DHS overhauls structure to set clear lines of accountability

Philadelphia's Department of Human Services is planning an extensive reorganization aimed at reducing confusion over who is responsible for abused and neglected children in its care.

Under the current system, DHS caseworkers, their supervisors, and outside social service contractors often are assigned to the same case. There are no clear lines of accountability and often work is duplicated.

Under the proposed structure, DHS would do initial intake and investigate cases, but would turn over follow-up care to outside contractors. DHS would plan for and monitor a child's care, but would not provide it. The department also would help make key decisions, such as whether to remove a child from parents or caregivers.

The plan is in response to the deaths of children over the last decade and is the latest in a series of efforts to fix a system that contributed to the 2006 death of 14-year-old Danieal Kelly, who had cerebral palsy and could not care for herself. The story of Kelly's death shocked the city and led to the convictions of two social workers, one a DHS employee and the other a contractor.

Kelly's medical care fell through the cracks because neither agency properly monitored her case.

"This is intended to provide clarity where we had major confusion that resulted in tragedy," DHS Commissioner Anne Marie Ambrose said of the proposed structure. Mayor Nutter appointed Ambrose to lead the agency and make changes.

The overhaul would also shift the care to neighborhoods, where the contracted agencies, in theory, should have a better sense of a family's and community's problems. Currently, DHS staffers have an average workload of 13.5 cases each, and those cases are often in different neighborhoods.

DHS serves about 100,000 children and families. The proposed structure initially would affect only about 6,000 children who receive in-home and placement services.

Ambrose said the need to streamline the system became clear when she was talking to a foster mother who was not sure who her DHS worker was because the mother was caring for three children. Each child had two caseworkers, one from DHS and the other from a contractor. The caseworkers sometimes gave the mother conflicting advice about what to do.

"When everybody's responsible, nobody's responsible," Ambrose said.