Document imaging is a solution that many are using to reduce the child welfare paperwork burden and to preserve a history of key documents and signatures for audit purposes. Child welfare practice has been and continues in many ways to be an inherently paper intensive process. All States, even those with SACWIS systems find case workers often having to handle paperwork and photos from courts, schools, and medical facilities among others.
The paper record often contains items that must be shared with other units or preserved as a history available to reviewers. These documents must be preserved in a paper case record as a supplement to whatever electronic system is in place. Sometimes the paper trail grows because there is no electronic interface in place; other times the need to preserve original signatures is the critical factor. A viable alternative may be at hand.
What is Document Imaging?
Simply put, document imaging is the conversion of paper documents into electronic images on a computer. The technology has been around for a number of years, with many computer users being exposed to it through affordable home digital imaging and publishing products. The basic elements of a document imaging system are the following:
- capture—utilizes a scanner to bring paper documents into the system or a conversion routine to handle electronic documents;
- storage—may take place onsite or offsite using a variety of media (e.g., computer hard drives, CDs, DVDs, etc.) to meet your needs;
- indexing—a system to organize documents which may mirror the Windows folder/file structure or may utilize categories/keywords/full-text options;
- retrieval—a fast and reliable method of finding the desired document; and
- access and security—planning around who may access which information and how they may do so.
Storage and access and security will likely be a function of the system architecture already in place for your child welfare information system. Document capture options will be decided based on the amount and type of information you are collecting, while indexing and retrieval will be accomplished through the selection of software products with capabilities to meet the needs of your organization.
The District of Columbia’s Solution
The District of Columbia’s Child and Family Services Agency (CFSA) handles cases that result in about 1,000 court hearings per month. Approximately 95% of those hearings result in court orders that become part of the official case record. Case workers attending the hearings would generally get a copy of the orders before they leave the courthouse and those workers were then responsible for entering the order into the DC SACWIS (Statewide Automated Child Welfare Information System), called FACES. After entering the data into FACES, workers had to keep the original signed copies in their files for use by groups such as service coordinators, quality improvement staff, and eligibility workers.
This original system had some limitations. Sometimes the workers would not get their copies at the time of the hearing, sometimes the originals would get lost, and sometimes the data would not be entered into the system or would be entered late. These problems were compounded when the courts began to experiment with longer forms for their court orders and with using more narrative and fewer check boxes. There was no longer a uniform template that could be used to easily record information in FACES.
When DC child welfare administrators began to try to calculate the potential negative impact that this process was having on their work, particularly on the process of reliably claiming Title IV-E reimbursement, they decided that the process had to change. The team considered several options. The simplest option was to photocopy orders and mail them to the interested parties. That option was still fraught with potential for documents to get lost or misplaced. Another option considered was faxing the orders to all interested parties. Again, there was no way to ensure that the documents would get to the right persons and that they would not be lost after being faxed. Finally, they hit upon the document imaging solution. Document imaging had the virtue of being able to put the documents into FACES, signature and all, which could be stored for audit purposes and would be accessible to all who needed them.
As implemented in January of 2003, CFSA’s solution is simple, yet effective. The courts agreed to give a space to a child welfare Court Liaison, who receives all original court orders. The Liaison enters a few basic pieces of information into FACES about the order and whether it applies to one client or several and then scans it into the system, where it is stored in an “Electronic Filecabinet.” The original document is then sent via internal mail to the responsible case worker. The major pluses to the solution were cost, less than $1,000 for the scanner and software, and accessibility. Now all interested parties with proper security profile have a copy of the signed orders at their fingertips. The only issue encountered was the decision on storage processes since the scanned images can fill a hard drive fairly quickly unless dedicated space is allocated to the documents.
Indeed, the experiment with document imaging has been so successful thus far that FACES management is considering adding the ability to scan other types of documents such as school and medical records. If you are interested in further information on the District of Columbia’s document imaging solution, please contact Anthea Seymour at (202) 727-3015.
We hope that the Tips, Tools, and Trends series will serve to stimulate an exchange of ideas and information among States and between systems and program staff. Your feedback is important to us. If you have additional information on the topic presented in this sheet, or if you have any comments or suggestions regarding its presentation or content, please contact Tom Wetterhan of Xtria, formerly Ellsworth Associates Inc., at (703) 821-3090 x250 or firstname.lastname@example.org.