High turnover and low retention in human services, particularly child welfare, is not new. We’ve been talking about it for decades. For the last several years we’ve discussed social work burnout, worker well-being, and retention and recruitment strategies on our blog as well.
The consequences of high turnover are felt by both agencies and the citizens they serve. In nearly every Annual Progress and Services Report (APSR) publish in the last couple years by the states, staffing issues are cited as a main barrier towards agencies meeting their goals for improving service and making progress towards important system changes. It is also well documented that turnover of caseworkers negatively impacts child and families.
It feels dire, and it sure keeps many leaders across the country up at night. But what gives us hope is that so many industry leaders refuse to give up trying to create more sustainable systems that support better, more equitable delivery of services.Sometimes the most creative solutions are born out of crisis. In recent years, there have been many examples of creatively approaching and restructuring the work of human services in innovative ways not tried before. We’ll share the following examples, but first let’s dive deeper into the problem.
- Missouri Department of Social Services: Central Consult Unit
- Indiana Family and Social Services Administration: Safe Assessment Closure Team (SafeACT)
- Jackson County Job & Family Services in Ohio: Case Aide Services by Northwoods
Decoding the Data: Turnover Trends in Human Services
While turnover is notoriously difficult to measure, our team scoured reports and news articles for post-pandemic statistics. Some key findings:
- The current average turnover rate in human services across 37 states is north of 30%, with some states reporting staggering rates of 50-60% or more. (The ideal rate? Below 12%.)
- Casey Family Programs reports the same pre-pandemic factors of emotional exhaustion and job dissatisfaction are still at play, in addition to “a range of workforce challenges—including role ambiguity, low compensation, organizational culture, lack of peer support, increased administrative requirements, high caseloads, and lack of community-based services.”
- The concept of moral distress has also recently been discussed widely as having an impact on the desires of staff to enter the field or continue to stay. A recent study of child welfare caseworkers states that “only about a half of the respondents stated with certainty that they were not planning to leave their current agency as soon as they could, and less than a half of the respondents expressed certainty about not leaving the field of child welfare as soon as possible. These statistics paint a picture of a very volatile workforce with high turnover potential and a weak workplace commitment.”
Leaders we speak to regularly report they just don’t have the people they need to be successful. A program manager in Pennsylvania told me recently: “We may have just hit critical mass when it comes to the amount of people available who want to do this type of work.”
Innovative Ideas to Stabilize Staffing, Increase Capacity, and Create a Sustainable Workforce
Technology, especially with advancements in AI capabilities, will continue to play a pivotal role in addressing these longstanding issues (and is typically where we center our discussions here at Northwoods). However, process re-engineering should not be underestimated as part of a holistic solution to stabilizing a workforce and creating sustainability. After all, it is only through a stable workforce that other key initiatives critical to system change (e.g., tackling disproportionality, advancing FFPSA implementation, etc.) can take place.
Findings from the caseworker study suggest that minimizing administrative burden such as mounting paperwork and implementing collaborative documentation techniques are two key strategies to reducing workplace-related burnout, a main driving factor of turnover. Bill Bott, child welfare lead for Change & Innovation Agency (C!A), knows this intimately, as he and the C!A team have worked with a number of states to re-think how to structure the work of child welfare. Bill explained that C!A’s work with states on this issue was born out of their own efforts to understand the root causes of today’s workforce crises.
He echoed the empirical research with his own experience interviewing hundreds of caseworkers. “Workers aren’t leaving because of the money or because of the type of work these roles demand. They know when they sign up they’re not going to get rich knocking on doors and having hard conversations,” he said. Rather it’s the stress of the job that comes from constant deadlines and having an impossible amount of work for hours in the day that wears down a caseworker quickly. “It’s the fact that a worker must spend four hours on compliance-based activities for every one hour they spend with a family,” Bill added.
C!A works with states and counties to map current processes and conduct workload studies to understand the gap between what their processes and policies mandate, and what their staff actually have capacity for. Further, they help states re-imagine how to structure the work to tackle that gap.
Missouri: Central Consult Unit to Support Child Welfare Assessments
Missouri is a great example of this work in action. Sara Smith and Teri Armistead, both former deputy directors for the Missouri Department of Social Services, presented at the 2023 Child Welfare League of America (CWLA) Conference on their experience implementing changes in the agency’s processes and increasing the capacity of their workforce.
After working with C!A, Missouri created a Central Consult Unit of 25 team members whose sole responsibility was taking on the consultation and closure of Investigations and Assessments that had been deemed safe by local staff on the ground out in the counties across the state.
Offloading this portion of work from the local counties to this centralized team increased consistency of closed cases and allowed local supervisors in the state to focus on the more complex unsafe cases that require the most attention. One key result? Regions utilizing the process observed an initial 40% reduction in caseload. For families undergoing assessment, they too can see closure to their involvement with the department expedited, rather than waiting for 45-60 days until deadlines loom to see their assessment officially closed by the state.
While both Sara and Teri have since moved to different roles within the department, we spoke recently and they said Missouri DSS is still maintaining the same levels and seeing the benefits reported last year. They believe the model works because it supports workers and supervisors in a more meaningful way. “It’s all about creating capacity to focus on the families who need our attention,” Bill added.
Indiana: Safe Assessment Closure Team to Minimize Out-of-Home Care
Indiana’s Family and Social Services Administration has implemented a Safe Assessment Closure Team (SafeACT), a similar model as Missouri, and have seen downstream impacts at least in part attributed to the implementation of this model. In addition to eliminating their assessment backlog and maintaining under 6,000 open assessments at any point in time (down from 21,000 open assessments in March of 2021), they have seen a 22.5% decrease in children placed in out of home care—10% over the national average decrease of 12%.
Why does it work so well? “When workers can commit more time to families, they can make better, more thorough assessments and decisions,” Bill said. Workers can repurpose time saved to put together more complex plans to keep families together. “Everything starts with the assessment phase. When we can make a difference there, we make a difference in case management workload, foster homes that are needed, and the cost of out of home care,” Bill added.
(Editor’s note: Bill and the Indiana team will be presenting at this years CWLA Conference regarding this implementation and outcomes on Thursday, April 18!)
Ohio: Dedicated Support for Caseworkers to Support Retention
Knowing that a key driver to burnout and turnover is the compliance-based documentation work which often takes the lion’s share of workers’ time, Northwoods too has launched Case Aide Services, a new offering aimed to help partner agencies reimagine how the work gets done. As we like to say, we handle the paperwork, you handle the peoplework.
A virtual assistant model with a child welfare lens, our teams of Case Aides located remotely in Ohio take core administrative tasks off the shoulders of caseworkers—like records requests, referrals, document summarization and organization, and even tasks like the dreaded placement packets. That way, workers can focus on people and the meaningful work that brought them to the field in the first place.
Jackson County Job & Family Services (JFS), one of the first agencies working with Northwoods’ Case Aide Services, saw such dramatic change in certain documentation processes that they received a one-time “most improved agency” incentive award in the state of Ohio. The results of Case Aide Services are helping the agency boost morale and support retention goals. “When it comes to retaining staff, the fact that we got this incentive gives everybody the sense that we can reach our goals. The agency is in a better place when we’re high performing. Everybody wants to work someplace where they can be successful and feel good about what they’re doing,” said Kristina Carlisle, social services supervisor, Jackson County JFS.
It’s worth noting here that even agencies with their own case aides on staff can benefit from this additional layer of support. Often, agency case aides need to assist with pressing face-to-face client work like transportation or conducting site visits. Case Aide Services is designed to supplement these roles and focuses on work related to documentation that often gets pushed to the backburner out of necessity.
Additional Strategies for Reimagining Child Welfare Work
Restructuring how the work gets done has been critical to the success stories in Missouri, Indiana, and Ohio. Other states have deployed strategies that center on tackling backlogs. A couple of examples:
- Many agencies (Oklahoma, Georgia, West Virginia, and large metro departments like NYC and LA) have implemented various backlog mitigation strategies where neighboring county and even state personnel have been deployed to work through particular types or aspects of cases to allow targeted jurisdictions to catch their breath and recover.
- Hawaii’s APSR mentions a Specialized Workforce Assessment Team (SWAT), a mobile support unit comprising three workers, two support staff, and one supervisor who can travel to offices that need assistance with statewide activities like AFCARS and audits. What began as a two-year pilot program has increased workforce capacity enough that it is now a permanent unit in the Hawaii Child Welfare Services Bureau.
Another common strategy is contracting out specialized portions of the work done in child welfare, including foster care recruitment, training and licensing, adoption services, independent living services for youth, and paraprofessional client support like transportation, visitation supervision and in-home supports—not to mention the vast services array of client services built to support families and help parents make positive changes.
Lastly, there are examples of even more widespread partnerships with private and non-profit community-based organizations in places like Texas, Florida, and Kansas where the government agencies partner and contract out case management functions to community-based organizations. Dividing up the total work of child welfare and partnering with outside entities can allow agencies to utilize a specialized workforce for key specific functions and tasks, without taking on the overhead.
Call to Action: Rethinking Assumptions to Support the Child Welfare Workforce in New Ways
While it can be so difficult to do while buried in survival mode, we must all collectively zoom out and consider how we have structured the work of human services, and child welfare in particular.
As we continue to add more requirements of the work, does it still make sense that one person can manage it all? Is it fair to ask one person to maintain consistency and proficiency in such varied skillsets? Why do we expect the same worker who is skilled at relationship building, de-escalation, and creative case planning to also be a policy expert, court reporter, exceptional writer, and talented data manager? What are ways we can split apart the work to create efficiencies we’ve seen in states like Indiana, Missouri, and Ohio?
There is a cost to doing nothing, and we are seeing it play out across the country. I challenge all of us to re-think the assumptions we have held about how the work is done and consider restructuring the workload in new ways. It may be our only hope of creating sustainable systems and building the capacity needed to enact change the child welfare system so desperately requires.
