CARAS: A School-Based, Case Management System for At-Risk Students
by EDUARDO J. ARMIJO, Evaluation Coordinator JOSEPH J. STOWITSCHEK, Research Professor ALBERT J. SMITH, C-STARS Director COLENE M. McKEE, Scientific Programmer KAREN J. SOLHEIM, Research Consultant and RICHARD D. PHILLIPS, Research Consultant Center for the Study and Teaching of At-Risk Students (C-STARS) University of Washington Seattle, Wash. Technological applications in education often fail to keep pace with the changing demands of the student body. Regardless of the direct applications of computers in instruction, an increasing number of students are recognized as being at risk of failing school. Indeed, a recent report by the National Center for Education Statistics (NCES) shows that 12.5% of persons ages 16 through 24 are high school dropouts.1 While many of the individuals cited in this report are younger students at risk for strictly academic reasons, many more are at risk because of family-related problems. Seeking different approaches to address both school- and family-related factors, educators have begun to turn to integrated service options, involving professionals in many disciplines. As more of these cross-disciplinary efforts are made with both students and their families, more effective methods of managing cases and coordinating school-based service delivery have become increasingly necessary. Recognizing this need, the Center for the Study and Teaching of At-Risk Students (C-STARS) at the University of Washington, in conjunction with the Washington State Migrant Council, developed a software application that allows users to efficiently manage the cases of students at risk of dropping out of school. Known as the Computer-Assisted Risk Accountability System (CARAS), this software is being pilot-tested in several districts across the state of Washington. The current version of the software aims to provide school-based case managers and their teams with more timely and accurate information on at-risk students and their families, as well as aid in evaluation and reporting. CARAS is also designed to help school district personnel get the most out of their available resources. What is unique about CARAS is that it is not simply a computer program, but a case management process, entailing all aspects of a case management program, from school- and districtwide screening for at-risk students to case closure. Why Computer Assisted? Most computer programs to assist at-risk students were developed for classroom use by either students or teachers, on the assumption that this is how students could be helped the most. The software was designed to increase students' reading or math levels, or other comparable skills, in an effort to help them "keep up" with peers. Such programs are valuable tools, but they typically focus solely on academic aspects of the at-risk problem. Other attempts to harness computing power to aid at-risk students involve adapting human-services software, originally used for billing and other client data-management purposes. We term these "macro" systems because they are usually designed to handle large numbers of students (often in the thousands) and are made principally for data reduction or aggregation, rather than assisting with decisions regarding the service needs of individuals (a "micro" system). Large systems often lack the flexibility and/or elements needed by human service workers in their day-to-day case management activities. Such activities include service planning, data and information storage (with easy retrieval), and instant reporting capabilities (often needed for team meetings and staffings). These are activities for which CARAS is ideally suited. With the growing interest in school-based case management for at-risk students, case managers need better assistance in their efforts. While the above mentioned computer systems are good at either helping each student in classroom instruction or managing large programs, one's focus is too narrow and the other too broad to take into account all of the influences responsible for a particular student being at risk. Influences include substance abuse, poor living conditions, parental unemployment, and/or homelessness and gang involvement. Specifically, much of the current software d'es not provide a means of developing service plans for students and their families, nor d'es it generate case reports and/or progress updates. CARAS addresses these particular case management needs. How CARAS Evolved Development and implementation of CARAS is part of a U.S. Department of Education Dropout Demonstration Assistance Program grant received by C-STARS. Built on a software program developed from the C-STARS model for school-based case management, this prototype underwent major changes, eventually resulting in CARAS. Problem areas emerged during this evolution. For example, not all the functions of case management are always applied with each student in a given caseload, nor are they applied to the same degree or in a prescribed manner. Without the means to properly focus the needed service functions on each student, optimal or even adequate achievement of service goals is not always obtained. What works with one student d'es not necessarily work with another. Another problem area continually faced by case managers is sorting referrals into specific, identifiable categories. For example, some students have specific problems in attendance, grades or conduct. Other students are reported as doing fine in these areas, yet are drop-out risks because of family situations. Eventually, family problems show up as school problems. This points to a second difficult area: who is identified as "at-risk"? More often than not, referrals include "problem" children who are sent for special services because classroom teachers are unable or unwilling to deal with their behaviors or special needs. Additionally, many students are not referred at all, either because they are perceived as not being at risk, or not at risk "enough" to warrant a regular referral. These include students who are having problems outside of class (unbeknownst to school personnel), yet show signs of being shy or withdrawn. CARAS addresses issues such as these, incorporating prioritized risk indicators. For example, CARAS screens contain specific categories pertaining to school- and family-based problems. This includes categories that school staff might otherwise not think of as risk factors, such as the shy or withdrawn behavior mentioned above. In addition, case managers can utilize the CARAS needs assessment component (discussed below) to identify at-risk students and the underlying reasons. As implementation of the C-STARS model of school-based interprofessional case management progressed, it became apparent that case managers and their teams needed a way to systematically manage and evaluate coordinated service delivery -- in short, a means of gathering and organizing data. Since the data had to be collected and reported for various audiences anyway (C-STARS, school administrators, social and health agencies, etc.), a database system was developed to include intake, case management, monitoring and follow-up components plus reporting capabilities. Components In Detail The following sections describe each component of the CARAS system in detail, offering readers insight into the functions and design of this comprehensive program. Intake The student intake component of CARAS is assisted by software developed to help perform needs assessment. The Needs Assessment and Monitoring System (NAMS) enables a user to identify students at risk. This assessment, which can do both school- and districtwide screening, incorporates 12 risk variables. The variables are derived from a needs assessment tool known as the "Ten-Minute Wonder." This instrument, developed by C-STARS personnel, lists school-based factors frequently associated with students identified as at-risk. It is completed for all students in a school, usually during a single faculty meeting, and the data is entered into NAMS. (Inputting this data electronically via scanning is being planned.) A school or district can add up to five optional risk variables if so desired, or other types of variables such as standardized test scores. In addition, three school-specific risk variables, pertaining to grades, attendance and conduct, are integrated. Figure 1 displays this component's primary computer screen, along with the main menu screen used to select and weigh risk factors. One also has the option of assigning different levels of "at-riskness" to variables. Users are cautioned to apply this as a service decision-making tool and not as a categorizing tool. Case Management The case management component is assisted by Case Manager Software (CMS). CMS is a detailed management information system that helps facilitate the case management process, including developing service plans and generating reports. The primary screen in this component is the Student Information Screen, which contains background and demographic information. From here, a user accesses other screens pertaining to a student's case history and service program. These include screens on: 1) Student Referral and Response, 2) Student Assessment, 3) Family Demographics, Composition, and Resources and Needs, 4) Agency Referrals, 5) Student and Family Service Plans, 6) Student and Family Progress Reports and Updates, and 7) Individual Service Planning. Examples of some of the intake and process screens can be seen in Figure 2. The CMS also will generate various reports. These include individual student reports (with family information), summary reports of an entire caseload, and a menu item known as the "C-STARS Report Pack" that contains specific reports the University of Washington uses to evaluate the impact of school-based case management on at-risk students and their families. Additional menus let a user download all information to a diskette, as well as identify agencies, case managers and programs for at-risk students and their families. This is especially helpful when developing a directory of service providers in a given area. Monitoring and Follow-up Monitoring and follow-up is assisted by NAMS. This allows the user to determine if students are still at risk, whether progress has been made, or if any new cases have emerged. This is done primarily through re-implementing the NAMS process as described earlier for the intake process. CARAS is designed so that school-based case managers (and other school personnel) have a comprehensive, user-friendly method of managing, as well as reporting on, their caseloads. Initially developed using Microsoft's FoxBASE+/Mac database program, efforts are underway to create a version that is compatible with MS-DOS. Current Method's Shortcomings As it stands now, the typical procedure for school-based case management is driven by a referral, followed by an assessment. At that point, a determination is made as to whether the student and family need a short-term, limited intervention to address an immediate need, or whether they should become "fully-targeted" for more complete service. The latter is usually provided over the course of an academic year and a written service plan is developed. Next comes service implementation and coordination (including monitoring and evaluation), eventually followed by closing the case. The whole process is handled by a case manager, with the assistance of a team of school and agency personnel, and, as needed, family members. The team usually prescribes what will help the student and family; the case manager ensures that prescriptions are fulfilled. This pattern generally corresponds to the practices of other human service disciplines where case managers often had social service, mental health or health science backgrounds. While a valuable starting point, several concerns have emerged: * Given no counterbalance, service providers tend to focus efforts where they are most comfortable, in activities closest to their training and backgrounds.2 * Case managers have little orientation or training in using data to assist decisions. They base their decisions regarding case selection, service prescription and case termination almost exclusively on general impressions and on the opinions of others. * By their training and interest in helping individuals, case managers' perspectives remain on the "trees" (students, families) and they have difficulty stepping back and looking at the "forest" (caseload, the at-risk population of a school, etc.). CARAS addresses such problems by helping case managers see the scope of the at-risk problem in a given school or district, thus enabling them to better coordinate the services needed. Data collected through CARAS assists them in all phases of a service plan, from referral through closure. The data also enables managers to see the impact they have on an at-risk population. Additional Benefits to Others Because CARAS is a detailed system, its benefits extend to all members of a case management team. A typical school-based team includes the following: Case Managers: With CARAS, case managers can continually monitor the progress of students and families in their caseloads. Readily available information covers referrals, demographics, service planning, social services and health agencies. In addition, its extensive reporting capabilities allow case managers to generate up-to-date progress reports. Data can be aggregated for one's entire caseload, or used to develop a portfolio/profile of individual cases. Students and Families: With CARAS in use, students and families benefit by having their case history kept in a single place, organized and available to them. A complete record of services received and progress attained can be generated with the click of a button. Case notes entered by the case manager allow for records to be kept on the effectiveness of the different interventions by school and agency personnel. All of this increases the efficiency of case managers in helping at-risk students and families in attaining long-term benefits. Teachers: Teachers, who often generate referrals as well as provide services to the targeted students, benefit by having progress reports instantly created on their at-risk students. In addition, CARAS helps identify who is a drop-out risk, with the degree of "riskness" defined by school personnel. School Administrators: Schoolwide identification of who is at risk is greatly facilitated, as is later identification of those still at risk and others who may have become at risk. CARAS also allows school staff to enter and update other special services' data to aid in state reporting requirements such as Chapter 1, Migrant Education, etc. Allied Agencies: Outside social and health agencies benefit by having a school-based system that can instantly provide a profile of each student and family with which they work. Information in the profile is continually updated, allowing more effective monitoring and follow-up. Involved agencies are indexed in a separate menu, offering an up-to-date directory. As a Program Evaluation Tool Program evaluation is an area in which CARAS greatly enhances the efforts of case managers and other school-based service deliverers. Sometimes these personnel may shy away from formal program evaluation; either they feel they lack the time to collect the necessary data or they may see it as focusing on punitive employment ratings, rather than increasing the effectiveness of their efforts with students and families. The best way to overcome this is to help them see how personally productive program evaluation can be, particularly when done with a computer-based system. We remind them that CARAS provides highly detailed sets of case management information. CARAS allows case managers and their teams to conduct a thorough and meaningful evaluation of activities. For example, the different causes of service success or failure can be compared across sites, thus indicating whether such incidents are site-specific or are consistent across sites, cases or circumstances. Indices such as these are most useful in explaining certain trends and making programmatic decisions. Additionally, useful collected data concerns family demographics, providing a wealth of background on the site cases. With this data, program strengths and weaknesses can be identified, allowing users to pinpoint items such as critical family contact points, or the points along the student pipeline at which students most often experience difficulties and begin "dropping out." CARAS also greatly enhances a formative evaluation design, leading to overall program improvement. Given the importance of documenting program development at each site, CARAS is ideally suited for building records of local implementation and adjustment while enabling on-going analysis. In turn, this allows adjustments and/or corrections to be made in the application of the case management model. Ongoing information processing makes it easier to interpret formative data. This capability is especially helpful if case management services are being implemented as intended, yet the desired effects are not occurring. The formative process is two-fold. First, as the overall project evolves and each site shapes its adaptation of the case management model, it is important for local case management teams to meet routinely to assess whether their activities are yielding success. Second, within the context of each student's individual service plan, case managers routinely convene their teams to assess whether the plan is producing desired results for the child and/or family. CARAS helps in both of these assessments by providing teams with current status reports. A final function of CARAS is providing data to ensure that all aspects of a program are "on-task" and in compliance with contractual or other service expectations. Quantitative and qualitative information regarding completion of activities to meet pre-set goals and objectives are easily retrievable from the system. Summary and Conclusions CARAS helps with the weakest areas of a case management program, particularly in the area of service. Whether it be individual counseling and/or referral, helping a family attain needed goods or aiding a student in getting better grades, CARAS provides insights on how successful case managers are in providing these services, as well as how effective these services are to the cases involved. Such indices will help to enhance the overall efforts of such school-based personnel. They will also promote CARAS itself as a necessary tool in case management, regardless of existing pre-conditions or notions on the part of a user, school or agency. A variety of factors can lead to students being at risk of dropping out of school, ranging from poor attendance to problems at home. A case manager has to stay on top of what is being done to help the student and family -- this often means interviewing the student, family, teachers, and other personnel (school counselors, social services workers, etc.). The myriad factors and personnel to take into account, combined with the differing circumstances of each case, often induces a case manager to make recommendations or conclusions without having systematically studied the facts or reviewed objective data summaries. CARAS offers a means to augment human impressions with factual profiles.
31134-34573
Future plans for CARAS include an Expert System component to allow case managers (and other school personnel) to draw upon data already in the database to assist them with decision making. Such an "advisory" component can only be developed after a pool of expertise is accessible, built upon data and information gathered, processed and evaluated through CARAS. As districts face budget cuts, they continually search for ways of doing more with less. Implementation of a program like CARAS can greatly augment their efforts in managing the cases of at-risk students and their families. CARAS meets the needs of school districts who conduct their own service delivery programs. By utilizing all of its aspects, the process used by such districts can be greatly enhanced. The University of Washington thanks the case managers, teachers and other school personnel participating in the piloting of this application. In addition, the university appreciates the cooperation and assistance provided by the following: The Migrant Child Institute, Grandview, Wash; Franklin Pierce School District, Tacoma, Wash.; Oakville School District, Oakland, Wash.; Pasco School District, Pasco, Wash.; Peninsula School District, Gig Harbor, Wash.; and West Valley School District, Spokane, Wash. For more information on CARAS, contact: C-STARS College of Education, University of Washington 4725 30th Ave. NE, GG-12 Seattle, WA 98195 Attn: Eduardo Armijo The authors of this paper are education faculty and professional staff at the Center for the Study and Teaching of At-Risk Students (C-STARS), located in the College of Education at the University of Washington in Seattle. C-STARS has developed several programs addressing issues pertaining to at-risk students and their families, including dropout prevention and substance abuse prevention/intervention. Many of the center's activities utilize school-based, interprofessional case management as a means of addressing these issues. References 1. Kaufman, P., McMillen, M.M. and Badby, D., Dropout Rates in the United States: 1991, report for National Center for Education Statistics (1992). 2. Hobbs, N., Perrin, J.M., Ireys, H.T., Moynihan, L.C., and Shayne, M.W., Chronically Ill Children in America: Background and Recommendations, Center for the Study of Families and Children, Vanderbilt University, Nashville, TN (1983) . The work reported herein is part of a grant from the U.S. Department of Education (Grant No. S201C12560). The opinions expressed do not necessarily reflect official opinion or policy of the Department.