such as in the Dane County courthouse, users can be working on their files while waiting to testify in a hearing,” Wutt explains. “They’re making better use of their downtime.”

The state has implemented a hardware loaner program, so counties can try devices out for a month or two to experience how they fit into their practice before spending roughly $2,000 per unit.

Sheila Hanson is convinced that using an HP tablet PC has made a difference in her work. The Dane County social worker uses it every day to enter case notes as she interviews families. That saves her time because she no longer has to write notes by hand and then enter them into a database later.

Besides entering notes, Hanson likes that she can remotely access files. Recently, a parent asked her if another social services specialist had completed a task related to her family’s case. Hanson didn’t know off-hand, but by using her tablet to log into the mobile version of Wiscon-sin’s SACWIS system, she could see whether the social service specialist had entered a new case note.

“I can also look at my own prior case notes,” Hanson explains. “Often at our last meeting, we’ve set family goals for the next month. I can quickly pull up my old case notes and review them. This helps me make sure we’ve covered the things we talked about the previous month.”

Hanson believes clients like that she’s gone high-tech. “People seem very comfortable with it,” she says. “Before we start, I ask them how they feel about my using a tablet, and I have never had anyone express concern. In fact, when I don’t have it, they ask, ‘Where’s your tablet today?’”

Jul 07 2008