In Part 1 of this blog post, the concept of child welfare case workers as Outcome Managers was put forth. It’s not an entirely new concept. Some states and jurisdictions that have moved toward privatized child welfare services are acknowledging and some even embracing this role for their public agency case managers. I would go a step further and say that most, if not all, public agency child welfare workers should be trained as Outcome Managers.
If you are wondering what the difference is between a case manager and an outcome manager, it might be helpful to provide an illustration of the context to my thinking behind this. Many years ago, as a foster care worker, I was sitting at the desk of an adoption case worker discussing a child whose case was about to be transferred to the adoption unit. The adoption worker was attempting to gain my support of her plan to have the child spend 9-12 months with a pre-adoptive family before moving towards finalization. Her rationale was a belief that moving quickly to finalize an adoption tended to result in placement disruption. (Mind you, this was pre-ASFA, when children in the foster care system often languished in care. However, Iowa, where I worked, was ‘ahead of the game’ in this regard and was implementing policies to limit time in foster care and speed up permanency efforts.) Essentially, what I was hearing was a mix of ‘push-back’ on the movement by the state towards reducing time in care and some personal experience with a few isolated cases in a medium-sized county. This was not based on best practices research or evaluation or even a review of data on placements across the state. In retrospect, I believe she was thinking like a social worker rather than an outcome manager. She was trying to ‘get in there and help children’ and manage the ‘case’, without benefit of research, outcome data, or other information to guide decision-making beyond her personal experiences. She wanted to ensure that there was not undue stress placed on a child by moving quickly towards a final disposition. Don’t get me wrong, my intent is not to be critical. It was the way the world turned at that point in child welfare history. And the person seated across from me was an experienced, caring, and professional adoption worker.
As a social worker, my colleague was focused on quality of life and what she perceived as the best way to achieve that — a lengthy adjustment period for child and family. As a case worker/manager, she was focused on obtaining the services necessary to achieve that quality of life. As an outcome manager, the focus would have been based on an analysis of outcome research and then managing service provision to ensure that the child and family achieved the positive outcome of timely permanence with a stable, secure family. In order to be a successful outcome manager, one needs to keep abreast of research on outcomes and be capable of successfully negotiating for the services and supports necessary to achieve positive outcomes. Purchasing services from a smorgasbord of choices or monitoring service provision and billing is not sufficient to achieve positive outcomes. This requires: a) knowing what current research says the most desirable outcomes, and b) an ability to work effectively with providers to achieve these outcomes.
While this social worker mindset may have been effective in the past, one look at outcomes in child welfare suggests that it is no longer working. For my alternative, continue on to Professional Outcome Managers, Part 3.
(I tried, I really did, to do this in two blog posts but I just couldn’t pull it off. So in the interest of length, I am opting for a Part 3. My apologies but it is that big of an issue in child welfare, IMHO.)