Administrative Burden Associated with Service Referral in Child Welfare Contexts: Drivers and Implications

• In Event: Administrative Burdens and Effectiveness of the Social Safety Net

Abstract

Introduction / Background:
This study examines the implementation of an online referral application (“referral tool”) designed to facilitate caseworker referrals of child welfare–involved families to evidence-based interventions intended to reduce risk of abuse and neglect (EBIs). The tool was a key component of statewide efforts to support implementation of the Family First Prevention Services Act (FFPSA) and to streamline referral processes within a centralized child welfare information system.
Purpose / Research Questions:
The study assessed (1) utilization of the referral tool over time, (2) case and caseworker factors associated with its use, (3) barriers to utilization, and (4) strategies to improve utilization rates. Increasing referral tool utilization serves two purposes: expanding access to FFPSA services and facilitation of rigorous quasi-experimental evaluations aligned with Prevention Services Clearinghouse standards.
Data:
Data sources included administrative records from the state child welfare agency reflecting EBI eligibility, case and caseworker characteristics, and initiation and submission of referrals. In addition, a REDCap system was employed to track EBI service use. Qualitative data included observations of caseworker administrative burden implied by the referral tool’s structure and documentation of Implementation Support Specialist (ISS) interactions with referral tool users over time.
Research Design and Methods:
This correlational study required extensive data cleaning to identify eligible cases, referral initiation, and service use. Analyses were conducted separately for three EBIs. For each, bivariate analyses examined factors associated with initiation of a referral within the child welfare information system among treated cases. Qualitative analyses focused on workflow complexity as well as systematic exploration of ISS-informed strategies to improve child welfare caseworker training, efforts to improve user experience, and additional strategies to address referral tool use-related challenges.
Results / Findings:
Across EBIs, half or fewer of treated cases were referred using the referral tool. Remaining cases were likely referred via a discontinued paper-based process, suggesting that caseworkers rely on street-level bureaucracy in response to administrative burden. Review of the tool’s two-part, 32-step workflow, along with ISS observations, supports this interpretation. Low utilization was consistent statewide across geographic locations and agencies.  ISS teams implemented multiple strategies in response to these concerns to address barriers and create alternative pathways to facilitate referrals.
Conclusions / Implications:
Findings suggest that caseworkers are committed to connecting families to services that they need but face significant administrative barriers in doing so. ISS teams have responded through targeted training, user support, and development of alternative referral mechanisms. However, these efforts require substantial ongoing resources. Limited use of the tool also constrains evaluation efforts, particularly the identification of an intent-to-treat group. Finally, challenges with referral procedures likely impact uptake of services, leading to impacts at the child and family level as well as the administrative level. Implications include the need to prioritize user-centered design in referral systems, reduce caseworker administrative burden, support the process of adoption of new applications through training and support, and consider evaluation impacts when administrative tools are inconsistently used across service settings.

Author

• Christina M Bruhn, Aurora University
  Presenting Author