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Thursday, Jul 24, 2014

Five questions for DCF’s Mike Carroll


T ­— Mike Carroll, the new interim secretary of the Florida Department of Children and Families, is a 21-year veteran of the agency — most recently as managing director of its 11-county Suncoast region, which stretches from Pasco to Collier counties and is headquartered in Tampa.

Gov. Rick Scott tapped Carroll to head the embattled agency last week, just as lawmakers were putting the finishing touches on new legislation and funding that the interim secretary will be charged with kick-starting. Carroll will replace Esther Jacobo, who has served as interim secretary since July.

Carroll, 52, has overseen programs dealing with substance abuse, mental health, family safety and adult protective services. He played a lead role in Florida’s move to community-based care and the redesign of the ACCESS system, which administers food assistance. More recently, he’s been involved with the transition to the “managing entity” concept in substance-abuse and mental-health treatment.

The News Service of Florida asked Carroll these five questions:

Q: You’re coming in at a challenging time for the child welfare system. How do the pending legislation and funding — whatever the final versions — affect that?

CARROLL: I think you’re right in that we have challenging times, but those challenging times also bring opportunity. And I’m actually hopeful that at the end of this legislative session, we’re going to have additional resources, and those additional resources are going to bring us to case levels that we can begin to implement some of the changes that we want to make in terms of case practice. And they’ll have a much better chance, I think, of being effective and successful because of the infusion of the resources. So I’m actually hopeful ... and we’ll see what happens.

Q: What will be your priorities as secretary?

CARROLL: We have got to do better within our agency at keeping kids safe, and I think under Secretary Jacobo we’ve started some of those initiatives, and I would like to continue them. I’m also hopeful that what’s going to come out of this legislative session, including the additional resources that will be in play, that will help us to reduce caseloads, that it’s going to make it more possible for us to do better work.

But I do think that in the short term, we need to focus on those families we’re working with right now. And we need to be particularly diligent around families that have children that are 3 years and younger. And in these families, particularly if they have a multitude of complex problems with substance abuse, domestic violence, behavioral health, we have to be very careful in our decision-making, and before we make decisions, have adequate information to make those decisions.

So the implementation of the new methodology, where we’re moving away from incident-driven investigations to a more thorough investigation of the family — I like to equate it to going away from snapshots to looking at the motion picture of the family. If we can actually get that motion picture look at the family, we have more information that we can make better decisions and hopefully get better outcomes for the kids and families we serve.

In the short term, until we get there — because it’s a big cultural change for us that’s going to include hiring additional staff, it’s going to include changing the way we do training, which we’ve already done much of that, but we have more to do — and it’s going to include on-the-job reinforcement all along the way, because I never believed that preservice training prepared anyone to do anything. It simply dips them in chocolate, but then I’ve got a hollow milk chocolate, right? So I believe that you only get real good decision-making when it’s constantly reinforced on the job. And we have to continue to do that.

Some of that technical assistance comes from outside agencies like Casey (Family Programs) and other groups that we’re working with. Some of it will come internally.

One of the things that we’ve implemented most recently is what we call the rapid-safety feedback approach. And it’s specifically designed to take our quality management — which used to focus on closed cases — and it was really a retrospective look at how we were doing on cases.

And we’ve moved that up into cases where we now want to look at cases specifically that meet the profile in those cases that when things go wrong, the outcomes can be the most severe. And those are with kids under 3, younger parents, substance abuse, domestic violence, behavioral health issues … that we can bring in some expert folks that are outside the normal chain of command that can review that case right at the critical juncture that decisions are being made, and to give us really a second look to make sure that our decisions are sound and that they’re supported by the information we have in the case.

In the short term, I think that is going to help us keep kids safer, particularly in those cases.

And in the longer term, it’s all about our staff. We’re a people-helping-people business.

Our most important resource are the folks that do the job, and we have to make sure that they’re trained and supported, that their caseloads are at a level that they can actually be successful.

Q: So it seems this is a time for a fresh start. Any thoughts about what that should include?

CARROLL: There will be a lot of continuity in this transition, because I am very much aligned to the things that Secretary Jacobo was trying to accomplish. We were colleagues before she became secretary. I thought she did a masterful job in her 10 months in a very challenging time.

So we’re going to continue a lot of that. I can tell you that I do advocate for more transparency within our agency, within CBCs, within our systems of care. I think if we’re going to say that we want community-based care, then let the community in. Good, bad or indifferent, the community has to be let in and has to see.

And I think we’ve begun that process. I think the Legislature’s asked for that, kind of demanded it. I embrace it. And so I think moving forward, we’re going to deal with some of these struggles. It’s going to be a very transparent struggle as we work through this, but in the end, I think that’s going to be a better thing, because I think that community by community, they can make a difference in their communities.

I think it’s imperative with them to partner, not just with us but with our CBCs, with our managing entities who provide the substance abuse and mental health services — and really come up with a plan locally to make sure their system of care is addressing all the needs of their children.

Secretary Jacobo implemented a needs assessment, which we’re currently in the middle of. I think that that’s going to roll out community by community. And so I think before the next legislative session, communities will be in a much better place to definitely say what services are present and where they have gaps in services and what that impact is.

So I think we’re on the right road. It’s going to be a hard road, but I think we’re on the right road. I think it will be very transparent — and hopefully it will be characterized by a very strong partnership with all the players. DCF cannot be successful by ourselves. We need our partners; our partners need us. And so I would hope that as we move forward, we can do it together, and in a way that benefits our kids and families in each of these communities we work.

Q: Gov. Scott initially recommended funding for 400 new child-protective investigators, but critics said they’d generate so many new cases that the demand for services would be overwhelming. But now, as the budget stands, there are funds for 191 new CPIs and more services, such as substance-abuse and mental-health treatment and case management. Is that a more balanced use of funds?

CARROLL: There’s always going to be a need for services. I think the argument that if you hire 400 CPIs, there’s this assumption that that means we’ll be looking at additional cases. These 400 CPIs will be looking at the same volume of cases that we’re looking at now; it just will be spread among CPIs differently. We don’t know what the impact of that will be. If we make better decisions, we may see more kids brought into services, and I suspect that will be true. But there’s a big difference between having lower caseloads and higher removal rates, or higher services rates — we’ll wait and see.

My wish is that as you bring these caseloads down, we have better decisions, so that the services, whatever action we take in a case, is really suitable for that particular family, so that we get better outcomes.

Nobody’s going to argue that we (don’t) need services at the end, but right now we are really bleeding in terms of CPI, and I was very thankful for the governor’s budget proposal to kind of stem the bleeding and get us the resources that we need to effectively do the investigative work.

Q: Talk about the murder in 1998 of 6-year-old Kayla McKean, which hit you hard.

CARROLL: From a personal perspective, I’ve got to tell you that when I’ve read child-death cases before, what I was looking at (them) for was from a systems perspective: What did we do right, what did we do wrong?

But I adopted a child through the agency, through the child-welfare system, and that child is now 17. And I can’t look at these cases any longer without looking at it through the lens of him — because there, but for the grace of God, goes my child. And I can’t imagine it.

So when I look at that particular case, I had an emotional response to that case, and I have emotional responses to the cases now.

We in the department are real people, and when I read some of the stuff that is done to some of these children, it absolutely appalls me.

So, yeah, Kayla McKean was the first one that really struck a chord with me because of the brutality of it. But there are many, many cases that we have looked at over time.

I guess the ones that I have the most regret — because one of the things I always ask when we get bad outcomes for a family is (to) look at our involvement and intervention in it, and try and figure out if we had done things differently, would we have come out with a different outcome? And in those cases, where you can definitely say, “Oh, my, in this case we might have had a different outcome had we done things differently,” those are the most difficult, I think, to swallow, because we’re in this work to protect kids.

So, yeah, I think (Kayla McKean) would be the first one, but there have been many through time.

The News Service of Florida and WLRN radio jointly interviewed Mike Carroll.