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[Welfare] - Management Study - Alameda County Welfare Department, 11/11/1971 (2 of 4)
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[Welfare] - Management Study - Alameda County Welfare Department, 11/11/1971 (2 of 4)
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Ronald Reagan Presidential Library
Digital Library Collections
This is a PDF of a folder from our textual collections.
Collection: Reagan, Ronald: Gubernatorial Papers,
1966-74: Press Unit
Folder Title: [Welfare] - Management Study -
Alameda County Welfare Department,
11/11/1971 (2 of 4)
Box: P39
To see more digitized collections visit:
https://reaganlibrary.gov/archives/digital-library
To see all Ronald Reagan Presidential Library inventories visit:
https://reaganlibrary.gov/document-collection
Contact a reference archivist at: [email protected]
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their home address. Consequently, it is difficult to contact them by
either mail or telephone and unless the patient has some reason to contact
the agency again on his own volition he can easily be lost.
Eligibility services at the hospital are a rather elaborate
mixture of at least three distinct operations. The first two, screening
and social services, are aspects of admissions procedure which will be most
affected by the recommendation in the hospital study we mentioned. The
third, eligibility, is the one in which the Welfare Department must inescap-
ably continue to be involved regardless of whether the hospital's responsi-
bility for eligibility is expanded beyond what it is now.
SCREENING PROCESS
Medical care at county hospitals is extended to everyone except
non-residents of the county -- those with certain private medical coverage --
and military personnel. Most persons entering the hospital have already been
issued Medi-Cal cards by virtue of previously determined linkage to categorical
aid programs or hold some private insurance coverage, Medi-Cal, etc. One of
the main functions that still remains, however, is the issuance of clinic
cards which are basically time-limited permits for medical service. Usually
they are issued from three to six months. The screening process sorts these
applicants out quickly and those whose coverage is clear are sent on into the
hospital for medical care with little further attention.
The medical eligibility unit at Highlands Hospital performs about
1,000 interviews per month. Verification in medical eligibility applications
is the same as with any categorical aid that is on the basis of the declaration
system. The basic difference between establishing eligibility for medical care
as opposed to money grants is that eligibility is established without the
-64-
benefit of a home visit. There are basically three types of decisions that
could be made through the screening process. A worker can:
1. deny aid;
2. issue a clinic card and determine the
percent of cost which the applicant will
pay in partial payment cases; or
3. determine that a person is eligible for
a cash grant as well as for medical care
and take the initial steps in processing
an application for categorical aid and
forward the application to the district
office closest to the home address of the
patient.
About two-thirds of the cases fall into this latter category.
SOCIAL SERVICES
Eligibility determinations are the primary responsibility of the
hospital units, but Social Workers III are used to staff the unit. The
stated reason for using social workers instead of eligibility technicians
is that the applicants are usually interviewed in stressful circumstances
and a broad knowledge of all categorical aid programs as well as Medi-Cal
is required. Why it is thought that only social workers can acquire a
broad knowledge of eligibility or handle tough interviews eludes the Task
Force. This may or may not be true but it is costing the county a consider-
able amount of money to staff the hospital with social workers as opposed
to eligibility technicians.
Technically, the hospital's eligibility staff are not supposed
to do any therapeutic counselling or social work but in our review of the
-65-
job descriptions provided by the hospital staff we do not think that is
the case. We think it is practically impossible to separate eligibility
from social service under the present staffing arrangement. There is a
strong social service flavor in almost everything that the staff at the
hospital does. We do not know what social services should be provided but
whatever they are they should not interfere with controlling the fiscal
aspects of eligibility which is the primary purpose of the unit. It should
also be remembered that there is a staff of MSW's employed by the hospital
who are supposed to take care of the non-medical needs of the patients.
Aside from the fiscal considerations there are some very good reasons for
management to reassess the whole social service concept that has been built
up within the hospital. There is just as much reason to separate pure
eligibility from pure service in a hospital setting as there is anywhere
else in the department.
Both of the supervisors we talked to at Highlands recognize that
there are weaknesses in the screening process which results in people getting
into the hospital without proper liability for their hospital costs established.
They see a great need for being able to secure more positive identification
of patients and getting better confirmation of addresses before the patients
are admitted. They also noted that it takes two to six months to submit a
bill to a patient after discharge. Staff at both hospitals feel isolated
from higher supervision and state that they see departmental management very
infrequently.
Our contact with the hospital staff convinced us that there are
major differences in the way the eligibility units are regarded and used
between Highlands and Fairmont Hospital. The Task Force considered this to
-66-
be a major problem too but it did not fall within the purview of this study
as it relates to management at the hospital as much as it does the welfare
department.
ELIGIBILITY FUNCTION
The focus of our review was here. It involved that group of
people whose coverage is not cleared in the screening process and which are
presumed to have eligibility for either Medi-Cal, a cash grant or both.
It involves about 250 of the admitted patients per month whose eligibility
must be cleared by further processing in one of the divisional offices. If
the applicant appears to be eligible for Medi-Cal by linkage to one of the
categorical aid programs and has not had previous contact with the agency an
application is taken and forwarded to the division closest to the home
address of the patient. It then becomes the responsibility of the divisional
Medi-Cal unit or regular eligibility unit to verify the property, income, etc.,
make the required home call, and forward the completed application back to
the hospital.
If the person cannot be linked to Medi-Cal his eligibility is
computed by county standards and a time limited medical card is issued. The
welfare department's responsibility ends when a full and definitive billing
instruction is forwarded to central collections. Any application not thus
cleared resides in central collections as an unbilled account. We see no
way in which clearing these referrals will be improved by simply placing
hospital eligibility under institutions because any cases which cannot be
cleared immediately must be routed back to the welfare department for the
final determination of eligibility. As simple as the procedure is it
apparently breaks down through the failure of the divisional units to
-67-
process these cases and get confirmation of eligibility and billing instruc-
tions back to the hospital within the 60 day period.
What concerns us more is that it has been evident for some time
that the system has not worked and no decisive, corrective action has been
taken. Regardless of whether the problems are related to procedure, inter-
departmental communications, or staffing at the hospital it seemed obvious
to us that this is not a matter that is going to be resolved without strong
intervention and follow-through from top management which has not occurred.
Some aspects of the problem involved interagency considerations that no
divisional chief is properly equipped to deal with considering the scope
and limited nature of his authority. The procedures established by the
responsible division chief to clear these medical referrals involves staff
and control measures in every division of the department. Yet, the division
chief is powerless to enforce compliance over a single element of the entire
procedure outside of his own division.
It was not surprising to find in our review that the operating
controls which are a highly important aspect of the administrative procedure
vary considerably. The method of follow-up on delinquent cases for example,
assumed the existence of one assignment clerk or control point which would
have responsibility for following-up on all the cases within a division.
These were not uniformly established.
Recognizing that this aspect of the procedure had broken down the
East Oaklanddivision chief responsible for the hospital eligibility units
suggested to management a data processing application that would help with
earlier notification and more effective follow-up on outstanding cases.
After reviewing the problem to the limited extent we did, we had questions
-68--
ourselves about whether a data processing application would compensate for
all the other weaknesses of the procedure. But the issue, again, is not
whether the data processing application would or would not have worked but
with the management reaction to the proposal. Our impression was that the
recommendation was neither accepted or rejected but ignored.
The thrust of the two recommendations we make go to one inherent
weakness which we find in the hospital procedure. None of the applications
taken at the hospital can be completed there. Even if the hospital eligi-
bility worker knows what programs the patient is eligible for, she cannot
complete the application because she is unable to make the required home
call, verify the existence of other dependents, income, etc. Moreoever,
two-thirds of the 250 cases per month which concern us have already applied
for aid in one of the division offices and an open but incomplete case is
in existence. The hospital worker, of course, cannot start a duplicate
case so they notify the district worker that the applicant has come to the
hospital and tell them to complete the application so they will know whether
to bill Medi-Cal for the costs.
These cases are scattered over hundreds of regular eligibility
workers who were basically trained to handle money grants. Medical cases
only are handled in other special Medi-Cal units. There is not only dual
eligibility to contend with but a great amount of flip-flop on cases coming
off cash aid who are still entitled to receive medical care. Two full-time
clerks at the hospital are used to chase down the responsible workers but
the backlog of uncleared cases has not significantly decreased.
16. THE SOLUTION WE RECOMMEND IS TO CENTRALIZE ALL MEDI-CAL UNITS
TOGETHER IN ONE DIVISION AND GIVE THE MEDICAL UNITS COMPLETE RESPONSIBILITY
-69-
FOR CERTIFYING BOTH CASH GRANTS AND THE MEDICAL PORTION OF THE ELIGIBILITY
ON ALL CASES WHICH ORIGINATE AT THE HOSPITAL.
The reason special medical intake units exist is because when
Medi-Cal was started five years ago it was a new program and it was considered
necessary to administer it through special Medi-Cal only units. At the
inception of Medi-Cal the main administrative problem was getting eligible
people qualified, but that was accomplished a long time ago. The main problem
now is accommodating the flip-flop that occurs between cash and Medi-Cal only
cases. Pure medical determinations are a declining function simply because
most of the people who are eligible for medical care are already on the
program. The use of these Medi-Cal units must be broadened to meet an
entirely different problem. Enough workers should be pulled from regular
intake units or from the hospital eligibility staff to permit these hospital
applications and flip-flop cases to be worked out completely by workers who
fully understand both cash and Medi-Cal eligibility.
We would limit the function of the hospital eligibility staff to
simply the initial screening and to responsibility for locating the pending
cases within the divisions so they can be transferred to a worker who can
complete the case. At the regular workload standard of 26 intake cases per
month the whole hospital caseload should not require more than six or seven
workers if they are free to do pure eligibility work without all the other
distractions and handicaps they have by trying to do eligibility work and
social services together. If some type of social services must be rendered
to the patients by the eligibility staff it should be cleanly separated in
such a way to avoid interfering with the eligibility process.
-70-
Consolidating these medical units in one place should also help
in getting more accurate allocation of the administrative costs which are
reimbursable from the State. We frankly believe that it is impossible now
to accurately estimate the amount of supervisory and administrative burden
to apply to Medi-Cal units when they are scattered throughout the organi- -
zation. If the State tightens up on this as we believe they should the
county will be in a much better position to make a full and proper claim
for administrative costs.
-71-
SECTION III
OVERPAYMENTS AND CASELOAD VÄLIDATIONS
OVERPAYMENTS AND CASELOAD VALIDATIONS
In retrospect, one of the mistakes the Task Force staff admit to
in the study was initially attempting to look at overpayments as a distinct
problem. We spent perhaps two weeks counting, categorizing, and trying to
analyze some 300 incidents of non-collectible and collectible overpayments.
It yielded nothing that a more experienced analyst would not have under-
stood beforehand. It is this: a high incidence of incorrect grant deter-
minations is absolutely and predictably a consequence of weakness in the
eligibility functions we have tried to identify and discuss in the sub-
sections of the first chapter. Overpayments cannot be reduced until these
functions of the eligibility process are in order and working together. To
think of checking overpayments or even discussing them out of context from
these very distinct individual parts of the eligibility administration is a
futile and thoroughly wasted effort.
The only thing we or the department know about overpayments is
the gross dollar value of those which have been found through the normal
process of working the caseloads. We cannot suggest even what a proper
allowance for overpayments should be. The only generality possible is that
they are much higher than they would be if the whole eligibility process
were working properly. For what little it means this table below shows the
growth and magnitude of non-collectible and collectible overpayments.
-72-
Collectible Overpayment Trends
January, 1969 - March, 1971
1970
1971
Month
1969
1970
1971
Collections
Collections
January
$ 45,826
$ 69,043
$ 86,103
$ 13,289
$28,465
Feburary
31,434
42,520
53,716
9,766
12,566
March
28,940
66,142
132,220
10,231
18,983
April
21,342
35,422
11,804
May
37,357
49,100
13,511
June
32,992
33,241
14,439
July
34,349
40,237
15,455
August
22,662
32,843
19,256
September
34,669
39,679
11,732
October
30,495
77,111
17,184
November
34,870
86,634
14,339
December
37,303
55,559
11,711
Total
$392,239
$627,531
$272,039
$162,717
$60,014
Non-Collectible Overpayments
November, 1970 - March, 1971
Date
Amount
November, 1970
$53,517.00
December, 1970
$38,745.93
January, 1971
$52,564.23
February, 1971
$47,860.31
March, 1971
$67,859.41
-73-
The other things we can say about overpayments are largely academic.
The staff presents the few observations we make more as enlightenment for
the Task Force than anything else. The comments below have been restated in
other ways throughout the entire report.
Overpayments may be categorized into four classes:
1. Those where the recipient reported correctly and
promptly (non-adjustable and non-collectible)
2. Those where the recipient failed to report correctly
and/or promptly (adjustable if liquid assets are
available in a two-month period from date of
discovery and collectible)
3. Those where the recipient willfully withheld
information (always adjustable in two-month
period and collectible) ;
4. Those where there was an administrative error
(non-adjustable and non-collectible)
When the client reports promptly and correctly, and an overpayment
occurs, this is usually due to unanticipated change in income or household
composition. It is anticipated that with assistance planning this type of
overpayment would be reduced.
When a client fails to report it immediately becomes incumbent
upon the eligibility worker to make a judgment regarding whether the
information was willfully withheld; or if the client tried to report and
could not. With clients frequently not knowing their worker or not seeing
a worker for considerable lengths of time, much can be overlooked. Discovery
of overpayments correlates closely with the dates of the last renewal taken
-74-
and since agency records show many delinquent renewals, one must assume
there are still many undiscovered errors. In the Family Service Division
overpayments increased approximately 50% after the Division Chief started
to enforce a renewal standard of 20 per month. Four conclusions seem
possible on the basis of this experience:
1. At intake, recipients' reporting responsibilities
must be clearly understood;
2. Recipients must be kept informed of the names of
their workers and reminded of their responsibilities;
3. Workers must be trained and experienced enough to
utilize information given them and also be able to
communicate responsibilities to clients;
4. Renewals must be current and be made with as many
face-to-face contacts with clients as possible.
When it is determined that a recipient concealed or willfully
withheld information a fraudulent situation exists. Besides being adjustable
and collectible, this type of case is usually referred to the Fraud Unit.
However, it is also possible that even this type of deliberate concealment
may be reduced if the client had more contact with the worker and if a home
call was more frequent and renewals taken promptly. Without current renewals
prosecution for fraud is most difficult. For some, an understanding of the
importance of a sworn statement might be a deterrent, but when there is not
contact on the part of the Welfare Department, the recipient is natually
more indifferent.
Administrative errors continue to make up a high portion of grants
incorrectly paid. The reasons are many. However, the same reasons reappear
-75-
frequently and it seems obvious to us where action should be taken. These
are the general conclusions we drew after reviewing 300 overpayments:
1. Inexperienced workers and inadequate training;
2. Inexperienced supervisors (some new supervisors
are frequently less qualified than their
subordinates)
3. Poor communication of changes in rules and
regulations and regulations received from the
State that are frequently retroactive, creating
unanticipated overpayments;
4. Numerous deadlines to be met (missing one day
might create an overpayment. Deadlines for
offices differ);
5. Poor clerical backup ("holds" placed but not
processed. Typographical and key punch errors).
Since little can be done in controlling overpayments without
a vast number of other administrative changes we cannot fault the
department too much for any of the procedures they have installed to
control overpayments. Workers find most overpayments in the course of
doing renewals or in normal, routine case reviews. Supervisors
review the circumstances and make the determination on whether the payment
is the result of an agency error, in which case it is non-collectible, or a
client error in which case it is set up as a collectible overpayment. With
collectible overpayments a notice is sent directly to Central Collections
in the County Auditor's Office by the worker to set up the overpayment as a
-76-
collectible account. Division chiefs review and certify the overpayments
which are determined to be non-collectible. From the data it appears that
Central Collections has had more of an interest in non-collectible over-
payments than the Welfare Department.
In view of the limited success that Central Collections seems to
have collecting overpayments considered to be collectible, there is probably
little point in reviewing the non-collectible overpayments from the stand-
point of whether more of them would be collectible. There is not, however,
a good review process for this and these determinations are made largely by
middle management or at the supervisory level in the organization. Recently
a change in Welfare Department procedure was made which will prevent non-
collectible overpayments from being reported to Central Collections.
As the staff's understanding of eligibility increased our convic-
tion about the root cause of overpayments became so strong that we were
strongly tempted to ignore overpayments as a specific problem. Overpayments
cannot be considered apart from the administrative process which controls
eligibility and income maintenance generally. The essentials of the process
as we see them was the subject matter of Section I. We deal with the subject
mainly as a way of responding to one of the policy items in this year's
budget concerned with the question of setting up a permanent staff to do
"conventional validation" of AFDC caseloads. The support for the item was
based on the argument that if management knew more precisely where its
errors were occurring they would be in a better position to control over-
payments, administrative errors, and other kinds of tangible mistakes in
eligibility. By "conventional validation" we mean anything similar to the
mandated procedure now followed in validating the adult programs. In adult
-77-
caseloads the validation workers review a regular number of cases each
month checking for a specified list of defects covering 20 to 30 points
of eligibility. Findings are presented in very abbreviated, statistical
State controlled format that shows only the incidence of error and what
kind of errors are occurring. The analysis does not show why the errors
occur.
The recommendation the Task Force submits on this policy item is
completely different from what we would have suggested at an early juncture
of the study. 17. IT IS RECOMMENDED THAT THE COUNTY NOT IMPLEMENT A
CONVENTIONAL VALIDATION PROGRAM FOR AFDC. The Task Force believes that
enough is known now about the condition of the AFDC caseloads to safely
make a managerial judgment that the entire caseload is in a bad condition.
We see no worthwhile purpose in developing more absolute statistics on how
many budget or eligibility mistakes are present before management starts
taking some action on the cause of the overpayment problem. Requesting
a regular validations unit for AFDC may superficially sound very enlightened
but in this instance we feel it is only another mistake in management's ability
to make a proper assessment of the real nature of the problem they confront
and to move decisively on the basis of data they already have.
18. WHAT THE TASK FORCE RECOMMENDS AS A SUBSTITUTE IN PLACE OF A
REGULAR VALIDATIONS UNIT FOR AFDC IS ABOUT A TWO OR THREE MAN TEAM OF
INTERNAL AUDITORS WORKING UNDER THE ASSISTANT DIRECTOR IN CHARGE OF MANAGE-
MENT. Some of the work they may do may closely resemble validation reviews
but the staff should be free to move throughout any part of the organization
including both Social Services and Eligibility looking for weaknesses in areas
that go far beyond what is examined in routine validation reviews. The work
-78-
of these internal auditors should not be as structured and as formalized
as the regular validation worker. Their real purpose should be to locate
problems for the sole purpose of finding solutions to them rather than
simply counting problems which is our view of validations now. The justi- -
fication for the three internal procedures coordinators was, also, a good
description of how we thought the unit should be used.
The staff furnished the department the following results of a
properly drawn validation sample we made of AFDC caseloads in cooperation
with the State Department of Finance. By itself we think it furnishes
sufficient data to management for them to identify a considerable number of
specific problems in the AFDC caseload. As we write this report six
months later it is not our impression that management has acted on any of
the sample findings. The Task Force is confident that if a permanent
validation unit was installed it would not show a significantly different
result from our own study at this time.
-79-
Eligibility Control
Sample Results
Adult and AFDC Cash Grant and
Medically Needy Only Programs
Alameda County
August, 1970
Adult
AFDC
Adult
AFDC
Cash
Cash
Medically
Medically
Grants
Grants
Needy Only
Needy Only
Universe (Case Action)
26,084
25,157
4,149
3,165
Sample Size
25
38
34
63
Number of Errors
Ineligible
2
1
Overpayments (1)
2
2
(a)
2
2
Underpayments (2)
3
2
1
Total
7
3
4
3
Percent of Errors
Ineligible
8.0%
2.6%
Overpayments (1)
8.0%
5.3%
5.9%
3.2%
Underpayments (2)
12.0%
5.9%
1.6%
Total
28.0%
7.9%
11.8%
4.8%
Amount of Errors
Ineligible
$ 145.00
$
148.00
Overpayments (1)
10.00
44.00
$ 78.00
$ 212.00
Underpayments (2)
38.00
7.00
1,516.00
Responsibility for Errors
Client
2
l
County
l
3
2
1
Client & County
4
2
l
Total
7
3
4
3
Percent of Responsibility
Client
28.6%
33.3%
County
14.3%
100%
50%
33.3%
Client & County
57.1%
50%
33.3%
Type of Error
Real & Personal Property
1
1
Living Expense
1
Special Need Allowance
3
Income
2
3
4
2
Other Requirements
Total
7
3
4
3
-80-
Eligibility Control - Sample Results
(Continued)
Adult
AFDC
Adult
AFDC
Cash
Cash
Medically
Medically
Grants
Grants
Needy Only
Needy Only
Projected Errors
Ineligible
2,087
654
Overpayments (1)
2,087
1,333
245
101
Underpayments (2)
3,130
51
Total
7,304
-
1,987
245
152
Amount of Projected Errors
Ineligible
$ 151,308
$
96,792
Overpayments (1)
10,435
29,433
$ 9,555
$ 10,706
Underpayments (2)
39,657
77,316
Total
$
201,400
$ 126,225
$ 9,555
$
88,022
Net Overpayments
$ 122,086
$ 126,225
$ 9,555
$
(66,610)
Estimated Annual Amount of
Errors
Ineligible
$1,815,696
$1,161,504
Overpayments (1)
125,220
353,196
$114,660
$
128,472
Underpayments (2)
475,884
(3)
927,792
Total
$2,416,800
$1,514,700
$114,660
$1,056,264
Net Annual Overpayments
$1,465,032
$1,514,700
$114,660
$ (799,320)
(1) Medically Needy Only Overpayments (share of cost too small).
(2) Medically Needy Only Underpayments (share of cost too large).
(a) Does not include one share of cost error in the amount of $48,458.
(3) In the interest of time and cost a figure on underpayments was not
developed. A general idea of how underpayments compare with over-
payments can be found from the report Review of the State System of
Audit and Control of County Determinations of Eligibility for Welfare
and Medi-Cal, Department of Finance, State of California, Jan. 25, 1971.
-81-
Eligibility Control
Analysis of Errors
Adult Cash Grant
Alameda County
August, 1970
Overpayment
Underpayment
Client
Client
&
&
Client County County Client County County Total
Real & Personal Property
Insurance
1
1
2
Living Expense
Own Home
Rent
Special Need Allowance
Restaurant
1
l
Telephone
1
1
Transportation
1
1
Income
Social Security
1
1
2
-
I
Totals
2
2
1
2
7
Eligibility Control
Analysis of Errors
AFDC Cash Grants (Federal Sample)
Alameda County
August, 1970
Overpayment
Underpayment
Client
Client
&
&
Client County County Client County County Total
Income
Other Income
3
3
-
-
-
I
-
Totals
3
3
NOTE: Sample investigations used in this analysis were included in the federal
sample for the 1969-70 fiscal year.
-82-
Eligibility Control
Analysis of Errors
Adult Medically Needy Only
Alameda County
August, 1970
Overpayments
Underpayments
Client
Client
&
&
Client County County Client County County Total
Income
Social Security
1
1
Interest-Dividends
1
1
Other
1
1
Excludable Income
1
1
I
-
I
I
I
Totals
1
1
1
1
4
Eligibility Control
Analysis of Errors
AFDC Medically Needy Only
Alameda County
August, 1970
Overpayments
Underpayments
Client
Client
&
&
Client County County Client County County Total
Income
Earnings (wages, salary,
commissions)
1
1
Other
1
1
Real & Personal Property
Money, Savings, Investments
1
1
-
I
-
Totals
1
1
1
3
-83-
19. IN THE EVENT THAT ANY KIND OF ONGOING VALIDATION PROGRAM IS
STARTED IN AFDC OVER OUR PREVIOUS RECOMMENDATION THE TASK FORCE ALSO
RECOMMENDS THAT IT BE A MUCH MORE LIMITED ONE THAN IS CURRENTLY BEING DONE
IN THE ADULT AID PROGRAMS. Twenty to 30 points of eligibility are checked
in the design of the adult validation procedure. We see some factors as
being infinitely more important than others. Why should any validation
effort be expended on checking the accuracy of something like a laundry
allowance or bus fare for medical transportation when the department knows
that there are not effective controls over earned income or the children
counted in the grants are not firmly tied down. Problems related to deter-
mination of basic need, number of children, income, and absent fathers are
much more significant and subject to ready verification. The whole emphasis
in the present validation program is completely backwards and is not centered
on the big, major problems in the caseloads (see Appendix B).
The present program for validating adult cases is largely deter-
mined by federal regulation. The State Department of Finance has severely
attacked the statistical methodology and the administrative use of the
present validation program and suggests a number of changes which would
affect local departments that we wholeheartedly support. The Federal Govern-
ment has so far failed to approve the revised procedure. 20. THE COUNTY
HAS THE STUDY AND IF A FEDERAL WAIVER IS OBTAINED WE RECOMMEND THE COUNTY
ADOPT THE STATISTICAL SAMPLING TECHNIQUES OUTLINED BY THE STATE DEPARTMENT
OF FINANCE. There were two important findings in the State study. One
was that sample sizes are about twice what they have to be for reliable
sampling conclusions to be drawn. Secondly, neither the state nor local
departments are presently using the validation findings to any advantage
-84-
after they get them! By this assessment, validation effort in the adult
program is more of a formality than a useful tool of management. We concur
with both conclusions from our observations in this department and believe,
along with the reasons already given, that management is not in a position
to effectively utilize more validation information than they presently have.
We have criticized management throughout this report for the failure of its
information gathering system. In this situation we criticize management for
its failure to act on information it has had at its disposal.
It troubled the Task Force to see the department trying to strengthen
its validation and quality control section by adding more staff when they
have been forced to do things which, in our opinion, seriously interfere with
the ability of the section to perform its present responsibilities properly.
We are referring to the effect of the Board of Supervisor's ordinance which
made the Welfare Director personally responsible for an ongoing caseload of
about 500 county employees who are also welfare recipients. As we interpret
the language of the ordinance we think it gave very little choice to the
Director but to bring the caseload into the validations unit where it could
be supervised by the Assistant Welfare Director in Charge of Programs.
These cases are unusual in several respects. All the recipients
have income and they probably know the law and regulations of welfare as
well as many of the case workers. Instances are cited where recipients have
actually called fiscal or data processing units to place holds or releases
on their own warrants. Some have made up their own budgets and sent them
to their eligibility worker. There is also a disproportionate number of
appeals among this group of recipients. They are, to use one of the phrases,
"welfare wise. 11 Newspapers brought considerable attention to some of these
-85-
employee cases so it is understandable why the department and the Supervisors
were particularly sensitive about them. There was some concern, too, about
protecting the identity of the recipients, since many of them worked in the
department. All of these factors made it important to handle the cases
competently and the Task Force accepts that there were very sound reasons
for consolidating these cases in one place. Getting all these cases
together was, indeed, a most prudent move. We believe, however, that a
fundamental mistake was made in having to relocate the cases within the
validation section. This is because the responsibilities associated with
managing any continuing caseload are just basically incompatible with the
primary purpose of the validations section. If the main purpose was to
provide competent handling of the caseload we agree that it has probably
occurred, but at great expense to the department. After reviewing all the
problems that seemed to be associated with handling the caseload within the
validations section we think that the ordinance which caused it to be placed
there was more of a nervous, political response to a public relations
problem than it was a studied administrative action.
In part, the decision to place the employee cases in validations
was an attempt to allow closer review by top management. That has occurred.
The Assistant Director in Charge of Programs is in direct charge of the
employee caseload. In addition to the close supervision he provides the
eligibility staff, he must review all new additions to the caseload.
We accept the need for exceptionally capable handling of this
group of cases for it is unusual in all the respects we indicate. But while
accepting that the Task Force believes that placing the caseload under the
direct supervision of an Assistant Director for Programs has forced one of
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the most wasteful and illogical uses of top management we encountered in the
study. The placement of this caseload within the office of the Program
Director has diverted and demeaned the essential managerial purpose of this
terribly responsible position. We cannot possibly accept the present arrange- -
ment as a proper placement of the responsibility regardless of how special
the case may seem. Seeing the many crucial problems we do in the department
and the kind of leadership and attention needed to meet them, it became most
difficult at times to follow the orientation of management.
The Assistant Director estimates he spends about 15% of his time
on employee cases. We see that portion of his time in another way. There are
approximately 20 new intake cases coming into the employee caseload per month.
An intake caseload for a full-time eligibility worker is only 26 cases per
month. If the Assistant Director is reviewing and making final eligibility
determinations on that many new cases he is, in fact, almost carrying a
complete intake caseload. Even if the Director is able to do the reviews ten
times faster than an eligibility technician or does them all at night he is
still doing an eligibility worker's job. It is inconceivable to us that one
of the four top men in the agency is being diverted from his managerial
responsibilities with such an incongruous, technical task.
The Task Force believes that the employee caseload belongs, like
any other group of recipients, back in one of the division offices within
the mainstream of the eligibility process under the supervision of a competent
Grade I Supervisor. The only special allowances we would make for it is
to add an additional eligibility worker for a time in order to catch up
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the backlog of renewals and to get the cases in good current condition. The
fact that there are an unusually high number of appeals originating from
this caseload may justify a slightly lower number of cases in the individual
caseload assignment but that is the only concession we would allow.
21. ACCORDINGLY, THE TASK FORCE RECOMMENDS THAT THE EMPLOYEE/RECIPIENT CASE-
LOAD BE TRANSFERRED BACK INTO ONE OF THE DIVISION OFFICES AND THAT THE
ASSISTANT WELFARE DIRECTOR AND THE VALIDATIONS SECTION BE RELEASED FROM ANY
DIRECT RESPONSIBILITY FOR EMPLOYEE CASES.
Another reason for this recommendation is that the State regulations
are fairly specific in saying that an appeal action should not involve workers
involved in the original eligibility determination. By moving the eligi-
bility caseloads within the validations and appeals section it seemed to us
that the department openly defied the intent of that regulation. We consider
many of these kinds of State directives nonsense also but it does suggest to
us that local welfare departments can be pretty cavalier about State regu-
lation when it serves their purpose to do SO. We hope the department offers
the same resistance to the State in considering our recommendation on
screeners. In this instance our recommendation on moving the employee/
recipient caseload back to the division should be looked upon favorably by
the State. Perhaps it will provide some bargaining material for negotiating
agreement on screeners.
We discuss a proposal for relocation of the validations unit
within a proposed Management Division under our section on the Organization
Plan, later in this report.
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SECTION IV
SOCIAL SERVICES
SOCIAL SERVICES
The Task Force finds itself addressing the question of the
management and delivery of social services in Alameda County almost a
full 10 years from the passage of the 1962 service amendments to the
Social Security Act. These amendments were based on the assumption that
more intensive social services delivered to welfare recipients would
improve the capacity for self-support and reduce welfare rolls. This
massive national effort, backed by increased federal subventions, was
implemented by limiting AFDC caseloads to no more than 60 cases per social
worker, requiring "social studies" on all family aid, and by providing
child protective services to AFDC families.
The move to 60-to-1 caseload ratios resulted in substantially
increased staffing of social workers in most county welfare departments.
However, by the late 1960's it had become apparent that smaller caseloads
were not having their desired effect. Five years of experience under the
1962 amendments had brought five successive years of caseload increases.
It was generally felt that one of the main problems was the fact that even
though workers had smaller caseloads, they were still required to spend
large blocks of their time in activities only remotely related to direct
delivery of services. A California legislative study in 1968, which
focused on selected urban welfare departments, disclosed that 86% of the
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social workers surveyed spent more than half their time in determining
eligibility, and that 37% spent three-fourths of their time on eligibility
1
determinations
In addition to eligibility determination, there remained
other office work to do, such as computing, revising, and writing budgets
for each welfare case, controlling warrants, recording case progress, and
office conferences and training sessions.
Since lower individual caseloads did not seem to have much impact
on welfare program increases, a new assumption began to emerge by the late
1960's: if social workers could be relieved of most of the essentially
clerical tasks associated with casework, then client-worker relationships
might, at last, begin to produce some results in reducing the growth in
welfare caseloads.
It should be noted that in addition to the finding that workers
spent little time on services, there was recognition of other problems in
the delivery of social services. The landmark study by the California
Assembly Welfare Committee in 1969 concluded that services were poorly
defined, were too often identified by workers as meaning individualized
therapy and counseling, and were too frequently forced upon unwilling
clients. The Committee report also concluded that no one was held
accountable for results and that community social service resources were
"fragmented, overlapping, and uncoordinated. 112
1
California Welfare: A Legislative Program for Reform. A staff report
to the Assembly Committee on Social Welfare, California Legislature,
Sacramento, February 1969, p. 175.
2
Ibid., p. 170.
-90-
The Assembly Committee examined these problems and responded
to them with a series of recommendations that aroused considerable
interest and testimony during the 1969 legislative session. Although
many of the findings achieved support from a wide spectrum of interested
groups, the only major recommendation that has so far been implemented in
any way has been the separation of social services from eligibility
determination functions, and the recognition of each as a distinct process,
forming separate social service and "income maintenance" caseloads. Of
course, it is not correct to say that the concept of "caseload separation"
commenced with this 1969 welfare committee report. The recommendation
actually came in the wake of a process that had already started in some
California welfare departments as a result of the 1967 Social Security
Amendments that gave the Secretary of Health, Education and Welfare the
power to effect caseload separation and backed it with a fiscal dis-
incentive of 50% (instead of 75%) federal matching funds for all caseloads
not separated.
It is also not correct to say that caseload separation has
developed quite as the committee report conceived it. Their separation
concept involved a still larger proposal for jurisdictional caseload
separation, with the State assuming social service caseload and the
counties taking over "income maintenance" functions.
We have mentioned caseload separation here in the context of
the 1969 Assembly report because the concept was prominent in the report,
and it was the only recommendation in this major study of social service
problems which was addressed to those problems and for which there is now
-91-
some experience. Obviously, state/county separation of social services and
income maintenance has not occurred, but it has happened within California
welfare departments, where it has been mandatory for AFDC since January, 1970.
Clearly, caseload separation has been the most profound organizational change
to occur in California welfare departments since the 1962 service amendments.
We discuss the implications of separation for such matters as eligibility
control, training, and departmental organization in other sections of this
report. In this section, we look at social services after separation, in the
hope of drawing some conclusions regarding the effect of this change upon services.
We could think of no better way of evaluating social services in this
post-separation period than to ask the same research organization that contri-
buted to the 1969 Assembly study to assist the Task Force in its review of
social services. The social service study was contracted with Scientific Analysis
Corporation, a San Francisco firm with considerable experience in social work
evaluation. The study was designed and supervised by one of the principal members
of the firm, Dorothy Miller, D.S.W. Dr. Miller's report is included as Appendix C.
The findings of Dr. Miller's study strongly suggest no essential
difference in the nature of social services between the periods of combined and
separated caseloads. Although Dr. Miller's analysis relies heavily upon a
design that focuses on differences in the perception of service delivery between
workers and client, her findings in this limited area raise serious, larger
questions for the field of social service in general:
1. How can social services be described; are they mainly
therapy and counseling or do they involve helping
people solve specific problems related to food,
clothing, shelter, education, training, employ-
ment, etc?
-92-
2. However described, what is the effect upon the
lives of people who are given services by the
welfare system?
3. What can be expected to happen to overall case-
loads as a result of the delivery of services?
4. If services are as ambiguous as most of the
research of recent years suggests, how can
social workers or welfare departments be held
accountable for what they do?
5. What would happen if services were eliminated
from the public welfare system? Would caseloads
increase? Would other community agencies fill any
gaps thereby created? Should social services, after
all, be a necessary adjunct to poverty services?
Does a system that was originally designed to
provide relief in cash or in kind create the most
effective environment or conditions for offering
social services?
6. Do personal, emotional troubles of the poor
require public attention and expenditure any more
than similar problems of middle-income people
or the rich?
These questions are not original with the Task Force; they can
all be found in current social work journals; in studies conducted by
social work professionals; Task Force staff heard them raised during
extensive interviews with Alameda County social work staff.
-93-
There is also another kind of question raised more frequently
by the social work profession, particularly since caseload separation has
forced closer examination of social work theory and practice. It is a
question born of the professional frustration in dealing with the unyielding
elements of the poverty environment; it is a question that is nurtured by
ambiguous goals, increasing self-doubt about personal and professional
effectiveness; it is a question that becomes increasingly insistent in a
bureaucratic environment of uncertain future, shot through with morale
problems.
The question is whether the proper role of the social work
professional is in the manipulation of the individual client or in the
manipulation of the environment in which he lives. Dean Alan Wade of the
Sacramento State College School of Social Work stated the question as far
back as 1965:
This brings us face to face with this question:
What is social work for? Is it for the purpose of
effecting individual adjustments to social conditions
that cannot be changed? Or is it for the purpose of
effecting planned and systematic changes in the social
system itself?3
There is no reason to consider this question an exclusive concern
of the social work professional. Workers in the fields of probation, public
health, law enforcement, mental health, and elsewhere are also presented
with this dilemma with no less frequency or sense of immediacy than the
social worker. The desired direction of social change varies with professional
3 Alan D. Wade, "Social Work's Triple Revolution," speech before the St.
Louis chapter of the National Association of Social Workers, March 17,
1965, quoted in California Welfare: A Legislative Program for Reform,
ibid., p. 182.
-94-
perspective, but the need for social change is nearly always viewed as an
imperative. It seems to us that the function of the worker in the helping
professions -- and in the agencies of social control -- is to address those
"people problems" for which he has been trained, and that this is distinct
from the personal exercise of his own citizen rights and responsibilities in
promoting social change.
The Task Force is not convinced that it would care to have the
social work profession divert and dilute services to people "
for the
purpose of effecting planned and systematic changes in the social system,"
any more than it would propose a similar emphasis in, for example, law
enforcement. Such large philosophical questions do occur, however, partly
because of the present confusion in the social work field regarding profes-
sional identity and function. Meanwhile, as this debate is pursued, events
occur in Washington and Sacramento which may lead toward the installation of
yet another untested assumption about social services which may be every bit
as significant as the 1962 amendments.
Without better evidence than is presently available on the nature
and value of social services, the next major national legislative change may
call for their virtual elimination from the welfare system; the measurement
of shift in national policy from one untested assumption to another will
thereby have been a full 180 degrees.
The answer to the social work dilemma lies not so much in speculation
on the profession's role in society, but in careful, disciplined evaluation
of the social service function within the welfare system itself. As we have
suggested with respect to other procedures in the system, what is needed is
-95-
evaluation of service proposals on a pilot examination basis. While
constraints of time and staff placed such an effort beyond the scope of
this study, our findings demonstrate the need for such study, and we propose
a number of objectives which further study should address.
One finding which forcefully demonstrates the present confusion
on the delivery of services is the great range in caseload staffing patterns
between counties. It suggests that in the months since the relaxation of
the 60-to-1 caseload standards caseload staffing has been characterized
more by casual drift, rather than conscious direction. As the table below
indicates we selected five counties, more or less at random, and collected
social worker staffing data and caseload data as of March, 1971 (with the
exception of San Mateo County, for which we used December, 1970). The data
was based on monthly caseload reports published by the State and staffing
information submitted by the counties to the State on report Form WP-11. We
were not able to adjust for such variable factors as caseload distribution
by aid category, differences in reporting, differences in optional programs,
percentages of caseload "in-service," etc. Even if this could be done we
sense the results would still be startling, for we have a caseload staffing
ratio ranging from 80 cases per worker in Contra Costa to 339 cases per
worker in Fresno -- a differential in excess of 400%:
-96-
COMPARISON OF CASELOADS AND SOCIAL SERVICE WORKERS
SELECTED COUNTIES
SERVICE WORKERS
SERVICE WORKER SUPERVISORS
Ratio
Ratio
of
of all
Super-
Author-
cases
Author-
visors
ized
Actual
Total
to all
Case
ized
Actual
to
Positions
Positions
Cases
Workers
Distribution
Positions
Positions
Workers
ALAMEDA
253
248
62,760
253 OAS
23.4%
51
50
5.0
Blind
1.5
Disabled
17.8
AFDC-FG
37.8
AFDC-U
6.0
Boarding Homes
2.2
Medically Needy
11.3
-L6-
CONTRA COSTA
401
356
28,453
80
OAS
21.2
66
63
5.6
Blind
1.2
Disabled
18.2
AFDC-FG
39.3
AFDC-U
7.3
Boarding Homes
.3
Medically Needy
9.8
FRESNO
107
100
33,936
339
OAS
31.4
17
17
5.8
Blind
1.2
Disabled
17.4
AFDC-FG
32.4
AFDC-U
7.1
Boarding Homes
1.9
Medically Needy
8.6
SAN DIEGO
381
350
55,431
158
OAS
29.2
61
61
5.7
Blind
1.5
Disabled
16.2
AFDC-FG
33.4
AFDC-U
5.9
Boarding Homes
3.3
Medically Needy
10.5
Comparison of Caseloads and Social Service Workers (Cont.)
SERVICE WORKER SUPERVISORS
SERVICE WORKERS
Ratio
Ratio
of
of all
Super-
-
Author-
cases
Author-
visors
ized
Actual
Total
to all
Case
ized
Actual
to
Positions
Positions
Cases
Workers
Distribution
Positions Positions Workers
SAN MATEO
150
145
16,779
116
OAS
26.3%
29
28
5.2
Blind
1.2
Disabled
17.8
AFDC-FG
33.7
AFDC-U
5.1
Boarding Homes
3.1
Medically Needy
12.8
SANTA CLARA
295
291
43,360
149
OAS
24.3
42
42
6.9
Blind
1.0
Disabled
15.6
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AFDC-FG
37.0
AFDC-U
10.9
Boarding Homes
3.5
Medically Needy
7.7
Source: State Department of Social Welfare Monthly Reports for March, 1971 (except San Mateo, which
is for December, 1970) and staffing as reported on Forms WP-11.
The basic purpose of a welfare department is the provision of
financial assistance in the form of cash grants, food stamps, or aid in
kind, such as medical care. Although there has always been a strong
interest in delivery of social services, the involvement in income
maintenance problems has prevented the concept of social services as a
distinct, single resource of necessary skills from developing. Since
caseload separation, this situation has become highly visible.
Because a set of objectives for services has never been developed
apart from services' relationship with income maintenance, it has now
become literally impossible to organize and staff for services with any
assurance that the most effective pattern of services is being offered
within the resources available. Without objectives against which performance
can be evaluated, there can be no determination of what kind of services
should be delivered by the welfare department, and where they should be
allocated.
As an initial response to this problem there has existed for
several months two methods of accumulating data on social services in the
Alameda County Welfare Department. One of them has developed as a pilot
research project out of some AFDC units at the 401 Broadway branch, which
is discussed in some detail below. The other data collection system is that
which has been developed and is operated out of Training Division, the
Services Section of which has been fully staffed for only one year.
The method employed by Training Division has involved the devel-
opment of training committees in each division (or branch office) repre- -
senting the various personnel groups (social workers, eligibility technicians,
-99-
first-line supervisors, and clerks). These committees, through discussion
of on-the-job problems and their perception of their own training needs,
indicate to Training Division the areas which they feel should be emphasized.
For social service workers, this has resulted in training offerings in
money management, pregnancy counseling, black family life, working with
public schools, etc. There are two general results which follow from this
approach --- training becomes a reflection of what the concerns of the workers
are (rather than reflecting specific needs of clients), and services tend
to be defined in terms of whatever a divisional or branch office training
committee determines them to be at a given point in time. The flaw in this
is that our own contract study, above, dramatically demonstrates that clients
and social workers perceive services quite differently. Furthermore, so
long as in-service training for social services is determined at the branch
office level it cannot be said that there is a departmental plan for admin-
istration of social services in Alameda County, nor that social services are
truly managed on a department-wide basis. Training, after all, is one
important instrument of management.
The other method for collecting data on social services is
currently operating in two AFDC units at 401 Broadway. Although initially
applied toward documenting delivery of emergency services, it has been
extended to workers carrying continuing caseloads. The method involves the
use of a measurement scale, designed on the basis of mandatory services.
The scale indicates the frequency and type of service requests made of
social workers, and the instances in which services have been provided
successfully and in which no change has occurred. The data which have been
collected in the past three months represents the first organized documentation
-100-
of what services clients are requesting. The initial results of this study
will be discussed later. The measurement scale currently being used in the
AFDC services project is also shown in a discussion of preliminary results
of that project.
Both methods for accumulating data on services -- the one in
Training Division and the one at 401 Broadway are modest, early efforts.
The method employed by Training Division has, as we have indicated, serious
flaws in terms of developing a relevant inventory of services and in its
organizational implications. Another flaw in the two methods is their lack
of connection; there has been no provision for comparison of data from
either source, nor has there been any effort to see how the two inputs may
be used in conjunction with each other. These findings underscore a recom-
mendation made elsewhere in this report for a. position of Assistant Director
of Social Services, which will make the concept of caseload separation
effective to the highest level in the organization, and concentrate in this
position primary responsibility for coordinating such matters as these
research and training activities which can have such a profound effect upon
social service concepts in this department.
The AFDC pilot project offers a very real possibility that much
of the mystery and ambiguity can be removed from the service program; social
services can submit to analysis and can be managed. The first step is to
determine what services of those offered are being utilized, and which
services are being provided with any degree of success. The critical need
for research in this area is emphasized by some of the problems encountered
in the offering of mandatory services, where contradictions abound. For
example, as suggested in another section of this report, why should a welfare
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department continue to be involved in employment services when the state-
wide policy direction is for these services to be provided by the State
Department of Human Resources Development? For another example, has the
mandatory service of "money management" ever been functionally defined?
How is it that in the face of an increase in child protective service
cases, there are only six workers in the main office to handle all referrals
with a resultant backlog that forces branch office workers to provide their
own protective services while waiting for referrals to be accepted? What
provision has been made to teach the recognition of these and many other
problems to the eligibility technicians so that they will know when to
refer cases to a social worker?
These questions only emphasize that services have not been
recognized as a distinct part of the Welfare Department administrative
structure and that services do not, therefore, receive the time and
attention that they deserve. Clearly, there is a strong need for continuing
the research into services within the department, and we are convinced that
such research can only lead to radical reorganization of the service delivery
system. We feel that research and reorganization of services is so imperative
that we place it and its objectives as the initial recommendation of this
section of the report.
22. IT IS IMPERATIVE THAT FURTHER IN-DEPTH RESEARCH IN SOCIAL
SERVICES BE CONDUCTED WITHIN THE ALAMEDA COUNTY WELFARE DEPARTMENT LEADING
TO A REORGANIZATION OF THE SOCIAL SERVICE DELIVERY SYSTEM. THE RESEARCH
AND THE REORGANIZATION SHOULD BE DIRECTED TOWARD THE FOLLOWING OBJECTIVES:
a. THE ELIMINATION OF DUPLICATION AND THE IMPROVED
COORDINATION IN THE PROVISION OF SOCIAL SERVICES
-102-
BY PUBLIC AND PRIVATE AGENCIES IN ALAMEDA
COUNTY;
b. THE DEVELOPMENT OF A DEPARTMENT-WIDE SYSTEM
OF ACCOUNTING FOR CLIENT REQUESTS AND SOCIAL
WORK RESPONSES;
C. THE DEVELOPMENT OF FLEXIBILITY IN DEPLOYING
SERVICE STAFF WHERE NEEDED, AS THE NEED IS
REFLECTED BY INFORMATION FROM THE LINE;
d. THE CLASSIFICATION OF SERVICE SKILLS BY UNITS
FOR FASTER, MORE EFFECTIVE UTILIZATION OF
STAFF;
e. THE COMPLETION OF AN INITIAL SERVICES ASSESS-
MENT WITHIN FIVE DAYS OF APPLICATION FOR AID;
f. THE DEVELOPMENT OF A CONTINUOUS FLOW OF
INFORMATION ABOUT COMMUNITY SOCIAL SERVICE
NEEDS AND RESOURCES;
g. THE REVISION OF THE TRAINING PROGRAM TO MEET
THESE OBJECTIVES, TO RECOGNIZE TRAINING AS A
MANAGEMENT FUNCTION, AND AS A REFLECTION OF
AND RESPONSE TO REALISTIC CLIENT NEEDS AND
WORKER PROBLEMS.
a. Elimination of Duplication and Improved Coordination.
The call for elimination of duplication and the improved coordi-
nation and direction of social services has been stated so many times in
studies of the welfare system that we are almost embarrassed to repeat the
obvious. We state it once again because we sense the finding usually has
-103-
been made without the necessary subsequent, specific, recommendation to
someone to take action, Therefore,
23. IT IS RECOMMENDED THAT THE BOARD OF SUPERVISORS APPOINT A
COMMITTEE CHAIRED BY THE COUNTY ADMINISTRATOR AND CONSISTING OF THE DIRECTORS
OF WELFARE, PUBLIC HEALTH, MENTAL HEALTH, THE CHIEF PROBATION OFFICER,
SHERIFF, COUNTY SUPERINTENDENT OF SCHOOLS, AND THE HOSPITAL ADMINISTRATOR
FOR THE PURPOSE OF CONDUCTING AN INVENTORY AND ASSESSMENT OF HEALTH,
EDUCATIONAL, AND WELFARE SERVICE PROGRAMS PROVIDED BY THE COUNTY AND THAT
THE COUNTY ADMINISTRATOR BE CHARGED WITH MAKING A REPORT TO THE BOARD BY
DECEMBER 31, 1971 WITH RECOMMENDATIONS AS TO THESE SERVICES WHICH SHOULD BE
CONSOLIDATED, REASSIGNED, ELIMINATED, EXPANDED, OR CONTRACTED FOR PRIVATELY.
Recommendations which originate in the recognition of the multi-
plicity and ineffectiveness of services generally are so drastic and near-
utopian in scope that they fail to be taken seriously by agencies and
legislators. While we concede the merits of the ombudsman-style "Community
Service Agent" called for by the Assembly Social Welfare Committee in 1969,
and the "Social Service Supermarket" approach called for by some prominent
welfare reformists, we feel that these options will not be tried until the
whole social service system chokes to death on its own procedures. Since
massive reform is subject to delay of so many contending forces we have tried
to frame recommendations in the context of "what to do until the doctor
arrives.'
The fact that so many jurisdictions and agencies are involved and
that responsibility is so diffused should not prevent the County of Alameda
from getting its own house in order. The study that we propose for county
staff would involve the department head (or designated representative) of
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every county agency providing social, health care, or delinquency prevention
or control services. It would call for submission of data in a standardized
format describing programs, caseloads, staffing, costs, source of financing,
etc. It would then call for hard recommendations and Board of Supervisors'
policy decisions on how local programs should be changed as outlined in the
recommendations, above. We recognize that we have called for a review that
does not provide for input from the many private, city, state, or federal
agencies that are also providing services in Alameda County. We suggest
that the formal involvement of those agencies be invited as "phase two" of
this effort. The problem of assessing the county's own service programs is
a formidable task in itself, and the very process of conducting the study
within the county agencies will suggest a pattern for conduct of the larger
study and ways in which recommendations can be translated into reality in
the intergovernmental arena. In addition, there are many examples of
duplication and poor coordination within county agencies. In one month in
Spring, 1971, seven public or private drug treatment programs were started
in the county. Two started within county departments -- Health and Probation.
The inter-agency services assessment has profound implications
both for effectiveness of services and county costs. One case encountered
during our social worker interviews affords a classic illustration. We
shall call the client Mrs. Smith, a mother who had been receiving AFDC in
another county. She came to the attention of Alameda Welfare when she
arrived at the home of a great aunt in Oakland with six small children
ranging in age from six months to 10 years. The great aunt, whom we shall
call Mrs. Green, is over 80 years of age and was already caring for three
other children of her niece. Mrs. Smith had received some treatment in the
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past in the state hospital system. When Mrs. Smith arrived, she had 6¢ in
cash, one small suitcase and the only clothes the children had were on their
backs. All of the children showed signs of physical neglect resulting from
Mrs. Smith's inability to provide proper care because of her severe emotional
difficulties; the six-month-old baby weighed 8 lbs., the four-year-old girl
was cross-eyed, the 10-year-old boy had a severe speech defect stemming from
emotional causes. Within a week of her arrival, Mrs. Smith suffered a
complete nervous breakdown and was hospitalized in Napa State Hospital,
leaving her nine children in the care of Mrs. Green, who was beginning to
manifest anxiety about her ability to cope with the situation. A week after
her admission to Napa, during which time she saw a psychiatrist once, Mrs.
Smith was released to the care of an Oakland physician. The state hospital
doctor advised that she be provided a full-time housekeeper for at least 30
days with periodic continuance thereafter.
Although the conditions of this case very strongly indicated
early intervention by the Protective Services Unit and Mental Health
Services, the delays involved in having referrals accepted -- added to the
obvious crisis conditions of the case -- made it essential that the case be
handled by the worker to whom it was first assigned. The specific services
provided included: 1) securing a housekeeper to help Mrs. Green care for
the children; 2) securing food for 15 days until a welfare check could
arrive; 3) getting clothing for the children so they could go to school;
4) sitting with Mrs. Smith for a half-day in the waiting room of the mental
health clinic to make certain she got to the local doctor -- prior to her
referral to Napa -- and after her hospital release, following through on a
local referral to a physician; 5) assisting in enrollment of the children
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in a local elementary school; 6) making arrangements for a volunteer driver
to take the child with a speech defect to speech therapy; 7) contacting
childrens' hospital to arrange for further care of this case; 8) referral to
protective services -- and several other specific services.
This case illustrates a number of issues for social services
which can be related back to our objectives for the conduct of further
social service research. In the context of improved coordination it
demonstates the need for improved support from protective services, and
local and state mental health agencies. It also demonstrates, in a small
way, something that was more forcefully brought to our attention in review
of other cases in this study -- the subtle but growing impact of the
transfer of state hospital caseloads upon the local communities and upon
the county mental health and welfare programs. While the concept of
community mental health services is a desirable alternative to state
hospital "warehouses," a shift in program also implies a shift in cost
burden. The costs of providing services for the mentally ill in
California have gradually shifted from an almost exclusive State burden,
to the local mental health programs, where the costs are shared on a 90/10
ratio, and -- as the mental health programs have been loaded up -- to the
Welfare Departments where the service costs are shared 75/25. Certainly,
it is less expensive and perhaps more humane to maintain Mrs. Smith at home
rather than in a state hospital. It is also cheaper and more humane to
seek to stabilize the nine childrens' home life in the residence of Mrs.
Green than to separate and scatter them into a variety of foster placements.
It would seem, however, that the cost burden of these desirable alternatives
should not bear inordinately upon the counties and upon increasingly
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impacted local property tax bases. Thus, the counties have a vital stake
in this shift, particularly with respect to its impact on Aid to Disabled,
and it would seem advisable for counties to carefully analyze their local
mental disability programs with a view to determining changes which have
occurred in allocation of cost burdens. Such review might result in
recommendations for stronger local mental health program efforts and a
shift of some services to mentally disordered from welfare back to the
mental health system where the requisite counseling skills are located
and where the county cost burden is lower.
b. Development of a Department-wide System of Accounting for Social Work
Requests and Responses.
Another immediate issue the department can address itself to as
larger federal or state welfare solutions are awaited involves changes that
would clarify social work functions and help create order where none cur-
rently exists. A formal department-wide system of accounting for client
requests and social work responses is the first step in the development of
a social services management system to be supervised by the proposed
Assistant Director for Social Services. As mentioned, this formal, on-
going, departmental analysis of social services would be closely coordinated
with social e vice training functions in the department, which we have
proposed be placed under the immediate direction of the Assistant Director
of Social Services.
We have also mentioned an AFDC pilot project in analysis of
social work requests and responses. Here are the initial results of that
project for the first two months of operation:
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INITIAL RESULTS - SERVICES MEASUREMENT
ALAMEDA COUNTY WELFARE DEPARTMENT
AFDC UNITS G27, G42
April-May, 1971
Services
No
Mandatory Service Category
Referrals
Provided
Change
A. PROTECTIVE SERVICES FOR CHILDREN
1. Relocation of a family member to prevent family violence.
1
2. Successful referral to counseling agency or medical facility.
1
3. Successful referral to Legal Aid, JPO, or Police.
5
4. Successful resolution without referral.
3
TOTAL
17
10
3
B. CHILD SUPPORT SERVICES
1. Obtain cash or income from other resources, i.e., Social Security
or Absent Father.
O
2. Client cooperated with FSD
l
TOTAL
O
l
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C. OUT OF HOME CARE - CHILDREN (i.e., Foster care services)
O
O
D. CHILD CARE SERVICES
1. Obtain help from friends or relatives.
2
2. Location of housekeeper.
O
3. Payments for child care.
14
4. Obtain day care.
1
5. Referral to pre-school.
O
TOTAL
31
17
5
E. INFORMATION AND REFERRAL SERVICES
1. All categories (no duplication of other count).
15
2. Service assessments.
38
TOTAL
17
53
8
Services Measurement - Continued
Services
No
Mandatory Service Category
Referrals
Provided
Change
F. EMPLOYMENT AND REHABILITATION SERVICES
1. Assisted in enrollment in training classes.
10
2. Successful assistance in obtaining job.
4
3. WIN/ETS.
17
TOTAL
28
31
28
G. SERVICES TO STRENGTHEN INDIVIDUAL AND FAMILY LIFE
1. Temporary shelter, i.e., relatives, good samaritan, etc.
11
2. Intercession with landlord for extension of time before move.
3
3. Intercession with landlord to upgrade housing.
2
4. Intercession with landlord - work out back rent payments.
9
5. Allowance for cost of relocation.
23
6. Successful referral to other agencies, i.e., public housing,
building and housing, sanitation.
3
7. Finding adequate shelter - permanent.
10
8. Reducing household composition so that present housing is adequate.
O
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9. Improving housekeeping standards.
O
10. Having utilities continued.
6
11. Marital, family or child development counseling or referral.
18
12. Client assisted in coping with existing situation.
30
TOTAL
139
115
41
H. MONEY MANAGEMENT
1. Successful food referral to private agency
76
2. Staff member picks up and delivers food to client.
9
3. Staff member arranges and helps client pick up food (together).
5
4. School lunches for children for month.
O
5. Referral to private agency for meal or meals.
1
6. Emergency special needs obtained for client.
10
7. Emergency special needs obtained for client through referral.
3
8. Food stamp certification.
O
9. AIK - vendor, protective payment.
3
10. Successful referral to other agency, i.e., Legal Aid, Wage Earner's
Plan.
4
Services Measurement - Continued
Services
No
Mandatory Service Category
Referrals
Provided
Change
H. MONEY MANAGEMENT (Continued)
11. Expedite AFDC grant, Medi-cal card, or food stamps.
33
12. Counselling in money management.
1
TOTAL
119
145
37
I. HEALTH CARE SERVICES
1. Arrange for medical appointment or treatment.
7
2. Arrange for transportation to medical facility.
4
3. Successful referral to public health or other facility.
6
4. Child obtain immunizations.
O
5. Have client take correct medication.
O
6. Clarify physical condition.
1
7. Explained use of Medi-cal card and prior authorization.
1
TOTAL
6
19
11
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J.
FAMILY PLANNING SERVICES
-
1. Counselling in therapeutic abortions - mandatory service.
26
2. Acceptance of family planning.
11
TOTAL
23
37
5
K. OTHER (specify)
1. Transportation.
1
TOTAL
1
1
1
GRAND TOTAL
381
429
134
The AFDC services measurement device is, of course, based on a
format involving the provision of mandatory services. Within that format,
however, services have clearly been cast in a context of specific, concrete
activities. A "safety valve" was included, however, along traditional
social work counselling concepts; items G-11 and G-12 have to do with marital
and family counselling and assistance to clients in coping with existing
situations. It might be expected that this area would be heavily loaded
with service activity. However, out of 429 "successful" service actions
provided in this 60-day test period, only 48, or slightly more than 10% of
the services fell in this category. The vast majority of services provided
were, indeed, quite specific in nature.
In the test period, 551 actual service actions were rendered.
121 of these actions were unsuccessful in resulting in any change in the
clients' condition. It should be noted that judgments on the effectiveness
of services were not made exclusively by workers, but by casework supervisors
in individual case reviews with workers. It is also interesting to note
that the 78% "success" rate of this study corresponds roughly with the 76%
finding reported by social workers in the contract social service study.
One essential ingredient is missing in the AFDC service project: the clients'
view. We understand that further study vill include this perspective, and
when this is done, it should be possible to make some rough comparisons of
client views between the AFDC project and the contract study.
One significant feature of the services project is the added
support it brings to the concept of more specifically defined services,
related more closely to the actual life problems of people in poverty
circumstances. This is also supported by our case of Mrs. Smith. We
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returned to our extensive notes of the interview with her worker and found
that the worker's response to the many problems of her family was always a
specific, supportive action and in not one instance was "counseling" or
"therapy" explicitly involved as a direct service by the worker.
There are several other advantages of a department-wide accounting
system for services: it brings to the surface many specific services which
the department may not even be aware it is providing, both in quantity and
variety; it is then possible to go behind this information and propose
solutions to given service needs that successfully attack the cause out in
the community; it makes possible decisions on alternative methods of handling
specific service needs that may be faster, cheaper, and more responsive to
the client; it helps suggest directions for service priorities and areas
where services should not be provided by the welfare department or should be
handled by some other public or private agency. The possibilities are
limited only by the imagination of management.
c. Flexibility in Deployment of Service Staff.
24. IT IS RECOMMENDED THAT THE 60-T0-1 CASELOAD STANDARD FOR THE
ASSIGNMENT OF CASES TO SERVICE WORKERS BE ABANDONED AND THAT THE DEPARTMENT
MOVE TOWARD A SYSTEM OF SERVICE CASE MANAGEMENT BASED ON SEVERITY OF CASE
PROBLEMS PRESENTED AND REALISTIC ESTIMATION OF WORKER PERFORMANCE. Our close
research into the service functions of the Alameda County Welfare Department
has served to reinforce our notions of the absurdity of the standard of
assigning 60 cases to each social service worker. This standard has been
relaxed as a budgeting device in California; we have not done the necessary
research to be absolutely certain of the current federal view on the point.
We must observe, however, that the standard is de facto not effective in
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California on a departmental level; recall the wide variations in caseload
ratios. The overall controlling factor, county by county, is the percentage
of caseload claimed to be "in service" and this also varies considerably.
It is important to recognize that the relaxation of the 60-to-1 ratio and the
application of the concept of "cases in service" applies to gross staffing
and gross budget considerations, and that while the end result is generally
fewer social workers, it has made little difference to the working situation
of the individual worker.
The social service worker in Alameda County remains responsible
for 60 "active" service cases and the general expectation is that a single
case will be serviced and returned to a caseload bank within 60 days of
assignment, unless there are extenuating circumstances. Except for a few
social service units in the department, as soon as a worker closes the
service aspect of a case, he is reassigned a new one, regardless of his
skills or interests, needs of the client, or intensity of the remaining
59 cases. Sixty separate sets of service problems are simply impossible to
comprehend. Consider, once again, the complex case of Mrs. Smith. The
worker on this case was forced to devote half or a third of her time to
this one case in the first two or three weeks following assignment, and the
balance of her assigned caseload was largely unattended. This system has
forced conscientious (as well as non-conscientious) workers into the game
of holding back on the release of completed service cases to unit super-
visors. The game can be played with two alternative goals in mind: 1) the
conscientious worker seeks to protect complex, multiple problem cases in his
caseload needing intensive services (like Mrs. Smith) from the distractions
of other cases needing attention, and 2) the lazy, incompetent worker seeks
to protect himself from working harder than he absolutely has to. The
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60-to-1 system of random case assignment does not discriminate between these
types of workers and therefore cannot be remotely considered a performance
standard. It does, however, promote game-playing in which both kinds of
workers pit their wits against management to beat the system for better or
worse and in which the viability of management is damaged.
The department should investigate a whole range of possibilities
in developing new ways of assigning cases. Obviously, number of cases is a
factor for which there are upper and lower limits. We believe the concept
of "x" number of cases carried per worker would be dropped entirely and
replaced with standards of case-turnover which vary according to type of
aid program, chronicity and complexity of problems, and depth of worker
involvement required. Using a case turnover concept (which, in itself,
connotes greater action than a case "carrying" concept), it seems possible
to conceive of completed case services actions ranging from eight to 12
per month in a few extremely complicated services to 60 per month in several
emergency service units. It should be noted that the standard established
in the emergency units in the AFDC project was 15 completed service activities
per week, which is being met and which is approximately double the turnover
standard for departmental AFDC caseload (i.e., 135 service actions versus 60).
In any event, workload, rather than caseload should be one of the keys to the
management of social services.
d. The Classification of Service Skills by Unit.
This concept is new only in terms of its present limited use.
Employment services provided by the Work Incentive Program are a form of
classification; the two emergency units now operating at 401 Broadway are
a functional assignment of workers on the basis of skills and interests,
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with the goal of helping clients with emergency problems and becoming more
expert in handling crises. Functional assignments have the added advantage
of making the best use of each worker's skills and eliminating the necessity
of training the whole department for a social service that only a few have
to perform.
Information leading to development of other functional assign-
ments could be drawn from current and future pilot projects on services. To
illustrate some possible alternatives, functional units could be built
around stronger protective services for children, closer work with children,
parents and schools to strengthen child educational achievement and develop-
ment, and work with the special problems of the emotionally disturbed who
are released by the state hospital system to their local communities.
One important advantage of functional classification of social
services is that it brings into clear relief the services that are actually
provided in the welfare system and almost automatically raises the question
of whether a given service should be provided within that system at all.
It is difficult to suggest a single social service for the welfare system
that is not handled in some way by another agency. In perhaps only one
area -- protective services to children and adoptions -- does welfare seem
to pre-occupy the field, for historical and legislative reasons, and
proposals to remove these functions from the welfare system are repeated
frequently. With regard to services offerred by welfare which are also
provided by schools, mental health, public health, etc., it seems absolutely
essential to settle the basic question of whether welfare should provide a
given service, and if decided affirmatively, to determine what aspects of
shared services should be provided by welfare. It could be that welfare
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service functions that are shared with other agencies will come to be cast
in the role of emergency, short-term, crisis intervention services, with
early referral to other agencies of those cases that require long-term,
specialized attention.
There is, perhaps, one functional classification that would
suggest longer term involvement by welfare social services, and that is
related to one of the time-honored reasons for having social services in
the welfare system at all: reversal of the welfare recipients' dependency
status. As suggested elsewhere in this report, one of the reasons for
failure of the welfare system to achieve much impact in this area is that
there has rarely been an organization of welfare caseload that would allow
concentration of effort on those cases that have some chance of escaping
the system. This idea, which recognizes a difference in the potential
welfare future of a 21-year-old mother of one child and that of a 40-year-
old mother of nine is discussed in the eligibility control section, but it
is mentioned here because of the need to effect a close coordination of
income maintenance and social service functions in this area. We by no
means suggest that services should be exclusively directed toward those
recipients that show some potential for removal from welfare, and that the
problems of our theoretical family of nine children be ignored. We are
saying that these are two different kinds of cases that should not be
assigned to the same workers, and that the development of special service
units to handle cases of those recipients only marginally involved in the
system would probably be more effective than the present system of random
assignment in promoting financial independence.
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e. Completion of an Initial Services Assessment within Five Days of
Application for Aid.
Current Federal law requires a social service assessment of all
AFDC applicants. At present, social service assessments in the Alameda
County Welfare Department occur weeks after a family has made application
for aid. It would seem extremely important to intervene in AFDC cases before
the situation which generated the original application becomes more severe.
Once again, our actual case of Mrs. Smith demonstrates that a delay beyond
the point of her going to the state hospital would have likely resulted in
the break-up and foster home placement of her nine children, serious effects
on the physical condition of Mrs. Green, more serious emotional consequences
for Mrs. Smith, etc. Effective delivery of social services that mean some- -
thing to the client and to the agency demand that assessments be accomplished
within five days of application.
f. A Continuous Flow of Information about Community Social Service Needs and
Resources.
An integral part of an effective social service system is the
development of information on service resources available in the community
and in other agencies, and the communication of this information to service
workers in the department. To be of any use, the information must be
current and therefore requires continual updating. Good resource information
is not only timely, it implies evaluation of resources by following-up after
referrals are made and by going out to the community to monitor results first-
hand. Resource development and information is extremely important not only
in terms of identifying services which will directly assist clients, but in
terms of the coordinated management of all such resources in the community.
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Recognizing resource development and information as a specialized function
can be an important factor in the early identification of social service
needs and the elimination of services that may be ineffective or duplicated.
Illustrative of the need for an activity such as this is the fact that
virtually every service worker or unit in the department has developed a
closely guarded, personal list of resources to be tapped in a given type
of service situation.
Tacet recognition of the importance of resource development and
information on a departmental basis is the position of Community Resources
Coordinator. We say "tacet" because the position, which has been in the
department for approximately five years, does not seem to have developed
as a result of a specific departmental proposal which was made in response
to a formal recognition of need. The origin of the position dates to the
administration of the last Welfare Director, and no present member of
management is closely familiar with the early history of the position. On
this point a staff review and report of the position made in September,
1970, stated that
"
there is no written material available outlining the
nature of this position as originally conceived." This staff report
indicated, however, that the incumbent of the position viewed her duties as
originally created to involve liaison between the department and the
community, coordination of all community resources to avoid duplication, to
assist in establishment of new services to welfare clients where needs
appear, interpretation of welfare policy to the community, and the continuous
updating of a community resources handbook for use by social workers.
It was the finding of departmental staff that the incumbent of
the position expends about 60% of her time in developing and coordinating a
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volunteer program in the department which, at the time of the report,
numbered approximately 85 people in volunteer service to the department.
The report also indicated that the position devoted eight hours per month
to teaching two casework classes, and considerable time in direction of the
Speaker's Bureau for the department, which handles presentations to various
community groups and organizations. The position carries a variety of other
special assignments and committee memberships.
The September, 1970 staff report concluded that the duties and
responsibilities assigned to the incumbent of the position today are different
from those assigned when the position was originally conceived; that the
volunteer program -- the position's major assignment -- either does not exist
or is carried out by lower position classifications in other counties, and
that positions similar to the original conception of the Alameda position
are assigned a high level of responsibility, though paid on a scale similar
to the Alameda position. The recommendations of the staff study were:
It seems to be that the duties originally assigned
as a Community Resources Coordinator are extremely
important ones and some of them are no longer being
performed by anyone in the Alameda County Welfare Depart-
ment, except as may occasionally happen by chance when
a social worker is dealing with a particular outside
agency. I think it is most important for the agency to
have an official representative to act as liaison with
community resources, to prevent duplication of services,
and to identify needs for new kinds of services.
I would suggest that these duties and responsibilities
be reassigned
and that she be released of any
teaching responsibilities. In addition, I would recommend
that she be given some assistance, perhaps of a clerical
nature.
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These changes would result in an increased level
of responsibility
more commensurate with her salary
and the minimum qualifications for her position. It
would also result in increased effectiveness on the
part of the Alameda County Welfare Department.
4
It seems to us a rather serious reflection on the management of
the Alameda County Welfare Department that a function of such significance
in the department should operate virtually unevaluated for such a period of
time and, in fact, back to a former departmental director. There should
at least have been an annual review of the function in connection with
preparation of the budget request. We must observe that the extent of
evaluation given the position in September, 1970, was quite thorough, but
the matter appears to have advanced no farther in the nine months since the
staff review and the time of writing this report.
We would also observe that the "continuous updating" of the
Community Resource Manual means that it is revised once annually on the
basis of a written questionnaire, which is neither timely, nor does it
suggest evaluation of community resources in the field.
Finally, the position does not appear to be under the super-
vision of any departmental management position, although the last depart-
mental organization chart (5/9/69) shows the Community Resources Coordinator
under the Chief of Training Division. The incumbent coordinator indicates
that she reports to the Chief Assistant Director. In addition to the
proposals regarding resource coordination made in September, 1970,
4
Memo from Departmental Personnel Director to Chief Assistant Director,
September 10, 1970.
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25. IT IS RECOMMENDED THAT THE DEPARTMENT UPDATE ITS COMMUNITY
RESOURCES MANUAL ON A CONTINUOUS BASIS THAT UTILIZES RESOURCE INFORMATION
AND EVALUATION FROM BRANCH OFFICE WORKERS WHICH IS IN TURN BASED ON FIELD
OBSERVATIONS AND FOLLOW-THROUGH ON REFERRALS, AND THAT THIS ACTIVITY SHOULD
BE SUPERVISED BY THE COMMUNITY SERVICES COORDINATOR;
26. IT IS RECOMMENDED THAT THE DEPARTMENT ASSIGN THE DIRECTION
OF THE COMMUNITY RESOURCES COORDINATOR TO THE PROPOSED ASSISTANT DIRECTOR
FOR SOCIAL SERVICES;
27. IF THE DEPARTMENT DOES NOT ACT AFFIRMATIVELY ON THE BASIS
OF ITS OWN ANALYSIS OF THE COMMUNITY RESOURCES FUNCTION AND ON THE BASIS
OF THE ABOVE PROPOSALS, IT IS RECOMMENDED THAT THE POSITION, AS NOW
CONSTITUTED, BE ABOLISHED.
INTERIM CONCLUSIONS ON SOCIAL SERVICES
The Task Force staff is painfully aware that aside from specific
recommendations for abandonment of the 60-to-1 caseload ratio and revision
of the departmental resources development function, we have responded to the
social services question with a recommendation for further study. We
recognize that most recent studies of services deal more with their pathology
than their potential, and this is true of our own contract study. It does
not help to remind ourselves that we had hoped to avoid this very thing in
this study; we were actually bold enough to expect that we could offer more
specific direction for future social services than we have been able to.
That we were not able to do this -- even with help -- is partly because
services were an entire study in themselves, caught up in the midst of many
other departmental problems which also demanded attention.
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Be that as it may, we cannot have spent the months of this study
as close as we have to social services and social workers without achieving
some interim conclusions at the very least. After all, even the further
study we have called for must start with some premises. Here is what we
conclude at this point:
1. Social Services do have an important role to perform within the
welfare system. They are a very necessary adjunct to provision of financial
assistance, in cash or in kind, which is the basic reason people in poverty
circumstances come to a welfare department. However, from all indications
of our study, services urgently require sharper definition and clearer
statement of objectives. We see the results of such efforts as a limitation
in the range and quantity of social services that the welfare system is
either expected to provide or claimed to provide. We see as other possibilities
of this effort a more efficient use of non-social service personnel within
the system in meeting some client needs, and a reduction of duplicative efforts
between welfare social services and those of other agencies through a better
client-referral system.
2. The social services that can be most effectively provided from
within a welfare department are primarily short-term, crisis-oriented, specific
services that assist recipients in overcoming an immediate, concrete problem.
There is a limited need to provide some services of a longer-term, comprehensive
nature, but only in terms of doing so until the case can be effectively referred
out to other agencies. One of the goals of this type of social service activity
should specifically be to concurrently work toward referral out. There is
also a need for further study in this caseload area to attempt an estimate of
how extensive the "multi-problem" social service workload is, and the kinds
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of skills it demands of workers in the welfare system.
3. It is essential and possible to move toward classification of
service problems not only in terms of types of problems encountered, but the
kinds of staff specialization required to meet them. It seems also possible
to develop, as the department is doing right now in the AFDC pilot project,
a system of weighted workload standards which can in turn be used for staffing
on the basis of type and complexity of problems and time required to work on
them. Without clearer indication of social benefits to be gained from social
services, it is virtually impossible to make sound judgments on the most
effective expenditure of public funds in meeting the needs of social services
which should be provided by the welfare system. The criteria for making those
budget judgments must be based on continuing analysis of the frequency of
demand and delivery of specific services, the effectiveness of change, and
the cost benefits of alternative methods of delivering services.
4. Separation of Social Services and Income Maintenance will still
require close coordination. Caseload separation is clearly the basic special-
ization of function in the welfare system; it recognizes that difficult skills
are required to provide service and income functions efficiently. However,
the effectiveness of both functions in meeting organizational goals will
require close coordination. One example would be the classification of case-
loads which would permit more effective work with those recipients that are
only marginally involved in the system.
-724-
SECTION V
TRAINING
TRAINING
Considering the special training problems presented by the
separation of AFDC in January, 1970 the Task Force makes a very critical
assessment about the use of the department's training division. The training
program for the eligibility workers is poorly suited to its task of training
the 600 people which now completely control the fiscal side of welfare. The
Committee finds, that in terms of the training division's staffing, its
direction, and budget, it is still heavily oriented toward social services
at a time when it clearly should have set goals related to meeting the
special problems of eligibility. The unfortunate effect has been to graduate
into permanent positions hundreds of eligibility workers who do not have the
necessary training or the technical understanding of their highly complex
jobs to function adequately, efficiently or confidently.
With the initial problems associated with mass hirings of new
eligibility technicians over, the emphasis must be shifted to upgrading the
training of the existing staff and culling out many of those who have found
their way into the organization during a crisis situation. To do this
successfully, radically different training formats will have to be devised.
It will also necessitate a measure of cooperation and understanding between
the Board of Supervisors, Civil Service, the County Executive and the depart-
ment in repairing a situation whose implications goes far beyond the welfare
agency. The Civil Service Commission must understand, for example, that most
of the three hundred eligibility workers hired last year received permanent
status without the benefit of any evaluation of their performance. We
believe many of them can be salvaged, by better training, creating a better
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supervisory class and by establishing performance standards. Many, however,
cannot and this must be recognized by the Civil Service Commission and
appeal bodies in reviewing dismissal proceedings.
The Committee presents this section with the firm conviction that
the reliability of the whole Income Maintenance program as well as the admini- -
strative control of it relates more directly to the ability and proficiency
of the eligibility worker than any other single factor.
The summary conclusion of the Task Force is that the training
component of the department must be strengthened significantly, with
primary emphasis on the eligibility side of the organization. Other specific
recommendations relate largely to getting more effective use of the training
staff, and achieving better control and coordination of their efforts.
The balance of our discussion is organized around these three
findings:
1. The priorities set by the Training Division are still
heavily slanted toward the social services when the
most critical and immediate needs are in eligibility
and income maintenance.
2. The Training Division is not attached to the organi-
zational structure in a manner that allows it to
receive proper direction for either its social
services or its eligibility training programs.
3. The training plans have been inadequate in terms of
their content, concept, duration and delivery.
1. Training Priorities. The training division consists of two
six member units with clerical backup, each supervised by a Grade II
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Supervisor. The social services team is in charge of the ongoing and
supplementary training of about 300 social workers. The second unit is
concerned with the induction, training, and in-service training of about
350 new eligibility technicians in AFDC in 1970 and for upgrading training
of approximately 300 others in the adult categories. In addition, it is
responsible for the training of about 100 eligibility supervisors. It
seemed to the Committee that the simple differences in numbers of employees
involved would have been reason enough to make some shifts between the two
sets of staff in the Training Division as an adjustment to the consequences
of separation.
The disparity in staffing seems even greater considering the fact
that most social workers were not new recruits, some had prior experience,
and all were college graduates. Most of the social workers had also received
at least six months of training and there has not been any significant
change in mandated social service programs in 10 years.
The eligibility technicians and their supervisors in AFDC, in contrast,
were new and totally inexperienced. The budget clerks and clerical personnel
who had any prior knowledge of the grant process had, for the most part,
already been used up in the adult categories which had separated earlier.
The problem in eligibility was aggravated further because the budget clerks
who had controlled the budgetary aspects of eligibility had been eliminated
in the separation plan. The training had to provide, then, for teaching
each new eligibility technician not only the incomprehensible law and
regulations covering eligibility but the intricacies of two budgetary systems
covering check holds, grant changes, etc. by which the system controls its
money. Management faced, in every sense of the word, an enormous training
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problem that was and still is proportionately much greater on one side of
the organization than it was the other.
Management must have been aware of some serious problems occurring
in the performance of the eligibility technicians almost as soon as separation
started. Administrative errors were increasing, renewals were falling behind
and the ratio of denials to applications received was falling off. While
not the only clue, the Committee thinks the application and denial ratio,
which shows the number of persons getting into the system in relation to the
number who apply, was one indication of what was happening.
Percent of Total Applications which are Denied in AFDC
Source: ABD 237
AFDC - 1970
Applications
Denials
Percent
January
1363
226
16.58
February
1143
305
26.68
March
1859
389
20.93
April
1561
435
27.87
May
1943
471
24.24
June
2166
657
30.33
July
2325
447
19.20
August
2504
728
29.10
September
2679
730
27.20
October
2151
832
38.70
November
1965
779
39.60
December
1824
912
50.00
AFDC - 1971
January
1896
611
32.20
February
1658
909
54.80
March
1694
823
48.60
April
1450
839
57.90
Something was obviously wrong and most of it, in the Committee's view,
strongly indicated that the new eligibility technicians were not meeting
the demanding requirements of their jobs.
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Aside from the questions we raise about the priorities, organi-
zation, and design of the training programs themselves the department had
requested additional training positions last year which were not approved.
When one considers the cost between adding a few training positions
and the financial effect of holding the denial rate a few percentage points
higher one can legitimately ask what administrative checks there are anyplace
in the county.
What the data means, we think, is as the workers' experience
increased so did the denial rate.
This data does not show it but in March and April there was the
first downward trend in AFDC caseload in 16 months. We do not think it a
coincidence that it corresponds to a high rate of denials in those months.
Through experience, the eligibility workers are, for the first time, starting
to get some control over their caseloads. This is most encouraging, but the
Committee is still of the opinion that the department is still operating
with virtually an untrained corps of eligibility workers. We also believe
the improvement of the worker is more a consequence of time and on-the-job
experience than the training program of the department.
28. OUR FIRST RECOMMENDATION IS THAT REGARDLESS OF THE BUDGET
LIMITS OR NUMBER OF PERSONNEL APPROPRIATED FOR TRAINING, MUCH GREATER
PRIORITY SHOULD BE PLACED ON THE TRAINING OF ELIGIBILITY TECHNICIANS. IT
IS STILL THE GREATEST TRAINING NEED OF THE DEPARTMENT. WE RECOMMEND THAT
FULLY THREE-FOURTHS OF THE TOTAL TRAINING BUDGET BE ALLOCATED TO TRAINING
ELIGIBILITY WORKERS.
29. UNLESS NEW POSITIONS ARE ADDED TO AUGMENT THE ELIGIBILITY
TECHNICIAN TRAINING SECTION WE RECOMMEND THEY BE TRANSFERRED FROM THE
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SOCIAL SERVICES UNIT. In recommending that we are aware that there are
unmet training needs in social services which this would seriously affect.
We support the recommendation on the reasoning that until the social
services training needs are better identified and more agency-wide training
is conducted for social services it is safer to reduce training in the social
services branch of the department. We see it as strictly a matter of priority.
30. WE THEREFORE RECOMMEND SUSPENDING TRAINING PLANS FOR SOCIAL
SERVICES EXCEPT FOR NEEDS CAPABLE OF BEING JUSTIFIED ON AN AGENCY-WIDE BASIS
APPROVED BY THE WELFARE DIRECTOR AND TO MEET THE MINIMUM STATE REQUIREMENTS.
31. WE FURTHER RECOMMEND THIS REMAIN THE POLICY OF THE AGENCY
UNTIL THERE IS A DEFINITE INDICATION THAT THE PROFICIENCY OF THE ELIGIBI-
LITY WORKER HAS IMPROVED, MEASURED BY SUCH FACTORS AS THE CLEARANCE OF PENDING
APPLICATIONS, NUMBER OF OVERDUE RENEWALS AND SIGNIFICANT DROPS IN OVERPAYMENTS
AND ADMINISTRATIVE ERRORS.
We make this series of recommendations aware that the social
service specialists may not be qualified to move over into eligibility
training. On that problem we can only suggest management transfer them to
places in the organization where they can be used and replace them with
others carefully selected for their knowledge of eligibility.
The Task Force faults management severely for its failure to
shift priorities in the Training Division much earlier. The Committee
considers it an example of organizational rigidity and believes it says
something quite unfavorable about management's ability and inventiveness in
responding to serious, identifiable problems quickly.
In addition to the questions we raise about priorities, the staff
believes the Training Division has also suffered from the line of authority
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it follows to top management; weak direction, internal dissension, and super-
visory problems. We turn to those issues as the next part of our discussion.
2. Organization and Supervision. The staff is inclined to see
training as basically a staff function to the two main service branches of
Social Services and Income Maintenance rather than a line function which is
implied by training's present location in the departmental structure. Above
all, training should be fixed to the organization structure in a way which
facilitates it being able to respond quickly and decisively to problems as
they are discovered in the line organization.
Presently the Training Division reports to the Chief Assistant
Welfare Director who is not directly responsible for any aspect of either
1
Social Services or Income Maintenance.
While it is true that by virtue of
the authority he holds, the Chief Assistant Welfare Director is in a position
to impose or change training in any way he wishes on either service branch,
but that is not the factor we considered important in locating training in
the formal organizational structure.
The main problem, we think, is the handicap the Chief Assistant
Director has in being able to see training problems as they manifest them-
selves from the day-to-day activities of the operating division. It is one
thing to have a problem described in a memo and quite another to be living
with the problem and to have responsibility for it. Our view is that if the
Assistant Welfare Director in Charge of Programs is accountable for programs
l
This statement may be subject to some qualification due to some recent
changes in the responsibilities which the Chief Assistant Director has
assumed for programs since this chapter was written. Our understanding
of the formal organization is that it still operates about as we describe it.
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he must be able to direct the training of the personnel who administer
those programs for him. Compounding the problem is the fact that there is
not a management information system in existence which systematically and
clearly points out training problems to anybody. The problem is aggravated
further by the physical isolation of the entire Training Division in a
separate downtown building.
It is our impression that in designing and delivering their
training plans the Training Division works in closer conjunction with the
division chiefs than they do the Assistant Director. Seeing, for instance,
the very limited amount of agency-wide training for social workers, suggested
to us that training is pretty much what division chiefs /ish to accept
rather than what the Chief Assistant Welfare Director decides should be
offered as an overall department need.
Specific training for crisis intervention and in techniques for
dealing with hostile clients has been offered, but the basic training issues
for social services relate to a much more fundamental issue. It is whether
the department is going to gear its whole social services program to short-
term or long-term care. A firm decision on this question is what will really
determine the character and content of social services. After that decision
is made training techniques can be taught with some assurance that they are
hooked up to the basic program concept the department has enunciated.
To be sure, division chiefs should have heavy input in the deter-
mination of what training is offered but final decision on which needs will
be met should be made at a much higher place in the organization than it
seems to be now. We believe it should be by the two persons directly charged
and accountable for Social Services or Income Maintenance.
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32. ACCORDINGLY, WE ARE RECOMMENDING THAT THE STATUS OF THE TRAINING
DIVISION BE ABOLISHED AS A UNIFIED DIVISION UNDER A DIVISION CHIEF AND THAT
IT BE BROKEN INTO TWO SECTIONS, EACH DIRECTED BY A GRADE II SUPERVISOR. ONE
SUPERVISOR WILL REPORT TO A NEW ASSISTANT DIRECTOR IN CHARGE OF INCOME MAIN-
TENANCE AND THE OTHER WILL BE ACCOUNTABLE TO A NEW POSITION OF ASSISTANT
DIRECTOR IN CHARGE OF SOCIAL SERVICES.
We regard the Chief Assistant Welfare Director as being, ideally,
an administrative backup on policy and administrative matters to the Welfare
Director. Diverting his time and attention by having to directly supervise
other line or staff functions of any kind interferes greatly with what we
regard as his primary use in the organization.
33. WE RECOMMEND THAT THE POSITION OF DIVISION CHIEF IN CHARGE OF
TRAINING BE ABOLISHED. The type, content and nature of the supervision
needed between eligibility technicians and social workers is so thoroughly
different since separation that we think it is a mistake to run them in
conjunction with each other.
Our recommendation concerning the elimination of the Division Chief
is made realizing that by State regulation training of social workers must
be supervised by a person holding a Master's Degree in Social Work. The
person holding the title of Assistant Director for Social Services will prob-
ably have that degree. The Grade II Supervisor over social service training
is also a M.S.W. so we think there is an easy way to meet the technicality
of this requirement.
34. THE STATE, AT ONE TIME, MIGHT HAVE ALSO PREFERRED TO SEE AN
M.S.W. MANAGE THE TRAINING OF ELIGIBILITY WORKERS ALSO. WE DO NOT THINK THAT
IS THE CASE NOW AND RECOMMEND IT BE AVOIDED AT ALL COSTS. A THEME WE TRY
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TO EMPHASIZE OVER AND OVER AGAIN IN THIS REPORT IS THAT ELIGIBILITY AND
SOCIAL SERVICES ARE VASTLY DIFFERENT FUNCTIONS, CALLING FOR DIFFERENT
TRAINING AND SKILLS.
In the Committee's judgment the priorities that have existed in
the Training Division represent, to a considerable extent, the social work
orientation of the Division Chief. That is not a criticism, but a simple
statement about what the Division Chief for Training and the Chief Assistant
Welfare Director considers important as a priority.
We can only allude to it, but the worst supervisory situation we
found in the division could be traced, we thought, to what professional
qualifications were necessary to manage a training program. In the long
run, any service has to be evaluated in terms of its failures and success. We
have tried to do that as objectively as possible and made our recommendations
accordingly.
Management must, however, recognize in all its personnel trans-
actions that many of the concepts that have traditionally guided employee
selection in welfare are not suitable for staffing a fiscal or purely admini-
strative operation. The importance of an M.S.W. degree is a delicate and
difficult problem to even discuss, but it is, nevertheless, a very real and
important concern in welfare management today.
It was evident to us that management has attempted to staff the
Training Division with experienced and capable people. For the most part
we thought they were interested, qualified, and an innovative group. The
one classroom session we visited was conducted with enthusiasm and seemed
to be organized well.
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We also observed the staff to be frustrated and discouraged by
lack of direction, a sense of isolation and indecisiveness in top manage- -
ment. The eligibility training specialists all seemed concerned that their
use in the organization was essentially limited to the orientation classes
and that they are not able to serve a broader, more specialized and far-
reaching use in the organization. Some complained that they were not being
used in between training classes because of poor scheduling and advance
planning between the Training Division and the line divisions. We were
limited in how far we could go in following work schedules but our interviews
with the training staff made us think that there are good reasons to question
the use of the training specialists between classes since the mass hiring of
eligibility workers stopped earlier this year.
Holding the position we do on the importance of eligibility
training in comparison with the training given to social workers we were
especially interested in the supervision and the direction that the eligibility
specialists received. In general, we can only say that the immediate super-
vision of the eligibility training unit is as vague and uninvolved as any super-
visory relationships we had a chance to review in the course of the study. As
we saw it, the primary responsibility of the Grade II Supervisor over the
eligibility specialists was in giving an orientation class to new employees on
Monday mornings. It is totally inconsistent with the purpose and level of
the position. Our overall impression was that the eligibility training
specialists are mainly self-directed and the Grade II Supervisor over the
unit is largely a wasted position. In saying this we are aware that there
are some delicate and difficult matters to deal with in correcting
problems which have been present for some time. Some of them might be
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alleviated somewhat by the recommendation we make in breaking the Division
into two sections. In any event, it is a problem that we believe must be
solved as a prerequisite to straightening out management's line of authority
to this important training unit.
In contrast, we thought the immediate supervision over the social
services unit was very good, but the social services unit also suffers from
the same lack of direction and indecisiveness from top management about the
content and coordination of the training plans it wants to implement. In
summary, both units are working without the benefit of well-defined training
objectives. Sound training objectives are almost impossible to develop until
the basic question we just mentioned about long-term or short-term services
is answered.
The staff is acutely conscious that the four-week classes they
have been conducting are hopelessly inadequate. They want to do more speci-
alized training in areas where they happen to have a particular competence.
There is much potential within the Training Division and with the right
leadership and support of the administration many beneficial changes can
occur. The broad outline of the training format we suggest in Section III
incorporates many of their views.
3. The Training Plan. The present training plan consists basically
of four weeks of classroom instruction after which the new trainee is assigned
directly to a full caseload in a division. Since the department's original
separation plan was built around the integration of intake and ongoing cases
the instruction had to cover all aspects of both budgeting procedure and
eligibility. Furthermore, it was never possible to train the employee for
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the special eligibility considerations that applied to a particular aid
program.
About the only thing we can say in favor of the classroom training
plan is, with the staff available, it was an efficient way to process a
large number of people. But processing is not necessarily training. A
training plan has to be judged by whether it prepares the employee to do
his job. Training must continue until that is demonstrated. By that criteria
the Training Division's program for eligibility workers is a dismal failure.
85% of the employees we surveyed in a 10% sample of the eligibility workers
said they were unprepared to handle the caseloads they were given after
training.
35. WITH THE PRESSURE AND PROBLEMS ASSOCIATED WITH MASS HIRINGS
COMPLETED THE COMMITTEE'S GENERAL RECOMMENDATION IS TO SHIFT EMPHASIS IN
TRAINING FROM THE CLASSROOM TO ON-THE-JOB TRAINING. The department's
training proposal for 1971-72 also recognized a necessity of more on-the-job
training but still included one month of classroom instruction as a specific
in the curriculum. 36. THE COMMITTEE DIFFERS ON THIS LATTER POINT AND
RECOMMENDS INSTEAD THAT THE INITIAL CLASSROOM ORIENTATION BE REDUCED TO ONE
WEEK OR JUST ENOUGH TO MEET STATE REQUIREMENTS. If any more classroom
training is needed it should be interspersed with the on-the-job training.
We believe that the classroom training should be reoriented around
the idea that it is primarily a screening and evaluation process as opposed
to a training period. The main purpose we see for classroom training is in
teaching those aspects of training that apply to all employees. We think
that represents a very limited number of training items. Beyond that, we
see the classroom part of the instruction as being a screening device.
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It should concentrate on trying to identify slow learners as well
as those with special aptitudes. There are general tests that show native
comprehensive ability, facility with a number concepts, etc. that are not
being used now. 37. THE COMMITTEE RECOMMENDS THAT THESE TESTING METHODS
BE USED AS A PART OF THE INITIAL EVALUATION AND INDUCTION PROCESS.
Secondly, the orientation period should try to make a deter-
mination on whether the employee should be used in intake or on a continuing
caseload assignment and in which aid program. Someone, for example, who
cannot run an adding machine or shows no facility for arithmetic should not
be assigned to an intake function that involves a great deal of budget
computation. Likewise, the quicker persons should go to AFDC, rather than
to Blind or OAS where the pace is different and the programs are simpler.
With the great differences between the aid categories we think a great deal
is lost in trying to train all new employees for the provisions of all aid
categories when they are only going to work in one.
The central concept of the training plan should be to bring the
worker into contact as soon as possible with a working situation that
approximates his actual job responsibilities. We would give the new employee
a limited caseload of perhaps 15 to 20 actual cases within the aid category
he will be assigned as soon as the screening and orientation period is over.
We believe that the new employee should remain under the supervision of the
training specialist for as long as the training period lasts. As the
trainee's ability increases his practice caseload should be increasing
accordingly until he is working at full capacity. We do not think that
division chiefs should have the responsibility as they now do for completing
the training process.
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Likewise, it is unfair to leave the full responsibility for
evaluating and culling employees to the division chiefs after they are
placed in a working status. What is obviously needed is some kind of grading
system. There is none now. 38. WE RECOMMEND, THEREFORE, THAT SOME KIND
OF GRADING SYSTEM BE DEVISED BY WHICH NEW EMPLOYEES CAN BE PROGRESSIVELY
EVALUATED AS THEY MOVE THROUGH THE TRAINING PERIOD. There are some very
objective factors which can be used such as administrative errors and
mistakes in budget computation, condition of cases, etc. The opportunity
to assess new employees objectively is made more difficult, however, due to
the fact that there are no agency-wide standards of the same type for perm-
anent employees.
Some of the inherent weaknesses in the present training programs
may have been mitigated to some extent had the trainees entered the organi-
zation under experienced, first line supervisors. This was not the case.
The major share of trained supervisors had been used in staffing the adult
programs and in the very first sections of AFDC which were separated in
January of 1970.
The length of experience of the first line supervisors in most of
the AFDC units is not markedly different from the workers they supervised.
In one section of eligibility units we looked at the average time of an
employee in a supervisory position was about 25 weeks compared to about 23
weeks of experience for the worker.
It is true that workers look to their first line supervisors for
augmenting their training but the supervisors are not equipped to do this.
Moreover, the department's training program has afforded little opportunity
for training supervisors. 78% of the workers answering our questionnaire
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estimated that they have received less than five hours training since they
assumed their position. About half of the workers said their supervisors
had been unable to help them with the problems they had encountered on the
job. 70% of the workers we surveyed said they had learned their job in two
ways: making mistakes and secondly, help from more experienced employees.
The department's formal training program had been the least helpful of all.
In short, even properly trained eligibility technicians must be
backed up by much stronger first line supervision. 39. THE COMMITTEE
RECOMMENDS THAT AT LEAST 35% OF THIS YEAR'S TRAINING BUDGET BE DEVOTED TO
INTENSIFIED TRAINING WORK WITH THE GRADE I SUPERVISORS. We believe the most
efficient method of getting the most training to the most employees in the
shortest time is through the first line supervisors. The Committee makes its
recommendation feeling that this important level of supervision has also been
created in a set of very unusual circumstances that have, themselves, not
been recognized in the department's training plans. Grade I Eligibility
Supervisors are employees who, generally speaking, were budget clerks or
clerical supervisors prior to separation but who are in no respect properly
trained for supervisory responsibility. As a consequence, the unit clerks
who are very important to eligibility work are mostly new people. Practically
no formal training has been given to them so far. We consider the clerical
positions as another strategic area for more training that we did not find
incorporated into any of the Training Division's written plans.
Structuring of the training program should reflect to a far
greater extent than it does specialized eligibility problems that are
exposed through validations and fraud referrals. This information is not
being coordinated with training. We are satisfied that enough is known
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about particular weaknesses in the eligibility and budgeting process to
set up correctional, intensified training programs in specific areas now.
As the department looks ahead to upgrading its existing eligi- -
bility staff it should be guided by the knowledge of these special problems.
Present data from validations shows high error rates in Special Need
Determinations and Personal Property Determinations, to mention two examples.
Our survey of eligibility workers asked this question:
j. List in order of their importance the important areas of your actual job
duties that were not covered in the formal training that you have
received.
1.
2.
3.
4.
5.
Answers covered a wide range of training deficiencies. We think we see a
pattern to the responses but after spending some time trying to summarize
them we decided that more understanding could be taken from a broad listing
of the answers themselves. When we show more than one problem in the same
grouping it is for the purpose of showing the proportion of that response
as the workers rank them in importance.
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RESPONSES TO
ELIGIBILITY TECHNICIAN QUESTIONNAIRE
The following question was asked in a questionnaire sent to the eligibility technicians and below we have
listed the response according to how they ranked the area in which they considered it the most important.
"List in order of their importance the important areas of your actual job duties that were not covered in
the formal training that you have received.
1. Budgeting
3. 10-16 Procedure
Documentation
Overpayments
Forms and their uses
Functions re: WIN & other training programs
Time spent doing forms
Special shelter funds
Use of forms
Unit procedures
Food Stamps
Use of forms
Documentation
Client/worker relationship
Food Stamps
Documentation
Budgeting
Budgeting
Budgeting
Posting
Interviewing
Laws & regulations
Handling irate clients and/or landlords
Clearance in categorical aids for Medi-Cal
Budgeting
Priorities not stressed
Knowledge of laws
Overpayments
Budgeting
Documentation
4. Filing systems
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Coping with pressure of mass changes & high workload
Budgeting
Human relations
Home call techniques
Procedure for various tax clearances
Laws & regulations
Overpayments
Documentation
Applicant job priorities
Preparing IBM cards
Budgeting
2. Interviewing
Deadlines re: transfers in & out of county
Documentation
Renewals not covered
What is federally eligible
Clerical procedure
5. Documentation
Special needs
Definition of duties for clerk & worker
Medi-Cal instruction
Placement of forms in case folder
Payroll & computer forms
Explanation of computer systems
Knowledge of laws & regulations
Sources for income clearances
Use of forms
(s.s., V.A., Civil Service)
Use of forms
Self-defense (verbally & physically)
Interviewing
Organization of caseload
Mixed aid households
Renewals
Budgeting
Job requirements re: eligibility VS. service
The options and alternatives in the training proposals presented
to management this year by the Training Division were basically variations
on the length of the training period. The Committee is of the opinion that
the Training Division has no idea of what constitutes an adequate training
period besides the obvious one that a longer-term of training is better
than a short one.
We wondered how the division could formalize a specific term of
training until it has had some experience with conducting an entirely
different training program. An average time period can be set after some
experience but until then we think the only guiding principle should be to
keep the new employee in a training status until able to handle a full
caseload as judged by some objective measures of performance.
The time an employee has to spend in training may vary considerably
depending on the background and aptitude of the trainee as well as the
content and degree of specialization in the training offered.
The last training proposal we reviewed after writing this section
indicates that the department has settled on a three-month training plan.
We noticed, however, that it still retains a full month of initial work in
the classroom and two-fifths of the time thereafter is spent in classroom
training. That would be about 40 working days in the classroom and 26
working days with on-the-job training. Feeling as we do about the value of
classroom training in comparison with on-the-job experience, which this plan
is supposed to emphasize, we still think there is a disproportionate amount
of classroom work. After reviewing the plan we were not persuaded to change
our recommendation for a one-week limitation on classroom study.
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The plan did not speak to the possibility of separating the classes
into special groups arranged around the different aid categories or by intake
or ongoing which we thought might be done as a way of narrowing the scope
and reducing the cost of training. The Task Force does not see the need for
providing the same generalized training to everyone when it is known that
workers will have different assignments in different aid programs.
Without mentioning the specific criteria it would use, the plan we
reviewed did recognize the need to formally evaluate trainees during the
training period. We were pleased to see the idea of an evaluative component
mentioned and suggest that the Training Division can be as specific about
how it will evaluate as it has with some of the other elements of their
training proposal.
After saying all we have about the importance of having a properly
trained corps of eligibility workers the Task Force is compelled to comment
briefly on the downgrading of the eligibility training instructors by the
County Personnel Department. These teaching positions were downgraded on
the reasoning that since separation the eligibility instructors only teach
budgeting procedure and eligibility aspects of welfare whereas before sepa-
ration they also taught social services case work and techniques. By the
same logic it would be appropriate to downgrade the social services instruc-
tor, but some state regulations apparently override local classification
decisions in this area. We are not so sure what is involved in teaching
case work techniques, but after nine months in this agency we are very
positive about what eligibility determination and budget computation is
and why it has to be taught very thoroughly if the county has any hope of
maintaining a fiscally responsible welfare department.
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After reviewing the correspondence between the Personnel Department
and the Welfare Department related to this classification dispute, we think
that the importance of eligibility may have somehow escaped the classification
analysts. There are about six positions involved in this classification con-
sideration. At the most it involves a few hundred dollars a month in salaries.
In contrast the eligibility instructors are instrumental in teaching all
aspects of an eligibility process which controls $130 million of cash aid.
Mixed up in this classification issue, again, is a lot of petty
nonsense about whether an MSW degree is needed, the relative importance of
subject matter taught in eligibility and social services what state regula-
tions require for the position and whether two years of college or four years
are needed. What makes the whole debate seem ludicrous is that, with possibly
one exception, there is not one classification specification in the department
which is acknowledged as accurately reflecting satisfactory job requirements
for any position. Even after our lengthy excursion into the Welfare Department
we cannot confidently suggest what kind of specification we would write for
these six critical teaching positions. All we know is that they should be the
best people the department can find. The Personnel Department spent one and
one-half days in the department to reach their decision on this matter. We
suggest that the County Administrator and the Civil Service Commission who
review this action should be very cautious in accepting the Personnel Analyst's
recommendation.
Our position is that regardless of what the training specialists
taught before separation the subject matter they are teaching now is the heart
of this organization. In comparison to social work techniques it must be
considered as being the more important. Holding a good teaching staff together
-145-
depends, obviously, on many things other than a class specification, such as
selection, discipline, leadership, etc., but to the extent that it is a
factor at all the Task Force believes it would be far safer to take risks
in other question ble areas of classification of which we found many.
40. THE TASK FORCE RECOMMENDS THE RECENT RECLASSIFICATION ORDER BE
RESCINDED AND THE POSITIONS RESTORED TO THEIR FORMER LEVEL IN LIGHT OF
THEIR IMPORTANCE TO THE AGENCY.
-146-
SECTION VI
FRAUD CONTROL
FRAUD CONTROL
The Special Investigations Units that exist somewhere in most
welfare departments are charged with an investigative function as definite
as that of the bunko squad in the local police department. The publicly
held view of the unit's activity, we are sure, is to find and prosecute
fraud in welfare as a means of deterring it. It is the Task Force's
finding that the ability of the Special Investigations Unit to conduct
forceful and efficient investigations is so constrained by philosophy, law,
and procedural restrictions that it absolutely precludes the possibility
of serving as an effective deterrent to fraud either before or after it
occurs. As an investigative body, it is hard to imagine anything similar
in other governmental agencies which run an investigative service to
police their administrative operations.
Our brief review of the Special Investigative Unit forces us
once again to reiterate this general finding: It is futile to try to
control fraud by anything done after it occurs. The incidence of fraud
can be most effectively minimized by reinstating strong initial eligi-
bility investigations, increasing the frequency of client contact to the
greatest extent possible and doing better initial and continuing veri-
fication and documentation of client information. In short, the way
to prevent fraud is by doing the sort of eligibility work we try to
describe in the preceding chapters of this report.
The Special Investigations Unit of the department is charged with
at least two other mandated responsibilities besides investigating alleged
fraud cases for purposes of criminal prosecution. Neither of them has much
to do with the prosecution of fraud. The prosecutions that result from
die 147 -
the investigations are actually byproducts of an investigative process
primarily set up to determine the precise amount of the dollar loss in
fraud or overpayment cases. About half of the 20 member staff, which
is called Special Eligibility Review, is concerned with these accounting
determinations.
It may be evident from the first hour of investigation on a case
that the statute of limitations has expired or because the eligibility
worker did not make a renewal on time that it would be pointless to
press criminal charges or to try effecting a recovery of the loss. Yet,
the investigator is required to complete a whole investigation anyway and
to fix the exact amount of the loss, because this figures into certain
adjustments the state and federal government make in their total grant
contributions to welfare departments.
The second principal reason the cases come to the Special
Eligibility Review is to determine what effects the recipient's action
may have on their current eligibility. In most cases the eligibility
worker makes this determination. The Special Eligibility Review unit only
deals with a very small percentage of the total number of overpayment
cases where probable fraud is indicated. The basic decision to be made
in any overpayment case is whether the recipient's action will sustain
an attempt to recover part of the loss by reduction of the recipient's
grant before the 60-day adjustment period runs out. The law requires
that before any adjustment reduction or termination of the recipient's
grant can be made the recipient must be notified. The recipient can also
appeal any such change, so evidence must be found to support a termina-
- 148 -
tion or a reduction in the recipient's grant. The cases which the Special
Eligibility Review unit receives involve some question about a point of
eligibility which the regular worker cannot respond without some investi-
gation into the case which she cannot do herself.
The table on the following page is our attempt to present the
investigative outcome of the 686 referrals which were handled by the
Special Eligibility Review team and the fraud unit last year.
The 207 cases in Column C of the table are not necessarily cases
in which clients did not do something fraudulent. Most probably they did,
but the case does not warrant further investigation for fraud because
of something else about the condition of the case. In most instances, the
cases were ones in which renewals were long overdue, the statute of limi-
tations had run out, or some technical administrative error was found which
would jeopardize the prosecution of the cases if they were prepared for
court. The Special Eligibility Review investigator returns them to the
worker with a ruling on whether to continue aid or to effect an adjust-
ment in the grant to recover part of the loss.
The 372 cases referred to the six-member fraud detail are the
outgrowth of the investigations performed for these other two purposes
by the six special eligibility review investigators. These are cases
where there appears to be reasonable cause to believe the fraudulent act
was committed and these are then passed over to the fraud detail for more
intensive investigation. At this point, emphasis is switched from deter-
mining the probability of fraud to developing factual evidence to support
a criminal charge.
- 149 -
FLOW CHART ON CASE DISPOSITIONS BY SIU AND DISTRICT ATTORNEY'S OFFICE
(a)
(b)
(c)
(d)
(g)
(h)
SER's
Total
Ret'd
Referral
(e)
(f)
Total
Ret'd
(i)
(k)
(m)
Rec'd
Compl.
to
Fraud
Informal
Formal
to
No
Cit'n
(j)
Dis-
(1)
Dis-
1970
1970
SER
Wkr.
Unit
Referrals
Referrals
DA
Action
Hearing
Acat'd
missed
Conv.
posed
Jan.
65
48
18
30
4
7
11
7
0
0
0
3
10
Feb.
57
55
24
31
11
9
20
3
2
O
O
2
7
Mar.
76
63
19
44
12
9
21
13
0
O
3
9
25
Apr.
55
47
20
27
15
8
23
15
2
0
)
O
15
May
52
44
15
29
12
16
28
8
1
O
O
1
10
June
32
47
16
31
17
3
20
23
1
O
2
O
26
July
65
53
25
28
21
9
30
16
1
O
2
O
19
Aug.
58
42
18
24
17
8
25
7
3
0
1
O
11
Sept.
52
48
15
33
9
11
20
16
4
O
1
8
29
Oct.
32
46
14
32
6
13
19
1
3
O
7
2
7
Nov.
62
38
12
26
21
13
34
17
3
O
0
1
21
Dec.
80
48
11
37
9
15
24
6
3
0
3
5
17
Total
686
579
207
372
154
121
275
132
23
10
13
31
197
150 I
Ave/Mo
57.2
48.3
17.3
31.0
12.8
10.1
22.9
11.0
1.9
0
1.08
2.5
16.4
KEY
(a) Special Eligibility Review (requests for
(d) Cases found to be probably fraudulent
investigation) received primarily from
and referred to the Fraud Investigation
the Eligibility workers.
Section of SIU.
(b) = (c) + (a)
(e) + (f) = (g)
(c) Returned to Worker after investigation
Columns (h) through (m) refer to dispositions
indicates there is insufficient evidence
made by the District Attorney.
to sustain a finding of probable fraud
(i) Citation Hearing
(j) Acquitted
(1) Convicted
Further investigation shakes out another 154 cases shown as
informal referrals turned over to the District Attorney. These are
cases in which sufficient evidence is not secured, the statute of limi-
tations has run out, or some other legal barrier to prosecution is found.
The 121 formal referrals that still remain are given to the District
Attorney with full investigations completed. From the standpoint of the
fraud investigators these are all prosecutable cases and which, as far
as the investigators know, have no legal barrier to prosecution. The
District Attorney reviews these, issues a citation if he feels it is
warranted and assigns the case to one of his trial deputies.
The balance of the table shows the results of both the informal
and formal referrals which the welfare investigators turn over to the
District Attorney. A high percentage of even the formal referrals which
are supposed to have no legal barrier to prosecution expire in the
District Attorney's office due to the statute of limi tations running out
before they are prosecuted.
There are no standards to go by and we have no comparative
data from other counties, but it is the Task Force's judgment the 31 con-
victions are not an impressive record out of 579 cases investigated. It
is true that the 13 cases dismissed and the 23 cases cited in for hearing
have gone far enough to scare the recipient, so there are some intangible
benefits to these proceedings as well. Whether the whole process
justifies the cost is a difficult question to answer.
- 151 -
All this only leads to the question of why the conviction rate
is as low as it is. We have already alluded to the fact that a great
part of the investigative process takes place for the purpose of fixing
the exact amount of loss in each case when it is really irrelevant to
prosecuting fraud. The amount of loss is not even mentioned in the charge
which is issued against the recipient. Its main purpose is in determin-
ing whether the violation is a misdemeanor or a felony. That has not had
much relevance either until lately because of all violations being
limited to misdemeanors. That is still the case in all the adult cate-
gories. A pending change in the law will alter that in AFDC so that
losses of over $200 can be prosecuted as a felony. The statute of limi-
tations will also be lengthened.
It is the opinion of the Task Force that the accounting deter-
mination in fraud investigations is a very uneconomic aspect of SIU's
investigative responsibility. There are no statistics on the size of
individual losses, but we estimate from the general run of overpayments
reported that the losses in 80% of the cases are probably less than $200.
Allowing about three days for the nonfraud aspects of the 579 cases in-
vestigated in 1970, we estimate that investigative costs of SER alone
average something more than $300 per case. Recoveries are probably less
than 10% of the discovered losses. It is hard to justify spending a
lot of time accounting for the losses beyond what is needed to charge and
prosecute for the violation. Even the determination on continuing
eligibility has very little to do with the size of the loss. 41 INSOFAR
AS IT IS NECESSARY TO DO ACCOUNTING INVESTIGATION FOR PURPOSES OF WORKING
- 152 -
OUT ADJUSTMENTS IN STATE AND FEDERAL SUBVENTIONS WE RECOMMEND THAT THE
DEPARTMENT BE ALLOWED TO AVERAGE THE LOSSES IN FRAUD CASES.
One of the primary advantages in reducing the time now spent
on these accounting aspects of the cases is that it will allow the SER
investigators to work their cases on a more current basis. Without at
least two more SER investigators the unit cannot keep abreast of the
incoming referrals. The SER investigators are receiving now about 10
more cases per month than they investigate. Without explaining all the
reasons for it, we are confident that working cases quickly is one of
the critical factors to successful investigation outcomes.
By delaying action on a case for three months, witnesses will
be lost, memories cloud up and even the facts which caused the referral
will change. It also seriously affects the time and effort needed to
accomplish the same kind and quality of investigation. Instead of the
investigator being able to interview three or four prime witnesses, they
may have to interview ten people to find out where the prime witnesses
have gone. The unit has contended with this handicap for a long time.
Yet, when one considers the final outcome of the cases which
are investigated, it seems rather pointless to us to investigate more
cases only to have them returned or bogged down in the final phase of the
prosecution process.
It is the feeling of the Task Force that the decision to prose- -
cute, dismiss or merely warn a charged offender is a rather subjective
trial or legal determination. AFDC mothers cannot be very exciting cases
to prosecute and the family and other heartbreaking human conditions in
- 153 -
most of the cases we reviewed makes anyone wonder how practical it is
to put a mother in jail when three or four children will have to be
placed in foster homes at county expense. Still, we believe these
facets of the case are just as important elements in the decision to
prosecute as the quality of the investigations and the evidence collected.
It is a terrible moral and economic dilemma, but we do think it is
deceptive and improper to set up an expensive investigative process
which implies the intent to carry out a hard brand of justice and
then frustrate it by imposing impossible administrative barriers.
Furthermore, these decisions are ones that can only be made by the trial
attorney, who is in the best position to understand the attitudes of the
courts and weigh the quality of the evidence collected. We accept them
as important subjective judgments but suggest that they can be made at
an earlier stage of the investigation as a way of avoiding the continua-
tion of an investigation in which some overriding factor is going to
make the case unprosecutable regardless of what the investigation sub-
stantiates.
42. ACCORDINGLY, WE RECOMMEND THAT A TRIAL ATTORNEY BE APPOINTED
FROM THE DISTRICT ATTORNEY'S STAFF WHO WILL MEET REGULARLY TO REVIEW CASES
ON WHICH THE FIRST SER PHASE OF THE INVESTIGATION HAS BEEN COMPLETED TO
MAKE A DECISION ON WHETHER THERE ARE FACTORS INVOLVED IN THE CASE WHICH
ARE LIKELY TO INTERFERE WITH A FORMAL PROSECUTION. We believe enough is
known about the case by the time the SER phase of the investigation is
done to make an informal but final judgment on the prospect of success be-
fore it is turned over to the fraud section for the intensive and expensive
- 154 -
investigative workup which is necessary for a court proceeding. No one
person should be completely responsible for making this kind of decision
so we suggest that a review committee be created which will include the
trial attorney, the Assistant Director of Management, SIU and the unit or
section chief in whose caseload the case was found.
Without any qualification, the biggest barrier to conducting
effective or economical investigations are the constraints placed on the
investigators by the general policy and procedures under which they
operate. Actually, the same policy and procedures control the kind of
investigation that can be done for all aspects of intake and ongoing
eligibility. Here is the pertinent regulatory section taken directly
from the State Manual of Policy and Procedures (underlining ours):
.3 Methods of Investigation
.31 The exploration of facts relating to eligibility of the appli-
cant is a joint responsibility of the applicant and the
county. Documents and other forms of information in the appli-
cant's possession or readily available to him are to be con-
sidered before the evaluation is extended to other sources.
To the extent that such evidence appears to be reasonably re-
liable, complete, and consistent, it shall be accepted as
establishing eligibility.
.32 Other sources of information are to be sought only when the
applicant does not have information and other evidence to
support his application, or when such information and evidence
as he is able to give is contradictory or inconclusive. In
such case, the investigation is to be directed toward obtain-
ing the most readily available reliable evidence for deter-
mining eligibility and need.
.33 The applicant or recipient shall to the extent he is able, assume
responsibility for obtaining such additional information and
evidence as is needed in the investigation process. However,
when he is unable to assume this responsibility in full or in
part, the county shall take the initiative in obtaining the in-
formation and evidence.
.34 All such further investigation, including any necessary contacts
with collateral sources, shall be undertaken only with the full
knowledge of, and agreement by, the applicant and only follow-
ing full explanation to the applicant of the information desired,
why it is needed, and how it will be used.
When needed in such further investigation, and as evidence of the
applicant's consent thereto, a specific consent form, signed by the
applicant and, if necessary, by his spouse (by both parents in AFDC
when this is possible) shall be obtained for each such contact. The
consent form should cover the purpose of the specific contact as well
as the individual or agency to be consulted. Form 228, Applicant's
Authorization for Release of Information, may be used for this pur-
pose. A signed consent form is not required when public records
are used.
35. If the applicant is reluctant or unwilling to help resolve incon-
sistencies or questions concerning his eligibility or to have the
county pursue the investigation on his behalf, his reasons are to
be considered carefully with him. Such consideration will help
assure mutual understanding of the facts and why further investi-
gation is needed. If he persists in refusing to resolve incon-
sistencies or to cooperate within his ability in establishing his
own eligibility, the application shall be denied or the grant
terminated.
The reader can make his own judgments, but it is the view of the
Task Force that it is simply not possible to conduct an effective investi-
gative operation under such constraints in a welfare department or anyplace
else.
The idea of having an investigative function inside a welfare
agency has always been an ideological sore point. One of the MSWs in the
department raised some very formal questions about the legality of conduct-
ing fraud investigations in conjunction with the work done in reviewing a
case for questions of current eligibility. The protest the MSW raised is
one of the main reasons for organizing the special investigations unit into
two separate sections As WC explained, one is concerned with considerations
of present eligibility and financial loss and the other section with fraud.
To our minds this organization doesn't make much sense because it causes
a great deal of duplicated effort, but it is perhaps the neatest way
around a technicality surrounding the incompatibility of two different
investigative functions. Ideally. we would think tl at an investigation
- 156 -
would be started and continued to a conclusion by the same investigator as
is done in most law enforcement agencies.
43. THE GENERAL RECOMMENDATION WE MAKE ON INVESTIGATIVE POLICY
IS THAT IT MUST BE CHANGED TO DISTINGUISH BETWEEL WHAT KIND OF INVESTIGATION
CAN BE CONDUCTED AFTER THE PROBABILITY OF FRAUD HAS BEEN ESTABLISHED AND
THE KIND OF INVESTIGATION THAT CAN BE DONE BEFORE THE PROBABILITY OF FRAUD
IS ESTABLISHED.
It is ridiculous to expect cooperation from the client in securing
useful evidence after they know their case is under investigation. It is
about as reasonable as expecting someone to testify against himself. Yet
this is the kind of logic that pervades the whole investigation procedure
written for local welfare departments. Clearly, there are some practical
and legitimate reasons for loosening investigative restrictions after the
probability of fraud is evident.
44. THE TASK FORCE RECOMMENDS AMENDING FINANCIAL CODE SECTION
1917 TO ALLOW BANKS AND LENDING INSTITUTIONS TO RELEASE INFORMATION RELATIVE
TO ASSETS AND ACCOUNTS TO WELFARE INVESTIGATORS AS THEY ARE REQUIRED TO DO
FOR ALL OTHER LAW ENFORCEMENT AGENCIES. Welfare investigators need this
information but are forced to get it through personal contacts in other
police agencies.
The same is true for DMV and CI&I clearances which the welfare
investigator cannot secure directly. The current restrictions are meaning-
less anyway because the welfare investigators process their requests through
informal channels but it is certainly not a practice conducive to efficient
investigations.
- 157 -
Another problem section of the law that must be heavily relied upon
to secure interjurisdictional cooperation in fraud investigations is Section
11478 of the Welfare and Institutions Code. We are sure that it was written
with the intent of requiring all state and local agencies to cooperate in
supplying information to welfare departments in investigating actions for
both absent fathers and fraud. The language is construed by many agencies,
however, to mean that cooperation is only required in collecting contribu-
tions from absent fathers and not in fraud investigations. The fact that
the problem exists only illustrates. we think, how much ideological resist-
ance there still is to fraud investigations inside welfare departments.
45. THE TASK FORCE RECOMMENDS THAT THE LANGUAGE IN SECTION 11478 OF THE
WELFARE AND INSTITUTIONS CODE BE FURTHER CLARIFIED TO REMOVE ANY AMBIGUITY
ABOUT INTERAGENCY COOPERATION IN FRAUD CASES. It doesn't matter to us how
it is done, but the department investigators suggest the section be divided
into two parts with identical requirements applied to both fraud and absent
fathers.
This problem of bureaucratic cooperation was represented to us as
a major obstacle in securing information, which is very often vital to a
fraud investigation. Our cursory review of the State's data bank in the
Central Registry operated by the Department of Justice makes us think that
it does work differently for absent parent enforcement than it does for
fraud. As an example, the coordinator running the Central Registry demon-
strated to us how quickly the Registry can supply information on whether
an applicant is receiving UI benefits. It was done in a matter of minutes.
In contrast, the process the investigators claim they follow in
getting information on unemployment insurance in a fraud investigation
-158-
takes weeks. A request for information about unemployment insurance goes
from SIU, to the Welfare Director, to the State Department of Social Welfare,
and finally to the Director of HRD. If the request is acknowledged, it has
to go back through the same channels. All this bureaucratic runaround is
required to answer a request which could be supplied immediately from the
local unemployment office in Oakland.
The problems related to getting copies of Social Security checks
from the federal government is even worse. The investigator usually knows
that a person is receiving unreported Social Security income, but for the
purposes of preparing trial evidence, photostatic copies of the checks are
needed, and it takes from six to nine months to get them. Our analysis of
486 collectible overpayments in March showed that approximately 20% of the
overpayments had occurred because the recipient had failed to report Social
Security income. There may not be a direct correlation with fraud, but it
does point, we think, to a special problem area which the department is
helpless to do very much about.
If this Welfare Department's problems are representative at all,
the Task Force thinks that there are some very good reasons for facilitating
access for information in Social Security and HRD, particularly. The county
has made a commendable attempt to tie Social Security numbers down in the
initial eligibility process. Social Security numbers have also been cross-
referenced on the computer to other case identification data.
In proportion to the size of the caseloads, we found about as many
overpayments occur in the adult categories as we found in the AFDC. Yet,
the number of fraud referrals from the adult caseloads is very low. For
the month of July, 25 cases were referred from AFDC, 2 from GA, 2 from
-159-
all the adult categories and 2 from food stamps. The other months we looked
at were not significantly different.
In asking why, we find that a felony fraud cannot occur in the
adult categories. All violations are limited to misdemeanors. Even the
recovery of an overpayment has to be processed as a civil procedure rather
than as a criminal action. As a practical matter it seems almost pointless
to try prosecuting fraud in the adult categories. Making a moralistic
distinction for the OAS recipients is quite easy to understand, but in view
of the liberalized qualifications for eligibility in ATD for psychological
impairment we see the law providing immunity to an area that is potentially
very susceptible to abuse.
The Task Force found no valid reasons for supervising the Special
Investigations Unit in the Family Services Division. Our recommendation
on this is contained in the section of the report dealing with the
organization plan.
-160-
SECTION VII
SECURING SUPPORT FROM ABSENT PARENTS
SECURING SUPPORT FROM ABSENT PARENTS
The major public assistance program in California is, of course,
AFDC, in which one of the chief eligibility requirements is a child's
deprivation of at least one parent. Even though both parents are obligated
to support the child under the law, it is usually the male parent who is
the object of child support enforcement activities. Excluding the 15%
of absent fathers in the AFDC caseload who are incapacitated or dead, there
were, as of January, 1971, about 230,000 AFDC-connected fathers who were
absent because of divorce, separation, desertion, imprisonment, or because
they had never married the mother of the AFDC child. 1 With regard to the
illegitimacy factor, 37% of the statewide AFDC-FG caseload in 1969 were
never married to the mother of the AFDC child. 2
Child support payments are significant; there was an estimated
$36,500,000 collected statewide from only 15% of all absent fathers in
1969-70.3
1
In making these descriptive comments, heavy reliance is placed on back-
ground information provided in The Final Report of the Task Force on
Absent Parent Child Support, State of California, State Department of
Social Welfare, January, 1971.
2
Ibid., p.9.
3 Ibid., p.12.
- 161 -
These funds primarily served to offset welfare grants and
resulted in savings in county, state, and federal costs. It should also
be noted that a very narrow margin generally separates welfare from non-
welfare mothers who receive child support payments. Regular receipt of
child support by nonwelfare, working, mothers is often the major factor
in preventing another AFDC case from being opened.
The major state study referred to in footnote (1) made some
interesting observations on characteristics of welfare and nonwelfare
absent fathers, which were in turn based upon about 600 questionnaires
sent to several counties. Included among these observations were the
following:
Both the welfare and nonwelfare absent fathers would
more likely live in the county where their family
resides
The nonwelfare father is more likely to have remarried.
The welfare father is more likely than the nonwelfare
father to still be married to the mother of the
children
With respect to the time lapse since the last payment
of child support, nonwelfare fathers were rather evenly
distributed across the several time categories. Welfare
fathers were more likely to have never made a child
4
support contribution
4
Ibid., pp. 10-11.
- 162 -
Enforcement of child support statutes and regulations is, of
course, a county responsibility. The state's recent study found a wide
variation among counties, not only in organization and procedures, but in
results in terms of percentage of parents contributing, average payments
per contributing parent and absent parent, etc. Since the state so heavily
qualifies its own report on intercounty performance in child support pay-
ments, and our own inquiry brings the state's figures into question, we
cannot present a measure of Alameda's performance in this area as compared
to other counties. However, the findings of the state report, as well as
some of its 40 recommendations, do have considerable relevance to the
county, and it is recommended reading to those interested.
As one example, the fact that only about 15% of the absent
fathers are contributing child support suggests that this is an area where
some dramatic gains might be achieved. For another example, the finding
that most absent fathers still live in the county where the family resides
suggests that better ways need to be found to improve the local enforce-
ment effort. For another item, the fact that 37% of the absent fathers in
the AFDC-FG caseload were never married to the mother of the AFDC child
emphasizes the strong need for quicker, more positive procedures for es-
tablishing paternity as a means of securing child support in these cases.
There are few operations in all county government which are more
complex, contradictory and duplicative than those concerned with securing
child support from absent parents. Three departments are directly in-
volved -- Welfare, the Family Support Division (FSD) of the District
Attorney's Office, and Probation. Also involved, of course, are the
- 163 -
courts, the Board of Supervisors, and the Central Collections Unit of
the Auditor's Office. But the day-to-day responsibility of enforcing
statutes, regulations, or court orders rests with the first three offices.
The major "caseload" of absent parents resides in the Alameda District
Attorney's office, where there are 28,500 absent parent cases, of which
approximately 5,000 are making contributions. There are in addition
700-800 cases involving absent parent contributions which are directly
supervised by the Welfare Department. In addition, there are approximately
400 welfare-connected absent fathers who have violated nonsupport provi-
sions of the Penal Code who are on formal probation and are directly
supervised by the Probation Department.
How do so many agencies get involved? A brief journey through
the procedure may be helpful. It should be noted that the procedure which
we are about to describe is in the process of being changed as a result
of a joint study by Welfare and the District Attorney that was filed with
and accepted by the Board of Supervisors in April, 1971. Let us assume
we are presented with an application for AFDC in which the mother knows
the address of the absent father and he does not deny paternity nor is he
unwilling to support the child. The eligibility worker is then required
to contact the father and establish a support agreement. The contact is
made by a form letter. If there is no answer within a week, a second
letter is sent by certified mail indicating that aid has been requested
for his child(ren) and informing him of his legal responsibilities for
support. He is asked to complete a form, showing his current contribu-
tions, his income, and his expenses. He is also advised that failure to
- 164 -
cooperate involves referral to the District Attorney's office. After 10
more days, the case is referred to the Family Support Division.
If, however, the absent parent is responsive and completes all
forms, and if he lives in town, he is asked to come to the office for inter-
view and to develop a support plan. Here again, he is required to present
verification of expenses and earnings. If the man is out of town, the
process is handled by mail, but in any event he must agree to support based
on a contribution scale. If he refuses to contribute according to scale,
he is also referred to the Family Support Division. (Until April, 1971,
Welfare and FSD operated on the basis of different contribution scales;
the absent father who found his case referred to FSD generally experienced
greater leniency in allowance for expenses than if it had remained a welfare
matter. The Welfare Department and the District Attorney should, however,
be credited with a major breakthrough here, because the Board of Super-
visors, on their joint recommendation, adopted on April 27, 1971 a uniform
contribution scale for child support).
Let us assume, nevertheless, that the absent father has met all
of the Welfare Department's requirements related to his contribution and
has signed the support agreement. At this point he is given the option of
sending support directly to the mother or to the county, although it is
ACWD policy to have the support sent to the county. The father then sends
his support payments to Central Collections who sends duplicate receipts
to the father and the absent parent control desk in the Welfare Department.
The control desk posts a ledger card, and forwards the duplicate receipt to
the caseworker. If a payment becomes delinquent, the control desk also
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notifies the worker. When this happens, the absent father runs the risk
once again of referral to FSD.
Without belaboring the finer points of procedure, Welfare has
been involved in securing absent parent child support until voluntary
compliance was no longer possible, after which the case was referred to
the Family Support Division of the District Attorney's office. In such
cases, if FSD was also unsuccessful in obtaining support, the father was
(if he could be found) brought into court on a complaint charging viola-
tion of Penal Code Section 270, as a result of which he may have been
placed on formal probation which then involved the Probation Department.
The procedure we have reviewed here is - as we write this - in
the process of substantial revision. We have discussed the old procedures
in order to explain the significance of the revisions that have been
adopted by the Board of Supervisors on joint recommendation of Welfare and
the District Attorney. We discuss the revisions here because they may
have some application in other counties, and also because in light of some
of the admittedly harsh judgments elsewhere in this report, the depart-
ment and the county deserve explicit acknowledgement for specific improve-
ments that have been undertaken.
In addition to the change already mentioned regarding a uniform
schedule of payments, the county has adopted the following revisions in
absent parent child support procedures:
1. Each AFDC application involving an absent parent
will be referred immediately to Family Support
Division. This is being supported at the state
level with appropriate changes in the Welfare
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