Why the Switch to IOC/CUAs?
The switch to DHS’ new IOC initiative began after the publicized tragedy of Danieal Kelly’s case. She was a 14 year-old with cerebral palsy who died of starvation and infection while receiving services through the child welfare system. Although she was living with her biological mother at the time, the family was reported to DHS a number of times and was accepted for services. When Denieal died in 2006, nine people were held responsible for her death, including her DHS social worker, provider social workers and her mother. The courts found that staff assigned to Danieal’s case rarely visited the home, and when they did, they often did not physically see or check on Danieal.
Danieal’s tragic story was not the first tragedy in the child welfare system, but seemed to be a sort of last straw. The Mayor at the time, John Street, changed the leadership at DHS and put together a panel of experts to investigate Philadelphia’s child welfare system and recommend reforms on every aspect of DHS. The panel recommended 37 changes for both DHS and its partner provider agencies and DHS set forth to address each one.
The IOC initiative grew out of the panel’s recommendations and research into successful practices in other child welfare systems throughout the country. IOC addresses some of the larger-scale issues identified in Philadelphia’s child welfare system–primarily, that with the existing dual case-management system was flawed and allowed for too much finger-pointing. The new DHS Commissioner, hired in the midst of the changes, Anne Marie Ambrose, noted that “when everybody’s responsible, nobody’s responsible.” Under the IOC’s “single case-management” system, families receiving child welfare services have one case manager that coordinates all of the family’s services and works with the family until they no longer need services.
A steering committee of six different working groups collaborated to flesh out the specifics and details of IOC initiative and how it would improve the well-being of children and families involved with DHS.
One of the major changes that came with the switch to IOC is that DHS will no longer partner with hundreds of provider agencies in the community, but rather will focus on just 10 “Community Umbrella Agencies” (CUAs) contracted to provide case-management services. The CUAs are community-based and therefore able to focus on strengthening their communities and building connections with other service providers in the CUA region. This helps to ensure that families in the community have access to the services they need and that they are more likely to be able to reach the goals set forth for them in their case plan. It also helps to keep children in the communities they come from, allowing them to maintain their community connections (school, religious organizations, friends, etc.), as well limiting the tendency of out-of-home placement to require switching schools (which can cause children to fall behind) or doctors (which often affects quality and continuity of care).
The IOC initiative is a large, multi-year reform plan that will be implemented and monitored over several years. While any large-scale change has associated risks, IOC pulls from promising practices around the country and therefore shows its own promise in achieving its goals of improving the outcomes of children and families involved in the child welfare system.