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YELLOW SHEET Office of the State Auditor of Missouri |
April 8, 2004
Report No. 2004-27
Child abuse hotline unit improved how
it classifies calls, but more timely contact with child victims is needed along
with increased monitoring of cases
This
report addresses the Department of Social Services� progress on the seven
recommendations most related to children�s safety made in our first Child Abuse
Hotline report (issued December 2000).�
Of these recommendations, the department has implemented three,
partially implemented three and not implemented one.� The audit concluded that while some
improvements have been made since the previous report, further improvements are
needed.�
In
fiscal year 2003, the hotline unit handled 108,685 hotline calls, and determined
79 percent needed investigation or follow-up by local offices.� In this follow-up report, auditors focused on
the case handling of children who had at least seven hotline calls made on
their behalf over a two and a half-year period in
Weaknesses continue in case
management at local offices
In
responding to this report, department officials said insufficient staff and
funding have limited their ability to address the case management deficiencies
noted below.
Overdue reports resulted in some service
delays to children
Overall,
auditors found 39 percent of the abuse/neglect reports were overdue by 3 months
(similar to 36 percent in the first audit), and 45 percent of the reports
reviewed were not completed in 30 days as required.� Auditors found at least two cases in which
slow report completion led to the child and family not receiving services for
months.� In one case, a young girl with
extensive medical problems possibly caused by her mother did not have a services
case opened until six months after the first call. �In addition, a services case involving an
11-year-old boy allegedly choked by his brother was not opened until six months
after the initial call. �(See page 9)
Initial contacts with children to ensure
safety not timely
Auditors
found caseworkers did not always follow policy in how quickly to contact a
child who was the subject of a hotline call.�
Face-to-face visits are supposed to occur within 24 hours of a call considered
an �investigation� and within 72 hours of a call deemed a
�family
assessment.� �Auditors found that in 16
percent of the cases tested caseworkers did not see the child within the
required time frame.� In one case, it
took 13 days before a caseworker contacted a young teenage boy who had been
kicked out of his house and threatened with harm if he returned and harmed
other household members.� Auditors also
found in 19 percent of the investigations reviewed caseworkers did not
interview the children apart from the alleged perpetrator or other influential
parties. �(See page 11)
Abuse/neglect service cases not always
closely monitored, one involved a fatality
Auditors
found caseworkers did not adequately follow-up on family centered service cases�those
cases where it was determined services were needed.� In such cases, a caseworker is supposed to
closely monitor the child and family through several face-to-face and
collateral contacts to help prevent further abuse and keep the family together.� Auditors found caseworkers did not make the appropriate
number of contacts in 19 of 41 cases reviewed. �In one possible high-risk sexual abuse case, the
caseworker had not made contact for three months, despite a policy requiring
multiple face-to-face contacts or contacts with collaterals during that
period.� In a fatality case, a caseworker
responsible for monitoring a 5-year-old child with a degenerative medical
condition only checked on the child�s medical treatment with the mother, and
did not confirm treatment with a physician. �The child eventually died from lack of medical
attention.� (See page 12)
Improvements made
Call takers and caseworkers have more specific
decision-making guidance in responding to calls
The
prior report suggested
Percentage of incorrectly classified
calls decreased
The
prior report disclosed 3 percent of the calls deemed �unable to investigate�
should have been investigated.� In the
current audit, auditors found 1 percent of "unable to investigate"
calls to be incorrectly classified.� In
addition, hotline call takers are now required to check for prior hotline calls
on a child and track the �unable to investigate� calls in a database for future
reference, both of which did not occur before the first audit. �(See page 7)
