REPORT HIGHLIGHTS THE DEPARTMENT OF CHILDREN AND FAMILY SERVICES CHILD SAFETY AND WELL-BEING PURSUANT TO PUBLIC ACT 101-0237 (TA’NAJA’S LAW) PERFORMANCE AUDIT Release Date: May 12, 2022 State of Illinois, Office of the Auditor General FRANK J. MAUTINO, AUDITOR GENERAL To obtain a copy of the Report contact: Office of the Auditor General, Iles Park Plaza, 740 E. Ash Street, Springfield, IL 62703 (217) 782-6046 or TTY (888) 261-2887 This Report Digest and Full Report are also available on the worldwide web at www.auditor.illinois.gov REPORT HIGHLIGHTS Background: Public Act 101-0237(Act) was enacted on August 9, 2019, and it amends both the Children and Family Services Act (20 ILCS 505) and the Abused and Neglected Child Reporting Act (325ILCS 5). The Act also directs the Auditor General to conduct a performance audit one year after the effective date of January 1, 2020. The audit is to determine if the Department of Children and Family Services (DCFS) is meeting the requirements of the Act. Within two years of the audit’s release, the Auditor General is to conduct a follow-up performance audit in order to determine if DCFS has implemented the recommendations within the initial performance audit. On May 5, 2021, House Resolution 165 was passed which renamed Public Act 101-0237 to “Ta’Naja’s Law,” after Ta’Naja Barnes. Ta’Naja was a two- year-old child who died on February 11, 2019, approximately six months after custody was remanded to her mother. Based on preliminary autopsy findings, her death was due to dehydration, malnourishment, physical neglect, and cold exposure. Ta’Naja Barnes’ mother and her mother’s boyfriend have subsequently been convicted of murder for her death. Key Findings: • Home Safety Checklists are home safety assessments and educational tools that assist in promoting the safety of children. A Home Safety Checklist is to be completed by DCFS whenever it is determined by a court that a child that has been court ordered into foster or substitute care can return to the custody of the parent or guardian. DCFS was unable to provide 192 of the 195 (98%) required Home Safety Checklists within our sample. Additionally, according to DCFS’ website, Home Safety Checklists had still not been updated with required new language as of March 16, 2022. • Aftercare services are to be provided to the child and child’s family by DCFS or a purchase of service agency, and shall begin on the date upon which the child is returned to the custody or guardianship of the parent or guardian. However, DCFS did not ensure that children and families were receiving the recommended aftercare services for the required six months upon family reunification. Of the 50 cases tested, 29 (58%) did not have at least six months of documented aftercare services, according to information within DCFS’ system of record. In addition, aftercare services procedures were not updated to reflect the new requirements within Public Act 101-0237 until December 28, 2020, almost an entire year after the effective date of the Act. • Children in DCFS’ care are not receiving their well-child visits/ check-ups as required by the federal Centers for Medicare and Medicaid Services, the Department of Public Health’s administrative rules, the Department of Healthcare and Family Services handbook for providers, and the American Academy of Pediatrics guidelines, as well as DCFS’ own procedures. Of the 50 cases tested within each category, 9 (18%) were missing at least one physical examination, 7 (14%) were missing at least one vision screening, 28 (56%) were missing at least one hearing screening, and 44 (88%) were missing at least one dental exam, according to data within DCFS’ system of record. There were also numerous data entry errors and inconsistent data entry locations for dates when services were received. • Auditors attempted to review 50 cases to ensure that children were up to date on their age-appropriate immunizations. However, after reviewing 10 cases, it was determined that the immunizations data within DCFS’ system of record was unreliable for testing. DCFS was able to provide hard copy medical records showing that only nine influenza vaccinations were actually missing. • The system of record for DCFS, the Statewide Automated Child Welfare Information System (SACWIS), is unable to track or identify child welfare service referrals and child protective investigations that are initiated as a result of the new requirements pursuant to Public Act 101-0237. Because DCFS was unable to provide a population, auditors were unable to test for compliance with the Public Act. • When reviewing the organizational chart data provided by DCFS, auditors determined that 3,291 (55%) of the 6,037 positions listed within DCFS’ Operations divisions are categorized as unfunded. Of the 2,746 positions that are categorized as funded, 573 (21%) are vacant. Key Recommendations: The audit report contains eight recommendations directed to DCFS including: • The Department of Children and Family Services should complete Home Safety Checklists as required by 20 ILCS505/7.8(c) and DCFS Administrative Procedure Number 25. In addition, the Department should include language in the Home Safety Checklists certifying that there are no environmental barriers or hazards to prevent returning the child home, as required by 20ILCS 505/7.8(c). • The Department of Children and Family Services should ensure that aftercare services are being provided to children and/or their families for at least six months after the last child is returned home, as required by 20 ILCS 505/7.8(d) and DCFS Procedure 315.250. • The Department of Children and Family Services should ensure that all children in care receive their well- child visits/check-ups, including physical examinations, vision and hearing screenings, and dental exams, as required by: — DCFS Procedures 302.360(e) through (g); — Sections II, IV.B.c, and IV.B.d of the EPSDT guide; — 77 Ill. Adm. Code 675.110; — 77 Ill. Adm. Code 685.110; — DHFS Healthy Kids Provider Handbook, HK-203.7.1; — DHFS Healthy Kids Provider Handbook, HK-203.7.2; and — The guidelines from the American Academy of Pediatrics. • The Department of Children and Family Services should ensure that immunization data entered into the system of record (SACWIS) is both valid and reliable. • The Department of Children and Family Services should develop a mechanism in SACWIS that allows the tracking of child welfare service referrals and child protective services investigations that are the result of a call from a mandated reporter that involves a prior indicated finding of abuse or neglect, or an open services case, per Public Act 101-0237. • The Department of Children and Family Services should review the unfunded positions within its organizational chart data and update the organizational charts accordingly in order to more accurately reflect staffing needs. If DCFS determines that there are unfunded positions that are necessary to fulfill its mission, funding should be sought for those positions. This performance audit was conducted by the staff of the Office of the Auditor General.