Save kids’ lives with better information technology
An unread fax led to the death of a child in Massachusetts. There is no other explanation for why the Department of Children and Families failed to respond in time to a report in April about potential child neglect filed by Grafton police after visiting the home of 4-week-old Aliana Lavigne and her mother, who according to the Globe had a history of mental illness. By the time a caseworker began investigating the report — nearly a week after it had been sent by police — Aliana was already dead.
It should not be this hard for social workers, police, and others who interact with the child welfare system on a regular basis to ensure that at-risk children are identified, receive the proper attention, and if need be, removed from a dangerous home. I guarantee you that Massachusetts Turnpike employees do not send notices of unpaid toll violations to the Registry of Motor Vehicles by fax. Yet the department charged with protecting the safety and well-being of the Commonwealth’s most vulnerable operates in a system clogged with paper and outdated systems.
Social service agencies do not work in a vacuum. They are constantly being fed information from teachers, public safety officials, and medical professionals as well as their own caseworkers about at-risk children. Outdated paper processes not only cause delays in the hand-off of critical information but also deprive agencies of the analytics and decision-support mechanisms that digital systems provide.
In the face of a child’s death, recriminations and second guessing reverberate from legislators to advocates. Voices are quickly heard calling for more money — increased personnel, expensive computers, and more training. However nothing will be sufficient until we wean government from the tyranny of paper and transform agencies such as DCF by applying easily available technology. While many in government understand first-hand the problem of non-existent or antiquated IT systems, connecting the digital dots remains frustratingly difficult.
Multiple problems obstruct reform. State procurement systems often do not keep up with technological progress, particularly in a data-heavy function like child welfare protection. Even as we are witnessing unprecedented breakthroughs, procurement cycles take up to two years to complete; by the time a new system is ready to come online, it has already been leapfrogged by new advancements. Federal child-welfare information-technology requirements contributed to the problem by funding almost exclusively large, hugely expensive and complex systems that were designed to control the actions of states and caseworkers, not designed to help them. Federal regulators concentrated on oversight, tracking from the top down, and helped create a culture that valued rule-based compliance above all else.
Across the country some agencies manage to merge all the pieces — modernized practices, technology, service providers management, accountability, effective management and case worker excellence. Indiana for one has shown that savvy investments in digital technology can transform a social service agency’s ability to protect children before it’s too late. Indiana officials redesigned the state’s data services so that information could be gathered across multiple agencies and carefully shared with those with a need and legal right to know, including foster parents, education professionals, medical staff, service providers, and potentially parents. Today, caseworkers armed with tablets instead of paper have the information they need exactly when they need it. Fieldworkers now confront time-sensitive critical questions armed with far more information. Nor do they communicate with others by difficult-to-find faxes.
What made these changes in Indiana unique was how they were implemented. Here there is an important lesson for Massachusetts. Strong leadership was central to the success of these Indiana reforms, as much of the data that was crucial to protection the well-being of the state’s children was held by other state agencies. Indiana Department of Child Services leadership beat down those who simply wanted to protect their own agencies’ turf by refusing to share critical data. Investments in caseworkers, training, and technology help, but only if they are accompanied by equally transformative organizational and informational changes.
Children live in systems of friends, family, health and school. They do not live in a single agency, and they do not live in slow motion. Yet we force our caseworkers in much of the country to operate blindfolded to information, with obsolete processes and antiquated technology and then second-guess their results. Dramatic change that saves lives is easily within reach, but we need leadership from agency heads and political backing from Beacon Hill to get us there.
Stephen Goldsmith, a former mayor of Indianapolis, is a professor at Harvard’s Kennedy School and directs the Innovations Program at the Harvard Ash Center for Democratic Governance and Innovation.