{"Multiple_Choice__291":"Kristine Frick","Short_Answer__292":"Brenda Mahoney","Date__293":"04\/17\/2018","Multiple_Choice__294":"Near Fatality","Yes_or_No__295":"No","Multiple_Choice__300":"8","Multiple_Choice__301":"Hennepin","Short_Answer__303":"Miangel","Short_Answer__304":"Scott","Date__305":"11\/29\/2004","Date__307":"02\/11\/2018","Multiple_Choice__308":"13 Years","Multiple_Choice__309":"1","Short_Answer__310":"Father","Multiple_Choice__316":"3","Short_Answer__317":"CP intakes not same or similar allegation (2\/9 & 2\/11 CP intakes) were referred to current workgroup.","Free_Text__318":"The 2\/9\/2018 predatory offender (24 hour response) and 2\/11\/2018 critical incident overdose (5 day response) allegations were referred to current workgroup nearing the end of 45 day timeline, however it was not closed yet. \r\no\tWorker was getting ready to close the family assessment, when worker discovered on a background check that the father to the sibling children had an egregious harm incident to a child not in this family in another state. As a result a new CP intake was made for this allegation based on predatory offender statute to screen in as 24 hour face to face. At this time, the track changed to a CP Family Investigation from Assessment. \r\no\tStaff's perspective is that either intake\/screening can open a new workgroup or can refer to current workgroup when the same worker is assigned to a case. \r\n\u00ef\u201a\u00a7\tWorker flips response tracks from assessment to investigation if new allegation is a 24 hour response. \r\no\tIntake protocol is to refer new intakes to current worker even if their workgroup has been open for longer than 45 days.\r\n\u00ef\u201a\u00a7\tReports came in near 45 day case closure timeline, however closing a case in the 45 day timeframe was not priority. \r\n\u00ef\u201a\u00a7\tStaff had to keep the workgroup active and open beyond 45 days due to the nature of how information was learned and evolved over time. \r\n\u00ef\u201a\u00a7\tObtaining records from out of state about the egregious harm\/ predatory offender went over 45 day timeline. \r\n\u00e2\u20ac\u00a2\tPractice is for the case\/family stay with the original worker on the case and document under one workgroup versus document in two workgroups. \r\no\tAvoid having to document same information in duplicate workgroups for the family and maximizing time more efficiently to keep all together in one workgroup.\r\no\tKeeping same worker with the family for all new intakes is viewed as a strength of continuity of care and being client focused. The preference to keep the same families with staff that they are working with or have worked with in the past due to rapport and working relationship established.","Free_Text__319":"An accepted procedural drift away from guidance to not close the family's workgroup within 45 days, influenced the two CP intakes (not same or similar allegations) to be referred to the open workgroup in SSIS. Considering the new allegations and information within the CP intakes was learned and being documented by the frontline staff working with the family, the agency's decision to prioritize continuity of care for the children and family was made, versus opening a new assessment for the allegations as the frontline staff already had the knowledge regarding the new allegations, as he\/she reported them.\r\n\r\nLocal agency practice within the intake and screening unit considers the totality of the circumstances, and has discretion to either open a new workgroup if an already open assessment\/investigation is near 45 days, or they can refer to the current workgroup when an assessment\/investigation is not closed. Commonly, the intake and screening unit consults with the Family Assessment\/Family Investigation (FA\/FI) unit, and refers CP intakes to the same FA\/FI unit who has a frontline staff already assigned and actively working with the family in an open workgroup. Priority is placed on continuity of care for the family, regardless if the workgroup is near the 45 day case closure timeline. This agency practice of one frontline assessment\/investigation staff assigned to work all allegations, beyond the 45 day case closure timeline, is a procedural adaptation that is viewed as best practice and a strength, as it is client focused and reduces trauma for families coping with child protection involvement in their lives. The sacrifice decision to not meet the 45 day compliance measure, was perceived to ease the pressure of needing to meet face to face timelines for allegations referred to an open assessment\/investigation, as staff believed SSIS reports only track face to face compliance for the first screened in CP Intake, and not for any others in which are referred to an already open workgroup. This workaround was believed to not impact face to face contact requirements that was tied to the legislative withhold funding when face to face compliance metrics are not met by the agency.  \r\n\r\nDocumentation practices are also simplified and more efficient for one frontline staff when they can chronologically document the information they are learning about the family under one workgroup over time. The tradeoff decision to not open an additional workgroup as a result of the new allegations that were made near the 45 day timeframe was made because with every new workgroup opened, there are a multitude of tasks to complete and document in SSIS (i.e. Safety Decision Making tools, ICWA screening tools, etc.). In effort to reduce workload tasks and requirements driven by both MN Statues\/Admin Rule and DHS guidance around the requirements for assessment and investigations, avoiding duplication of the same information being documented in multiple places better supports frontline staff's daily work as well as the agency's ability to retain staff and reduce turnover.\r\nResearch and best practice around continuity of care resulting in safe and healthy outcomes for children and families presented a competing priority and pressure for the local agency to adapt to in this case. Furthermore, this research and best practice presents a goal conflict for child welfare staff regarding the need for pursing the continuity of care while simultaneously trying to meet the requirements to open and document new CP intakes and allegations on the same family. In cases such as this a procedural adaptation was made by the local agency to refer the CP intakes to the open workgroup (although near the 45 day timeline) to support continuity of care for the family.","Short_Answer__320":"Face to face contact regarding 2\/11 CP intake Allegation: Neglect (access to alcohol, controlled substance, or prescription drugs) to subject child by the father occurred after 5 days.","Free_Text__321":"The CP intake was initially screened out and later screened in as a 5 day response, therefore the worker perceived it as a lower priority.\r\no\tPrioritized as lower risk based on the nature of the allegations and response path being family assessment.\r\n\u00ef\u201a\u00a7\tResponse type of family assessment \u00e2\u20ac\u201c 5 day is used per protocol for all allegations unless staff learn of egregious harm, fatality\/near fatality, predatory offender, sexual abuse or any other major injury.  \r\no\tFive day responses are less priority for staff because of the intense nature of all other cases received, most are severe abuse\/neglect\/egregious harm type cases that require staff to responds within the same day to meet 24 hour response.","Free_Text__322":"As a result of this CP intake initially being screened out and later screened in as a 5 day response, the worker perceived it as a lower priority and prioritized meeting face to face requirements for other cases with allegations with safety and risk concerns that were higher. Supporting that this was a lower priority case was the identified allegation and the response path assignment to family assessment. Unless staff learn of egregious harm, fatality\/near fatality, predatory offender, sexual abuse or any other major injury, the local agency uses a 5 day response per protocol for allegations such as this one. At the time of the incident, the severity of the incident was not believed to be near fatal based upon the information received in the report.  Five day responses are less of a priority for staff because of the intense nature of all other cases received by this Family Assessment\/Family Investigation (FA\/FI) specialty unit, which most cases involve severe abuse\/neglect\/egregious harm, and substantial harm that require staff to respond within the same day to meet the 24 hour face to face response timeframe. The implementation of the Department's Intake, Screening, and Response Path guidelines expanded the number of cases that require a 24 hour face to face response, particularly those allegations that are within the predatory offender statute. As a result, the agency experienced more cases being screened in for a 24 hour face to face response, which impacted the time staff have available to respond to 5 day response cases since they are a lower priority. Due to the high number of cases assigned to this FA\/FI unit, it was not uncommon for supervisors to direct staff to place lower priority on cases like this one to ensure higher priority cases are managed first.  \r\n\r\nFurther impacting the delay in face to face contact with the alleged victim was that the frontline staff had just made face to face contact with the child two days prior. Additionally, the frontline staff was the professional who learned and reported the new allegation for the critical incident. The staff had knowledge about the child being in the hospital at the time the information was learned, and the staff had not received a cross report from law enforcement, therefore, there was a presumption of safety since the hospital was caring for the victim child. Also supporting the decision to delay face to face contact was that staff did not want to cause additional trauma to the child and her family after the critical incident. At the time of the report the incident was not believed to be a near fatal event, however, the severity of the incident being near fatal was learned when the frontline staff was able to receive medical records regarding the incident, which occurred later in the investigation. The pressure to meet prescribed practice written in statute and admin rule around meeting for face to face timelines in circumstances when a child is presumably safe in a hospital setting, is not aligned or supporting the work.","Short_Answer__323":"Face to face contact was not documented regarding 3\/9\/2018 allegation of educational neglect, and it did not occur.","Free_Text__324":"CP Worker made a collateral contact with the reporter, and learned there was nothing new being reported about the twin half- sibling's truancy. Reporter felt obligated to report again due to the number of absences that one twin sibling had accumulated since the reporter last reported Ed neglect in January. \r\n\u00e2\u20ac\u00a2\tFurther supporting face to face contact not being made in this case was that work was being done as prescribed and expected in regards to addressing Ed neglect concerns. Worker was actively supporting the family's needs around getting the children's attendance to improve. She worked with the school to set up transportation for the children to increase children's ability to attend consistently. \r\n\u00e2\u20ac\u00a2\tThe 3\/9 allegation was same or similar allegation already assessed in January on 1\/11, and 1\/30 under this same workgroup\r\n\u00e2\u20ac\u00a2\tPriority is on making new face to face contacts for 24 hour reports when they are referred to current workgroup, not 5 day response reports for same or similar allegations that are already being assessed in current workgroup.","Free_Text__325":"Face to face contact regarding 3\/9\/2018 allegation of educational neglect not occurring was that the 3\/9 allegation was same or similar allegation already assessed in January on 1\/11, and 1\/30 under this same workgroup.  Further influencing face to face contact not occurring in this case was that the CP Worker made a collateral contact with the reporter, and learned there was nothing new being reported about the twin half- sibling's truancy. Reporter felt obligated to report again due to the number of absences that one twin sibling had accumulated since the reporter last reported Ed neglect in January.  Also impacting face to face contact not being made in this case was that work was being done as prescribed and expected in regards to addressing Ed neglect concerns.  Staff was actively supporting the family's needs around getting the children's attendance to improve.  An additional face to face contact would not have changed the trajectory of work in this case as the educational neglect allegations had already been assessed and ongoing work with the family was being conducted.    \r\nFurthermore, staff believed that the investigation around the educational neglect allegations had been completed, although not officially closed within SSIS.  As a result staff's interpretation of this new allegation was that it was screened in and the allegations had already been assessed.  Therefore, not requiring an additional face to face to be completed since this was perceived by staff to be a duplicate report and therefore guidance (Intake, Screening, and Response Path Guidelines) would indicate that a report of this type can be screened out as already assessed which would not require face to face to contact.  \r\nAdditionally, priority is placed on making new face to face contacts for 24 hour reports when they are referred to current workgroup, not 5 day response reports for same or similar allegations that are already being assessed in current workgroup.","Multiple_Choice__346":"3","Free_Text__347":"LP1 - The sacrifice decision to not meet the 45 day compliance measure, was perceived to ease the pressure of needing to meet face to face timelines for allegations referred to an open assessment\/investigation, as staff believed SSIS reports only track face to face compliance for the first screened in CP Intake, and not for any others in which are referred to an already open workgroup. This workaround was believed to not impact face to face contact requirements that was tied to the legislative withhold funding when face to face compliance metrics are not met by the agency.\r\n\r\nLP3 - Furthermore, staff believed that the investigation around the educational neglect allegations had been completed, although not officially closed within SSIS.  As a result staff's interpretation of this new allegation was that it was screened in and the allegations had already been assessed.  Therefore, not requiring an additional face to face to be completed since this was perceived by staff to be a duplicate report and therefore guidance (Intake, Screening, and Response Path Guidelines) would indicate that a report of this type can be screened out as already assessed which would not require face to face to contact.","Multiple_Choice__348":"1","Multiple_Choice__350":"0","Multiple_Choice__352":"0","Multiple_Choice__354":"2","Free_Text__355":"LP2 - Staff did not receive a cross report from law enforcement and as a result they were not aware of the critical incident occurring and the severity of the incident being near fatal.  \r\n\r\nDelays in accessing child protection reports from another state (Michigan) around predatory offender\/ egregious harm allegation","Multiple_Choice__356":"3","Free_Text__357":"LP2 - CP investigator was not aware of the severity of the child's condition at the time of the critical incident. Critical incident was originally screened out, and later screened in as a 5 day response. The life threatening nature of the incident was not known to the worker until 1 month after the incident when medical records were received and was not cross reported by law enforcement.","Multiple_Choice__368":"2","Free_Text__369":"Delay in obtaining medical records was approximately 1 month after critical incident occurred. Prior to receipt of the medical records severity of the overdose was not known to be near fatality.","Multiple_Choice__358":"3","Free_Text__359":"LP1 - Prescribed practice around continuity of care for children and with DHS requirements for new CP intakes to not be referred to an already opened workgroup near the 45 day case closure timeline. \r\n\r\nLP1- Research and best practice around continuity of care resulting in safe and healthy outcomes for children and families presented a competing priority and pressure for the local agency to adapt to in this case. Furthermore, this research and best practice presents a goal conflict for child welfare staff regarding the need for pursing the continuity of care while simultaneously trying to meet the requirements to open and document new CP intakes and allegations on the same family. In cases such as this a procedural adaptation was made by the local agency to refer the CP intakes to the open workgroup (although near the 45 day timeline) to support continuity of care for the family.  \r\n\r\nLP2 - As a result of this CP intake initially being screened out and later screened in as a 5 day response, the worker perceived it as a lower priority and prioritized meeting face to face requirements for other cases with allegations with safety and risk concerns that were higher. Supporting that this was a lower priority case was the identified allegation and the response path assignment to family assessment. Unless staff learn of egregious harm, fatality\/near fatality, predatory offender, sexual abuse or any other major injury, the local agency uses a 5 day response per protocol for allegations such as this one. At the time of the incident, the severity of the incident was not believed to be near fatal based upon the information received in the report.  Five day responses are less of a priority for staff because of the intense nature of all other cases received by this FA\/FI specialty unit, which most cases involve severe abuse\/neglect\/egregious harm, and substantial harm that require staff to respond within the same day to meet the 24 hour face to face response timeframe. The implementation of the Department's Intake, Screening, and Response Path guidelines expanded the number of cases that require a 24 hour face to face response, particularly those allegations that are within the predatory offender statute.  As a result, the agency experienced more cases being screened in for a 24 hour face to face response, which impacted the time staff have available to respond to 5 day response cases since they are a lower priority. Due to the high number of cases assigned to this FA\/FI unit, it was not uncommon for supervisors to direct staff to place lower priority on cases like this one to ensure higher priority cases are managed first.  \r\n\r\nLP2 - Further impacting the delay in face to face contact with the alleged victim was that the frontline staff had just made face to face contact with the child two days prior. Additionally, the frontline staff was the professional who learned and reported the new allegation for the critical incident. The staff had knowledge about the child being in the hospital at the time the information was learned, and the staff had not received a cross report from law enforcement, therefore, there was a presumption of safety since the hospital was caring for the victim child. Also supporting the decision to delay face to face contact was that staff did not want to cause additional trauma to the child and her family after the critical incident. At the time of the report the incident was not believed to be a near fatal event, however, the severity of the incident being near fatal was learned when the frontline staff was able to receive medical records regarding the incident, which occurred later in the investigation. The pressure to meet prescribed practice written in statute and admin rule around meeting for face to face timelines in circumstances when a child is presumably safe in a hospital setting, is not aligned or supporting the work. \r\n\r\nLP3- Also impacting face to face contact not being made in this case was that work was being done as prescribed and expected in regards to addressing Ed neglect concerns.  Staff was actively supporting the family's needs around getting the children's attendance to improve. An additional face to face contact would not have changed the trajectory of work in this case as the educational neglect allegations had already been assessed and ongoing work with the family was being conducted.\r\n\r\nLP3 - Furthermore, staff believed that the investigation around the educational neglect allegations had been completed, although not officially closed within SSIS.  As a result staff's interpretation of this new allegation was that it was screened in and the allegations had already been assessed.  Therefore, not requiring an additional face to face to be completed since this was perceived by staff to be a duplicate report and therefore guidance (Intake, Screening, and Response Path Guidelines) would indicate that a report of this type can be screened out as already assessed which would not require face to face to contact.","Multiple_Choice__360":"3","Free_Text__361":"LP1 - Documentation practices are also simplified and more efficient for one frontline staff when they can chronologically document the information they are learning about the family under one workgroup over time. The tradeoff decision to not open an additional workgroup as a result of the new allegations that were made near the 45 day timeframe was made because with every new workgroup opened, there are a multitude of tasks to complete and document in SSIS (i.e. Safety Decision Making tools, ICWA screening tools, etc.). In effort to reduce workload tasks and requirements driven by both MN Statues\/Admin Rule and DHS guidance around the requirements for FA\/FI, avoiding duplication of the same information being documented in multiple places better supports frontline staff's daily work as well as the agency's ability to retain staff and reduce turnover.\r\n\r\nLP2- Five day responses are less of a priority for staff because of the intense nature of all other cases received by this FA\/FI specialty unit, which most cases involve severe abuse\/neglect\/egregious harm, and substantial harm that require staff to respond within the same day to meet the 24 hour face to face response timeframe. The implementation of the Department's Intake, Screening, and Response Path guidelines expanded the number of cases that require a 24 hour face to face response, particularly those allegations that are within the predatory offender statute.  As a result, the agency experienced more cases being screened in for a 24 hour face to face response, which impacted the time staff have available to respond to 5 day response cases since they are a lower priority. Due to the high number of cases assigned to this FA\/FI unit, it was not uncommon for supervisors to direct staff to place lower priority on cases like this one to ensure higher priority cases are managed first.  \r\n\r\nLP3 - Priority is placed on making new face to face contacts for 24 hour reports when they are referred to current workgroup, not 5 day response reports for same or similar allegations that are already being assessed in current workgroup.","Multiple_Choice__362":"0","Multiple_Choice__364":"0","Multiple_Choice__366":"3","Free_Text__367":"LP1 - An accepted procedural drift away from guidance to not close the family's workgroup within 45 days, influenced the two CP intakes (not same or similar allegations) to be referred to the open workgroup in SSIS. Considering the new allegations and information within the CP intakes was learned and being documented by the frontline staff working with the family, the agency's decision to prioritize continuity of care for the children and family was made, versus opening a new assessment for the allegations as the frontline staff already had the knowledge regarding the new allegations, as he\/she reported them.","Yes_or_No__370":"Yes"}