Children's Administration, Department of Social and Health Services
Children's Administration, Department of Social and Health Services
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Operations Manual

6000. ACCOUNTABILITY

6110. Accountability

The Children's Administration (CA) has a system of accountability wherein all levels of the organization have a role in assuring that services are provided to the clients of CA in compliance with policy and statute. The Office of Quality Assurance and Training has primary responsibility for statewide quality assurance reviews and oversight.

6120. Shared Decision Making

All Children's Administration staff are expected to perform in compliance with the CA Case Services Policy Manual, Appendix C, Shared Decision-Making.

6130. Quality Assurance and Continuous Quality Improvement

Approval

By: Jennifer Strus, Asst. Secretary

Effective Date: February 15, 1998

Revised Date: May 1, 2014

Sunset Review: June 2018

Purpose Statement

Children's Administration seeks to continuously improve the quality, efficiency, and effectiveness of culturally competent services provided to children and families. The Quality Improvement Division has primary responsibility for statewide quality assurance, including reviews that measure compliance with performance standards and oversight of continuous quality improvement efforts.

CA Headquarters and regional Quality Assurance/ Continuous Quality Improvement (QA/CQI) staff:

  1. Provide tools, expertise, resources, and training to support the pursuit of innovative improvement initiatives.
  2. Recognize and respect diversity.
  3. Focus on improved client outcomes while fostering innovation.
Laws

RCW 43.88.090

Executive Order 97-03

Executive Order 13-04

Policy
  1. Program Managers, Supervisors, Area Administrators, Regional Administrators, the Division of Licensed Resources (DLR) Administrator and the CA Headquarters Management Team use data to inform practice improvements through information driven decision making.
  2. Performance benchmarks are established in the areas of child safety, permanency, and child and family well-being.
  3. Quality Assurance (QA) and Continuous Quality Improvement (CQI) efforts engage staff (internal stakeholders) from all program areas and levels of authority as well as community and tribal advisory groups (external stakeholders).
  4. Training on the use of performance measure data and continuous quality improvement methods is available to all staff.
Procedures
  1. Gather data to inform practice improvements from multiple sources, including but not limited to:
    1. FamLink
    2. Case reviews (central and targeted case reviews)
    3. External sources (e.g., Office of the Family and Children's Ombuds, federal child welfare reports, Administrative Office of the Courts)
    4. Surveys (staff, caregivers, etc.)
  2. Establish performance benchmarks and report agency performance regarding those benchmarks. Benchmarks support CA and DSHS strategic goals.
  3. Convene
    1. A statewide CQI Advisory Committee to meet regularly to provide oversight and consultation for QA/CQI activities. The Quality Improvement Division will convene and facilitate these meetings.
    2. Local office QA/CQI committees to regularly identify and set goals for areas needing improvement. Goals may support CA and DSHS strategic goals or practice improvements identified by local offices QA/CQI committees. Regional and DLR Administrators will convene the local office QA/CQI committees and assign responsibility for those committees.
  4. CA Headquarters and regional QA/CQI staff will
    1. Provide training on the use of performance measure data and continuous quality improvement methods.
    2. Monitor achievement towards CA goals and strategies through tracking benchmarks, program expectations and performance measures.
    3. Support staff in quality data collection and reporting.
    4. Provide technical assistance for QA/CQI processes.
Forms and Tools

DSHS 10-495 Case Review Feedback Summary

DSHS 10-497 CQI Action Plan

Resources

Lean In Washington

6200. PROGRAM OVERSIGHT

6210. Field Responsibilities

Division of Children and Family Services (DCFS) Regional Administrators and Division of Licensed Resources (DLR) Regional Managers work together to provide their respective services in a manner which will best meet client outcomes and serve the best interests of the children and families served by Children's Administration.

6220. DCFS Field Responsibilities

6221. Regional Administrator

  1. DCFS Regional Administrators establish systems and procedures designed to achieve regional expectations discussed in chapter 2000, section 2310, and to improve client outcomes.
  2. Regional Administrators are responsible for service delivery, management of regional personnel, implementation of all CA policy, oversight of practice, and compliance with CA manual requirements.

6222. Area Manager Responsibilities

  1. DCFS Area Managers are expected to review one case per unit supervised per month.
  2. Area Managers report to the Regional Administrators on a monthly basis regarding the status of the monthly reviews and the quality of the records reviewed.
  3. The Area Manager meets with each supervisor on a monthly basis to review casework supervision and practice.
  4. The Area Manager monitors achievement toward CA goals and strategies through tracking benchmarks, regional expectations, or other performance measures.

6230. DLR Responsibilities

  1. DLR Regional Managers establish systems and procedures designed to improve the health and safety of children in out-of-home care and to monitor and license placement and child care resources in compliance with CA policies and applicable federal and state statutes, and quality assurance as described in this chapter, section 6100.
  2. The Supervisory staff will schedule a conference with each worker at least once a month.
    1. The details and thoroughness of each case review will vary from case to case as determined by the social worker and supervisor.
    2. Supervisors will be available on an as-needed-basis to workers regularly during the month for case consultation on issues of:
      1. health and safety of children;
      2. placement; and
      3. resource decisions.

6232. Office of Foster Care Licensing

  1. Office of Foster Care Licensing (OFCL) Regional Managers establish systems and procedures designed to achieve the implementation of WAC minimum licensing requirements, oversee and conduct group care and family foster home health, and safety reviews in compliance with CA policies and applicable federal and state statutes, and quality assurance as described in this chapter, section 6100.
  2. The following is a guide for monthly meetings between supervisor and worker:
    1. Facility Incident Reports:
      1. Discuss all new and outstanding reports;
      2. Find out if all FamLink licensing/incident Report Modules are up to date, and if not, what are the barriers and the plan for addressing the barriers.
    2. Health & Safety Concerns:
      1. Is any additional support needed to particular homes?
      2. Are any additional monitoring calls, visits and/or evaluations needed to determine quality home environment?
      3. Are there revocations or denials to be reviewed and considered?
    3. Health and Safety Reviews
      1. How many Health and Safety reviews have been conducted this month?
      2. What were the concerns, and did any child report not feeling safe?
      3. Was there a case in which there was serious professional disagreement, including disagreement by the foster parents(s), regarding:
        1. risk of death,;
        2. serious injury;
        3. out-of-home placement of a child; or
        4. child's return home as a result of a decision to leave a child in the home or to return the child to the home.
    4. Licensing/ Re-licensing
      1. Is there a backlog of applications over 90 days or pending re-licenses?
      2. Is there a backlog of Criminal History Background and FBI Clearance - average wait for licensing?
      3. Is there a plan for catching up on any backlog?
    5. Morale & Training needs
      1. Are there any problems or other issues of concern?
      2. Are there plans for employee development?
    6. Documentation:
      1. Supervisors will read 100% of files when the home is licensed/re-licensed to review for:
        1. any health and safety concerns;
        2. to track both individual worker and unit practice patterns;
        3. record maintenance and written work.
      2. Supervisors will read 100% of incident reports to review for risk factors and to track for completeness and closures within a timely manner.
      3. Supervisors will document monthly case reviews. Forms of documentation may include:
        1. Pull a FamLink list of cases & "com tics";
        2. Case lists in Word with conference notes entered; or
        3. Case Note Narrative for the client; or
        4. Notes in the worker's file; and
        5. A log of cases discussed.
    7. Supervisors must audit, with documentation, a minimum of one case per worker per month for audit compliance in addition to those reviewed for licensing/relicensing.
    8. The supervisor will retain the audit review instrument in a Supervisor's desk to be used as a method to identify areas of training needs, clarification of policy, and practice issues for the individual workers and for the unit.
    9. Supervisors are expected to monitor services and expenditures authorized by their staff.
    10. Regional managers will review three records per month that the first line supervisor has reviewed, in addition to meeting the above requirements for the licensors they directly supervise.

6233. Child Abuse and Neglect Investigations

  1. The CPS Facility Investigation Section Manager establishes systems and procedures designed to implement facility investigations in accordance with the standards outlined in chapter 5000, section 5300, of this manual.
    1. Supervisors review 100% of case closures and transfers.
    2. Supervisors will complete a case file audit of at least one open case per month per worker.

6240. Division of Program and Policy Development Responsibilities

  1. Under the direction of the division director, program and policy development, managers assist field staff in the coordination and monitoring of programs for compliance with statutes, regulations, and policies to maintain program integrity and evaluate program effectiveness.
  2. Program and policy development managers monitor headquarters-based contracts for compliance and participate in quality assurance activities in conjunction with field staff and the Division of Management Services.

6250. Management Services Division Responsibilities

Under the direction of the division director, Management Services staff coordinates statewide contract and accountability functions to support field and headquarters operations in conjunction with the Divisions of Program and Policy Development, Licensed Resources, and Children and Family Services.

6251. Operations Support

  1. Operations Support managers develop and implement data collection, data reporting, and accountability mechanisms including regional performance expectations, quarterly reporting systems, and client-based outcome measures. The managers provide feedback to regions regarding their performance.
  2. Operations Support works with the Division of Program and Policy Development, DLR, and the Office of Children's Administration Research (OCAR) to plan and implement policies, procedures, and systems that achieve CA program implementation in compliance with policies, applicable federal and state statutes, and quality assurance, as described in this chapter, section 6100.

6400. PERFORMANCE ACCOUNTABILITY AND REPORTING

6410. Regional Expectations and Quarterly Reporting

Operations Support maintains a system for the quarterly collection and reporting of data on performance measures related to program operations, client-outcomes, and policy compliance as directed by the Assistant Secretary, who reviews regional performance information with each regional management team during quarterly reviews.

6420. Benchmark Reporting

  1. Benchmarking is the process of continuously comparing one's own performance against the best. The Divisions of Program and Policy Development, Management Services, and Licensed Resources collaborated on the identification of permanency planning, child safety, and child and family health and well-being performance measures for CA bench-marking.
  2. Regional Administrators and Managers are responsible for establishing and progressing towards performance targets on bench-marked measures at the regional, area, and office level.

6430. Client Based Outcome Measure Reporting

Operations Support is responsible for collecting and reporting progress on client-based child safety, child and family health and well-being, and permanency planning outcome measures associated with the CA budget.

6500. PERFORMANCE AUDITS

6510. Criminal History Record Inquiry Audit

  1. The Criminal History Record Inquiry (CHRI) Unit is subject to a Washington State Patrol (WSP) system audit every two years.
  2. While previous audits have been limited to the CHRI Unit's terminal site at headquarters, the audit may include field offices, licensers, social workers, etc.
  3. The Federal Bureau of Investigation (FBI) may, at its discretion, audit the CHRI Unit.

6520. Operations Review and Consultation Services

  1. The DSHS Management Services Administration's Operations Review and Consultation Services section is available, upon request by the Assistant Secretary, to conduct special audits of and consultations on Administration operations as well of Administration contractors.
  2. Audits and consultations may include assessment of program performance as well as fiscal management, as requested by the Administration. Directors, Regional Administrators, and Office Chiefs present requests for these services, through the Director of Management Services, to the Operations Review and Consultation Services section.