Audit of the Office of the Child Advocate Overview of Audited Entity

This section describes the makeup and responsibilities of the Office of the Child Advocate.

Overview

The Office of the Child Advocate (OCA) was established by Section 2 of Chapter 18C of the Massachusetts General Laws, which states,

There shall be an office of the child advocate which shall be independent of any supervision or control by any executive agency. The office shall:

     (a)  ensure that children involved with an executive agency, in particular, children served by the child welfare or juvenile justice systems, receive timely, safe and effective services;

     (b)  ensure that children placed in the care of the commonwealth or receiving services under the supervision of an executive agency in any public or private facility shall receive humane and dignified treatment at all times, with full respect for the child’s personal dignity, right to privacy, and right to a free and appropriate education in accordance with state and federal law;

     (c)  examine, on a system-wide basis, the care and services that executive agencies provide children;

     (d)  advise the public and those at the highest levels of state government about how the commonwealth may improve its services to and for children and their families; and

     (e)  impose temporary cost share agreements . . . to ensure children’s timely access to services.

The office shall act to investigate and ensure that the highest quality of services and supports are provided to safeguard the health, safety and well-being of all children receiving services. The office shall examine systemic issues related to the provision of services to children and provide recommendations to improve the quality of those services in order to give each child the opportunity to live a full and productive life.

OCA partnered with the Executive Office of Health and Human Services (EOHHS), the University of Massachusetts (UMass) Chan Medical School, and the UMass Boston Behavioral Health Integrated Resources for Children (BIRCh) Project to launch and implement various programs to improve the quality of state services for children.

According to OCA’s latest organization chart, as of April 1, 2022, OCA had 15 employees: the child advocate (director), four unit directors, two managers, one senior staff member, and seven additional staff members. OCA also has an Advisory Council, which has 23 members, including secretaries and commissioners from various child-serving state agencies; the chief justices of the Juvenile Court, the Probate and Family Court, and the Superior Court; and one member appointed by the Governor.

Communicating with the Public and State Agencies

According to its internal control plan, OCA mainly communicates with the public by publishing annual reports. OCA and OCA-led commissions also publish various special project reports (covering topics such as the Massachusetts Juvenile Justice System and childhood trauma) and investigative reports (covering individual cases regarding children receiving state services) on its website. In addition to these publications, OCA hosts a public Advisory Council meeting every fall to update OCA Advisory Council members on its work.

Cost Share Agreements and the Unified Planning Team

Under Section 2(e) of Chapter 18C of the General Laws, OCA can create temporary cost share agreements as necessary. OCA establishes these cost share agreements, if necessary, following a review from the unified planning team (UPT). This UPT is an interagency review team, established by Section 16R of Chapter 6A of the General Laws.¹ The UPT consists of representatives from EOHHS, the Department of Early Education and Care, and the Department of Elementary and Secondary Education. The UPT reviews complex cases² and determines whether existing state services that the child is receiving are appropriate and adequate to meet the child’s needs and whether additional state services are necessary. If the child needs additional state services, the UPT determines which state and/or local education agencies³ should provide and pay for those services.

According to Section 17.04 of Title 101 of the Code of Massachusetts Regulations, the referral process begins with any of the following parties submitting a referral form that is developed by EOHHS to the UPT:

• a state agency, such as the Department of Children and Families or the Department of Mental Health;
• a justice of a court that oversees civil and criminal affairs regarding children;
• the child; or
• the child’s parent or legal guardian.

After the UPT receives the referral form and meets with the relevant parties, the UPT has 30 days to determine which state agency services are appropriate and available to meet the child’s needs, recommend which state agencies should provide those services, and how such services will be coordinated.

If the UPT is unable to reach a consensus within 30 days, then the UPT refers the case to the regional directors, if any, or to alternative staff members who represent their respective state agencies on the UPT. These regional directors or alternative staff members meet within 10 business days of the referral and issue their decision within 3 business days thereafter.

If the regional directors or alternative staff members are unable to reach a consensus, and the disagreement involves matters solely within the purview of EOHHS, then the UPT must notify the Secretary of EOHHS, who will then make a decision within 30 days of UPT’s notice.

During the audit period, the UPT had 14 days from the day it decided that a child was eligible for additional state services to agree on which state and/or local education agencies should pay for those services. If the UPT could not reach an agreement in this time, it was required to notify OCA. OCA’s director then imposed a temporary, binding cost share agreement on those state and/or local education agencies, so the child could access those services. OCA’s temporary cost share agreement stayed in place until the UPT implemented a permanent cost share agreement or the child was no longer eligible for these services, whichever happened first.

Enacted Budget Responsibilities

OCA is responsible for fulfilling its enacted budgetary responsibilities, approved by the Governor, according to a yearly General Appropriations Act (see Appendix A). OCA partnered with EOHHS, UMass Chan Medical School, and the UMass Boston BIRCh Project to launch the following four major projects during the audit period: the Worcester Trauma and Resilience Collaborative (WTRC), the Center on Child Wellbeing and Trauma (CCWT), the Transition Age Youth (TAY) housing pilot program, and Trainings for Paraprofessionals and Mentors.

WTRC

Partnering with the Commonwealth Medicine Division of UMass Chan Medical School, OCA established the WTRC pilot program in fiscal year 2020. The pilot program provided training for early childhood educators in Worcester regarding techniques for recognizing childhood trauma and racial inequity. In fiscal year 2021, OCA expanded the program by making training materials on racial equity and childhood trauma accessible to Worcester Public Schools through a learning management system.

CCWT

OCA partnered with the Commonwealth Medicine Division of UMass Chan Medical School to launch CCWT in October 2021. CCWT aims to educate child-serving organizations and professionals across Massachusetts (such as those working at child-serving state agencies, contracted service providers, and Massachusetts public schools) to recognize and respond to childhood trauma by offering training, technical assistance, and professional learning opportunities. Despite its name, CCWT does not have a physical location, but it does have a website that offers training materials, online courses, and self-assessment questionnaires on how to recognize childhood trauma and support children experiencing trauma.

TAY Housing Pilot Program

In fiscal year 2021, OCA contracted with EOHHS and UMass Chan Medical School to launch a TAY housing pilot program in Worcester County, Springfield, and Holyoke. The pilot program went statewide in fiscal year 2022 and provided housing and employment opportunities for young people (ages 18 through 21 years) who opted out of the Department of Children and Families’ foster care program after they turned 18 and were at risk for homelessness.

Trainings for Paraprofessionals and Mentors

In fiscal years 2021 and 2022, OCA partnered with the UMass Boston BIRCh Project to develop a 10-module training curriculum for paraprofessional and mentor workforces with the goal of improving social, emotional, and behavioral services for children across multiple settings. This was part of a larger OCA effort to improve the cross-agency coordination of early childhood and school-aged student wellness efforts to address barriers to student academic success, health, and safety. 

1.    On November 8, 2022, the language in Section 16R of Chapter 6A of the General Laws was amended to require an OCA representative as a UPT member. However, for this audit, we are exclusively referring to the language in Section 16R of Chapter 6A of the General Laws that was effective on August 9, 2018, which did not require an OCA representative on the UPT.

2.    Under Section 17.03 of Title 101 of the Code of Massachusetts Regulations, a complex case is defined as “a circumstance in which a child is involved with at least three state agencies.”

3.    According to UPT annual reports submitted to OCA by the UPT director of EOHHS, for fiscal years 2020 and 2021, some state agencies involved in the UPT case review included the Department of Children and Families, the Department of Mental Health, the Department of Developmental Services, the Department of Youth Services, and MassHealth. 

Date published:	October 7, 2024