“Indiana has embraced the most sophisticated, state-of-the-art policies and practices, and made an investment in the futures of Indiana’s vulnerable children and families.”

– Tracy Field of the Annie E. Casey Foundation at a 2007 award ceremony honoring Mitch Daniels for Indiana’s child welfare achievements

Good to Great? More like Worst to Best

Observing how the Indiana’s Department of Child Services (DCS) is viewed in and outside of Indiana is kind of like watching how a prophet is received in and outside his hometown. Just as the former is proverbially rejected at home, so DCS is regularly subjected to rhetorical beatings in Indiana media. However, outside of Indiana, DCS has been praised for the way in which it has turned around the nation’s worst child services agency and made the kind of progress other states only dream of.

When Mitch Daniels was elected Governor, Indiana was a national leader in child deaths. No one wants to lead in that category. One child a week was dying because of abuse or neglect.

DCS was at the time a division of the state’s primary human services agency, the Family and Social Services Administration (FSSA). Known for having 92 different administrations in Indiana’s 92 counties, FSSA was terribly outdated, inefficient, and poorly organized. Records were kept in paper files, stacked in boxes, handled in completely different ways depending on your county. Child services was one the divisions of a human services agency using mid-20th century technology and processes to address 21st century challenges.

Mitch Daniels heard plenty about Indiana’s dysfunctional child services division from families in communities across Indiana as he traveled the state during the 2003 and 2004 campaign. He decided that fixing the problems would be a priority on day one if he were elected.

So on his first day in office in 2005, as part of the Executive Order that terminated collective bargaining among state employees, Daniels pulled child services out of FSSA and created the Department of Child Services as a stand-alone agency. He doubled the number of case workers and had the state take over the role of financing the agency from the counties, which had previously funded their work through local property taxes.

Seven years later, DCS has established itself as a national model because of these types of results:

• Total fatalities declined 44 percent since 2004.
• More than 33 percent of child fatalities due to abuse and neglect in 2004 were to children who had some prior involvement with DCS, compared to 16 percent seven years later.
• Indiana has seen a 70 percent increase in adoption of children in the state’s care since 2004.
• Indiana now ranks 2nd in the nation in timeliness of adoption.
• Compared to 10 percent in 2005, 96 percent of children in the DCS system receive a monthly case worker visit today.
• Only 2 percent of children in Indiana’s child welfare system reach age 18 without a permanent home, compared to 21 percent in Illinois, 16 percent in Kentucky, 15 percent in Ohio, and 11 percent in Michigan.

When Daniels created DCS in 2005, neither he nor his team expected they would see results such as these. They were starting in the midst of such a mess that any progress would seem like a triumph. So what paved the way for Indiana to go from the very bottom of the child services barrel to the top in such a short time?

Getting the Basics Right

By the time Daniels created DCS in January 2005, he and his team had identified some core, systemic problems within the agency’s predecessor:

• Employees in the agency were overwhelmed by so many cases that 9 in 10 children never got a monthly visit from their caseworker.
• Training for caseworkers was virtually non-existent.
• Because all 92 counties had their own child services offices “doing things their way,” coordinating cases across county lines was inefficient at best, impossible in the worst cases.
• The county-based financing of the child services offices made increasing funding to increase caseworker capacity difficult to achieve.

Like all dysfunctional environments, the sources of the breakdowns and problems in Indiana’s child services were many and not without unique histories. Federal incentives led counties to pull children out of troubled homes because of how matching funds were structured. The state had been paying for administrative costs while counties were responsible for service delivery, which created significant problems with recruiting and retaining caseworkers. Caseworkers were overwhelmed with caseloads the moment they started the job, so any training that happened occurred after they had already been on the job. By the time they received training, if they received any at all, they had already established their own way of doing things.

It was clear from the outset that Indiana needed more caseworkers, those caseworkers needed more and better training before they started working, and the overall management practices of the department needed modernization.

Pulling the Right Levers

Daniels wasted no time getting the State into gear on DCS reforms. He knew that it would take the better part of the first year to hire as many or more caseworkers than the state currently had employed in total.

Building up the front lines 

When most people hear “caseworkers,” they think of poorly paid government workers shuffling papers around that have something to do with getting services to disadvantaged people. In reality caseworkers are the front lines of services to the most vulnerable people in a state. They have to make tough decisions, often on the spot, when a family is in crisis. They have to know how to relate to people who serially fail at some of life’s tasks that most people take for granted. In summary, they have to have good judgment, strong interpersonal skills, and a solid knowledge of the resources available to children in need.

After creating DCS, Daniels immediately set about doubling the number of caseworkers in Indiana. Based on an assessment that had been done in the state a couple years earlier, Daniels set a goal of 12-17 cases per worker. Daniels installed a strong leadership team that increased the number of caseworkers from 785 to more than 1,600. The number of cases per worker dropped from approximately 50 on average down to 12.

One often-overlooked reason for getting the caseworker caps right is this: people who get into the profession want to help others. When they are overloaded with cases, they actually get very little time with the families they originally took the job thinking they would get a chance to help. By getting the caseload smaller, caseworkers can invest more time with the families, which in turn provides better care for children and better results – which then in turn helps with retention.

DCS is now an agency focused intensely on serving the needs of Indiana’s most vulnerable children. DCS has approximately 2,800 employees, 2,650 of which are focused on directly on child welfare.

Equipping the front lines 

Daniels’ team changed the previously ineffective training regimen, which happened on the job, to a twelve-week, intensive course that occurs at the beginning of a caseworker’s tenure with DCS. In fact, caseworkers are not even allowed to handle a single case until they have completed the training.

In a report the Casey Foundation published on the Indiana DCS reforms, a caseworker describes what she tells new hires who complain about the depth and scope of the 12-week training: “I tell them that when I started, I didn’t get 12 minutes of training.” After completing their training, new caseworkers are sworn into office at the Statehouse in Indianapolis.

The training has been an important way to get rid of the irregular and often contradictory practices that had been occurring in child services across the state for a long time. “What if every McDonalds made burgers their own way?” That’s a question Jim Payne, DCS director from 2005 to 2012, would ask when describing the importance of DCS’s training course. Counties had different protocols for removing children from homes with drug usage, different ways of reviewing and assessing cases, different criteria by which children were kept in their homes, and so on.

If McDonalds franchises all did their own thing, some would offer great burgers, others would be terrible. So it was with child services in Indiana before DCS. You never knew what you were getting. Today, the statewide training has created a much more coherent, consistent set of practices and procedures. As a result, the State has been able to ensure that the best practices for intervention are put into place no matter which county you live in.

Putting the family first 

For years, partially because of federal policy incentives and partially because of inertia, the trend across Indiana had been to pull children out of troubled homes. Child service workers didn’t typically look to relatives as a source of care for a child. If a father was not in the home, rarely did anyone try to find him. Foster care was always utilized, especially since foster parents are typically likely to adopt, but so was residential care.

In 2004 there were 1,500 residential facility placements in Indiana. Today, that number has dropped to 300. Conversely, the state has seen placements with relatives jump from 1,700 to more than 4,000 during the same time period.

What made the difference?  DCS built its intervention model on the knowledge that 75 percent of the children who enter the child welfare system end up back home at some point.  So starting by looking for resources in and around the home is important. Families have informal networks with whom caseworkers can work to provide the best care for the child. All DCS work begins at that level before other options are sought.

As a result, the percentage of children who were placed with a relative when they needed removal from their home jumped from 6 percent in 2004 to 35 percent today. Conversely, the percentage who were placed in a congregate care setting dropped from 31 percent to 7 percent during the same period.

Payne describes the shift in practice this way: “We’ve gone from knocking on doors and saying, ‘We’re taking your child, and here’s a number to call to figure out how to get them back,’ to stopping by and saying, ‘Let’s get a group of family and friends around the table to figure out the best care for your child.’” Instead of “rescuing” children, caseworkers primary job becomes stopping by to see how a particular child is doing.

Adapting adoption policies to the concerns of adoptive parents

Daniels also wanted to increase the number of adoptions of children in the child welfare system.

Today, adoptions are up 70 percent compared to 2004. One key driver of this increase was the recognition that prospective adoptive parents aren’t motivated by money as much as other important factors.  Previously, Indiana provided state and county level adoptions subsidies based on the very reasonable assumption that families would not want to adopt if the subsidies they received for foster children would end if they adopted the children.

Daniels and his team heard while traveling around the state that cash subsidies were not a motivating factor for prospective adoptive parents as much as the concern that the parents would lose the Medicaid option for the child they hoped to adopt. As a result, DCS made the continuation of Medicaid for adopted children a priority and ended the practice of “paying people to adopt.”

Adoptions rose from 1,045 in 2004 to 1,787 in 2011, which is pretty compelling evidence that subsidies for adoption are not the incentive that conventional wisdom holds they are.

Paying for it

Mitch Daniels is known nationwide as the most successful cost-cutting Governor in recent memory. As he is fond of saying, you’ll be amazed at how much government you’ll never miss. DCS was something of an exception, however. Guided by a firm belief that preventing child abuse and neglect is a primary duty of the state, Daniels ensured that some of the savings realized through cost-cutting elsewhere made it possible to double the caseworker force and train them. That doesn’t mean that DCS was immune from budgetary reductions. Like any other agency, it was required to find 15 percent reductions from the start. But the approximately $100 million it found in savings was partially offset by nearly $50 million required to hire and train new workers.

A small increase in the state’s sales tax was used to fund DCS as the state took over the role of financing its operation from the counties, part of Daniels’ overall effort to bring greater effectiveness to the agency’s work. The bottom line is that Daniels made the commitment necessary to bring Indiana’s caseworker-caseload ratio to one-to-twelve, which is directly related to the drop in childhood deaths and increase in services to children.

Indiana’s child welfare turnaround is nothing short of a tremendous feat in government reform. As with any child welfare effort, it will not be without its critics. But from the caseload ratios to the de-institutionalization of children to the increase in adoptions, its success is undeniable.