Baker pushes back against critical DCF audit findings

Dec. 15, 2017 | G. Michael Dobbs
news@thereminder.com

State Auditor Suzanne Bump’s report on the Department of Children and Families was called “scathing” by some.
Reminder Publications file photo

BOSTON – Gov. Charlie Baker’s office didn’t seem too impressed by the results of an audit of the Department of Children and Families (DCF) that was released last week and described by some as “scathing.”

The audit detailed how crimes against children in its care were not reported. Among the disturbing findings: “Using the information in the Medicaid Management Information System (MMIS), we analyzed the medical information related to a sample of 566 children in DCF care and found 617 occurrences that appeared to involve serious bodily injury to a child, based on the description of the medical treatment provided. For 260 of these occurrences, DCF had no record of their ever being reported to the department or of DCF identifying them as incidents that should be followed up to determine whether they were critical incidents that should have been reported and possibly investigated. Examples of these occurrences include a 15-year-old with brain damage from a firearm injury, a 1-year-old with first- and second-degree burns on multiple body parts, and a 12-year-old with multiple head contusions that the treating physician determined were a result of an assault.”

When asked for comment by Reminder Publications, Communications Director Lizzie Guyton responded, “The information in this audit is not current as it began four years ago during the prior administration, and the Baker-Polito Administration began implementing a comprehensive overhaul of DCF reforms in 2015 to support the Commonwealth's most vulnerable children.  While many of our reforms have already corrected or addressed concerns raised by the auditor, the department has increased its budget by over $100 million, hired nearly 400 new social workers and managers and implemented several new intake and management policies – including an improved DA referral process to require written citations of sexual assault allegations. The administration takes very seriously the well-being of children under DCF care and will continue to work closely with the department and other state agencies to ensure the safety of every child.”

Auditor Suzanne Bump responded with a release of her  own to the remarks made by the governor’s office: “Gov. Baker has issued a political statement and I respect his ability to do that. The public, however, should consider not the governor’s statement, but DCF’s own acknowledgement that the circumstances that gave rise to the audit findings have not changed. The governor is denying a reality that DCF itself does not dispute.

“The governor has cited progress that the agency has made in several areas. This audit, however, points out that there are additional areas that must be remediated. For instance:
• DCF still does not proactively consult the MassHealth data to which they have access in order to supplement the reports of physical injuries to children in their care that they already receive. We know the value of this information; it is how we identified 260 instances of injuries to children that DCF did not know about.
• DCF is not reporting all so called “critical incidents” of child abuse to the Office of the Child Advocate. Our data indicates there has not been a reduction in critical incidents, yet the number of reports to the OCA has gone down.
• DCF still does not consider sexual abuse a critical incident to be reported to the Office of the Child Advocate.
• As for the 19 cases we believe should have been referred to the District Attorney’s offices, DCF has offered no proof they were referred and the District Attorneys have told us in writing they had no reports of the cases.

“This doesn’t mean that other positive actions are not being taken by the agency. It just means there is more work to be done. This is not an indictment of the leadership nor the dedicated workers of the agency. It is a continuation of systemic flaws that we urge DCF and Governor Baker to address.”

Peter MacKinnon, social worker and President of SEIU Local 509, wrote, “Frontline workers at the Department of Children and Families come to work every day to protect the Commonwealth’s most vulnerable children. In recent years, these workers, through their union, have pushed for ­– and secured – many necessary reforms to ensure that the agency does everything in its power to fulfill its sacred mission.

“We agree with Auditor Bump that DCF must be constantly and rigorously evaluated to ensure the safety of the children in its care, and the safety of the workers that provide that care. However, it is concerning that this report did not take into account the experience and viewpoint of child protective workers, including those involved in cases or examples discussed in the report.”

He concluded, “As the union for DCF social workers, we will continue to work with the agency to implement necessary reforms and extend the important progress that has been made to improve DCF, including in the years after the timeframe of this report. Frontline social workers have the first-hand knowledge critical to capturing a complete picture of the agency, and we remain willing, as always, to participate in future reports or audits.”

The audit looked at information assembled for the period of Jan. 1, 2014 through Dec. 31, 2015.

“The audit’s executive summary read, “In this performance audit, we examined DCF’s process for reporting critical incidents and fatality investigations. Below is a summary of our findings and recommendations, with links to each page listed.

“Finding 1 Page 13  DCF does not effectively identify and investigate all occurrences of serious bodily injury to children in its care.  

“Recommendation Page 14  DCF should establish policies and procedures that require its staff to routinely monitor data from the Medicaid Management Information System in order to ensure that it can identify, and investigate as necessary, medical occurrences that appear to be critical incidents involving children in its care.  

“Finding 2 Page 16  DCF does not report all critical incidents affecting children in its care to the Office of the Child Advocate (OCA).  

“Recommendations Page 17  1.  DCF should establish a single consistent standard for defining and reporting critical incidents that matches the General Laws.  2.  Based on this standard, DCF should develop policies, procedures, controls, and monitoring activities that allow for adequate oversight of the reporting of critical incidents.  

“Finding 3 Page 19 Recommendations Page 19  DCF does not report incidents of abuse, neglect, and/or sexual abuse of children in its care to district attorneys’ (DAs’) offices for investigation whenever it is required to do so. 1.  DCF should update its policies and procedures to include clear and consistent criteria and reporting standards and should establish monitoring activities over all parties to ensure compliance with these standards.  2.  DCF should establish monitoring controls to ensure that its staff complies with its policies and procedures for reporting critical incidents to DAs’ offices.  3.  DCF should schedule regular meetings with DAs’ offices to ensure that the incidents it reports are applicable and that the DAs do not need additional information to help with their investigations.”

The audit noted the scope of responsibilities charged to DCF during that period. “The department administered its services from a central office in Boston and four regional offices administered by regional directors who oversee 29 local area offices. In fiscal years 2014 and 2015, DCF served an average of 44,919 and 51,822 children under 18 years old each month, respectively. DCF had an annual appropriation of approximately $827 million for fiscal year 2015 and an annual appropriation of approximately $908 million for fiscal year 2016.”

The entire audit can be read at www.mass.gov/files/documents/2017/12/07/201610583s.pdf.pdf

Reminder Publications requested a comment from DCF but had not received one by press time.

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