Audit  Audit of the Department of Children and Families

Finding 1

DCF does not effectively identify and investigate all occurrences of serious bodily injury to children in its care.

Recommendation

DCF should establish policies and procedures that require its staff to routinely monitor data from the Medicaid Management Information System in order to ensure that it can identify, and investigate as necessary, medical occurrences that appear to be critical incidents involving children in its care.

Finding 2

DCF does not report all critical incidents affecting children in its care to the Office of the Child Advocate (OCA).

Recommendations

1. DCF should establish a single consistent standard for defining and reporting critical incidents that matches the General Laws.
2. Based on this standard, DCF should develop policies, procedures, controls, and monitoring activities that allow for adequate oversight of the reporting of critical incidents.

Finding 3

DCF does not report incidents of abuse, neglect, and/or sexual abuse of children in its care to district attorneys’ (DAs’) offices for investigation whenever it is required to do so.

Recommendations

1. DCF should update its policies and procedures to include clear and consistent criteria and reporting standards and should establish monitoring activities over all parties to ensure compliance with these standards.
2. DCF should establish monitoring controls to ensure that its staff complies with its policies and procedures for reporting critical incidents to DAs’ offices.
3. DCF should schedule regular meetings with DAs’ offices to ensure that the incidents it reports are applicable and that the DAs do not need additional information to help with their investigations.

Finding 4

DCF does not complete its fatality investigation reports and submit them to OCA within the established timeframe.

Recommendation

DCF should take the measures necessary to ensure that all fatality review reports are completed and submitted to OCA within the established timeframe. Specifically, DCF should evaluate its current processes, identify opportunities to make them more efficient and less complicated, and update its policies to reflect these changes.

CMR

Code of Massachusetts Regulations

DA

district attorney

DCF

Department of Children and Families

MMIS

Medicaid Management Information System

OCA

Office of the Child Advocate

OSA

Office of the State Auditor