atlantic canada child welfare forum iii – differential response
DESCRIPTION
Atlantic Canada Child Welfare Forum III – Differential Response. John Fluke Child Protection Research Center American Humane Association. March 25 th & 26 th , 2010 Oak Island Resort, Nova Scotia. Part I: Differential Response Models: What is Differential Response? Origins Status - PowerPoint PPT PresentationTRANSCRIPT
Atlantic Canada Child Welfare Forum III – Differential Response
March 25th & 26th, 2010Oak Island Resort, Nova Scotia
John FlukeChild Protection Research Center
American Humane Association
Part I: Differential Response Models: What is Differential Response?
OriginsStatus Practical Challenges Limitations Promise and Potential
Overview
• Purposes of Differential Response• History and Status• Core Elements• Assumptions• US QIC DR
– Literature Review– Findings From Research and Evaluation
• Canadian Perspective (Barbara Fallon, UT)
Slide 3
Purposes of Differential Response in Child Protective Services
• CPS was established to respond to all reports of suspected child maltreatment– numbers overwhelm available resources
• CPS currently either screens out or does not open for services on more than half of reports– yet many children are vulnerable
• Traditional investigatory practice is often adversarial and alienates parents and/or caregivers
• DR is conceived of as a way to serve more screened in reports at an earlier stage by engaging families in a non-adversarial process by conducting assessments and linking them to needed services
4
Core Elements
5
• Two or more discrete responses to reports of maltreatment that are screened in and accepted
• Assignment to response pathways is determined by array of factors
• Original response assignments can be changed• Ability of families who receive a non-
investigatory response to accept or refuse to participate in Differential Response or to choose the Traditional Response.
Two Track SystemsCourtesy of Institute of Applied Research
6
Exit System
Families Appropriate for DRFamilyAssessments
All reports accepted as potential child maltreatment
Track Assignment
Families NOT Appropriate for DRTraditionalInvestigations
Declines voluntary services or no services needed
Unsubstantiated
Accepts voluntary services
Exit System
Exit System
Substantiated investigation
Agency or community services / formal or informal cases
Exit System
Formal cases / child removals
Tra
ck c
hang
e
Core Elements
7
• After assessment, services are voluntary for families who receive a non-investigatory response (as long as child safety is not compromised)
• Establishment of discrete responses is codified in statute, policy, protocols
• No substantiation of alleged maltreatment and services are offered without formal determination that maltreatment has occurred
• Use of central registry is dependent upon type of response.
Principles and Assumptions of Differential Response
• Circumstances and needs of families differ and so should the response
• Majority of reports do not need adversarial approach or court-ordered interventions
• Absent an investigation:– child safety will not be jeopardized– services can be in place more quickly– families will be more motivated to use services
8
Assumptions continued...
• Effective assessment tools can used to determine safety and provide an informed response
• Frontline staff in CPS and other agencies are trained in strength based and collaborative interventions
• Only cases of greater severity need to be on state central registry
• Cases are monitored sufficiently to change paths when situation requires
9
Key Program Assumption: The Importance of Family Engagement
• Family members have significant expertise; whenever possible, engage them in identifying issues and honor family choices when they do not jeopardize safety
• Seek collaboration with family and their formal and informal support system
• Whenever possible, eliminate practices that produce resistance such as drop in visits, joint visits with law enforcement, and interviewing child without parental knowledge
10
US Funded National Quality Improvement Center for Differential Response in Child Protective ServicesPhase I (2009): Activities (Completed)
• Comprehensive Needs Assessment– Review existing knowledge– Key informant interviews– Focus groups
• 4 Information Summits (geographically diverse locations)• Legal research• Legislative tracking and analysis• Literature review and annotated bibliography• Family listening sessions
11
Website
• http://www.differentialresponseqic.org/
13
• Select and fund research and demonstration sites• Select and fund doctoral students/dissertations• Develop, implement and monitor cross-site
evaluation data collection methods• Provide technical assistance—implementation and
research focused
US Funded National Quality Improvement Center for Differential Response in Child Protective ServicesPhase II (2010-14): Activities
Phase II: Salient Activities• Site selection• Grant management• Technical assistance for research and demonstration sites
– Project implementation, data collection and evaluation procedures• Technical assistance for doctoral students• Product development• Collaborative partnerships and information network
– Build knowledge and answer critical questions about improving child welfare outcomes via DR implementation
• Evaluation– Research and demonstrate sites and Cross-site
14
QIC DR Online Survey of US State Child Welfare Directors
• Based on the survey implemented for National Study by American Humane and CWLA (2005-06)
• Questions about – Current differential response system
• Status, structure, and scope– Historical differential response models– Plans to implement such a system
• Survey Monkey • Invitations sent to list of State child welfare
directors provided by CB
Survey Results
• 36 States responded• 16 have current DR• 18 do not have current DR
• 4 with defunct DR• 8 planning DR• 8 with no DR activity
• Of 16 with current DR• 7 have DR for Screened In only• 7 have DR for both Screened In and Screened
Out• 2 did not respond
17
Legislative Tracking• 21 states
– Pilots– Statewide– Clarifications, amendments– Many not within Federal definition of DR
• Recent– New York 2007 statute– Vermont 2008 statute– Washington pending 2009– Colorado pending 2010
• Provisions– tracks, definition/scope of investigation/assessment,
immunity, confidentiality, central registry, other stakeholders, services, court/judicial, track adjustment
QIC-DR: Literature Review
• Bibliography with over 110 reports, articles, books, and presentations on DR
• Structured summaries for each piece for online annotated bib• Contents includes:
– Program models and implementation– Review and synthesis of existing DR program evaluations– Legal issues related to DR
19
Literature Review: Selected Findings on Program Models
• Differential response defined as much by what it is not, as by what it is.
• Shared goals and principles, but significant variation across programs in execution: e.g. screening, tracking criteria, number of tracks, and service content and delivery
• Even within states, variations in the interpretation and execution of DR-related law and policy.
• Substantial variation in the percentage of families referred to DR across programs and across sites or providers within programs
20
Literature Review: Selected Findings from Evaluation Studies
• 26 programs at some stage of evaluation, 15 with reviewable findings• Only 1 evaluation using random experimental design. (A second is underway). Other
methodologies range from quasi-experimental (matched site, matched families) to natural experiment and simple pre-post.
• Only 1 completed evaluation has included cost effectiveness. ( A second is underway)– Initial increased costs followed by decreased service costs overall.
• Implementation– DR referral rates generally increased as programs matured
• Outcomes– The safety of children is not compromised by DR– Modestly better outcomes for families in the alternative response track in terms of
safety (re-report, risk level) and permanency (placement)– Both workers and clients prefer the alternative assessment approach to the investigation
approach
21
Literature Review: Selected Findings on Legal Issues
• Equal protection rights not likely implicated by use of DR
• Due process rights not likely implicated by use of DR
• Procedural due process rights not likely implicated by use of DR
22
Findings in Missouri and Minnesota
• New CA/N Reports and Later Placements of Children Reduced– Recurrence of CA/N reports decreased in MO and MN – In MN, fewer DR families had children later removed and placed in out-of-
home care than control families– In MN, positive effects of new approach were equally evident among
Caucasian, African-American and American Indian families.
• Short-Term Costs Greater, Long-Term Costs Reduced– In MN, cost neutral and in MO, cost-savings
• Community stakeholders were satisfied with have more than one pathway to respond to cases
23
Findings in Missouri and Minnesota
• Child Safety not Diminished– In MO, children were made safer sooner.
• Family Engagement under DR– Cooperation of families improved in both states.
– Families were more satisfied and felt more involved in decision making in both states.
– In MN, families reported that workers helped them obtain services or directly assisted them and connected them to other community resources.
– In MN, families had increased positive and reduced negative feelings following the initial visit.
• CPS Staff Reacted Positively– Workers in both states overall reacted positively and believed approach to be more effective.
• Services to Families and Children Increased and Changed– Needed services were delivered more quickly.
– Services delivering basic necessities (food, clothing, shelter, and medical care) increased.
– Greater utilization of community resources in both states.
24
Findings in Missouri and Minnesota
• Model Fidelity: DR works best when the basic model is followed:– Non-adversarial, respectful approach to families– Open invitation to families to participate in group decision making– Broad and early assessments of family strengths and needs and the
indicators of child well-being– Increased services responses and community referrals– Mutual worker-family decision to continue contacts and support– Child safety assessment and safety planning– Readiness to change tracks (assessment to investigation) when
imminent danger is found
25
A Canadian perspective on differential response (courtesy of Barbara Fallon, Univ. of Toronto)
• What is differential response in Canada?– A swing in the pendulum– A shift toward family preservation
• 6 of 13 provinces/territories have some form of differential response
– British Columbia– Alberta– Manitoba– Ontario– New Brunswick– Nunavut
Slide 26
Highlights of differential responsefrom Canada
• British Columbia: Family Development Response– Investigation not required– Providing a range of responses and community based options– Keeping children safe within the family and community– Intake and assessment are collaborative, comprehensive, and solution focused
• Ontario: Eligibility Spectrum– Upon report, it is determined if there is a need for investigation, or a community link
• New Brunswick: NDCPSI– Phase 1: implementation of family group conferences and child protection mediation– Grounded in evidence base
• Alberta: Family Enhancement– Provision of supports to allow family to continue caring for children– Screening process and initial assessment to determine if full assessment/investigation
needs to be conducted
Slide 27
Part II: Going forward:
Prospects for strengthening child protectionAdaptive value of differential response
Overview
• Trends in DR Reporting to NCANDS• Safety Data• Funding and Cost
Slide 29
DR Reporting to NCANDS
• Of 16 states that have DR, 11 report to NCANDS.
• Of those that report to NCANDS, 5 report in categories other than DR.
Differential response
• From NCANDS as states have implemented differential response approaches over time
– Proportion of DR responses of all responses have tended to increase– total responses (including investigations) is about the same or greater – Mostly, rates of victimization have gone down in these states
• So far research indicates that children are as safe
• Quality Improvement Center on Differential Response (CB, AHA, WRMA) has funded three research and demonstration sites
Slide 31
NCANDS and differential response(Schusterman, Hollinshead, Fluke & Yuan, 2005)
Kentucky
-10,00020,00030,00040,00050,00060,00070,000
1998 1999 2000 2001 2002
Alternativ eResponse
Inv estigation -Nonv ictim
Inv estigation -Victim
Minnesota
-
5,00010,000
15,000
20,00025,000
30,000
1998 1999 2000 2001 2002
Alternativ eResponse
Inv estigation -Nonv ictim
Inv estigation -Victim
Slide 32
Missouri
-
20,000
40,000
60,000
80,000
100,000
1998 1999 2000 2001 2002
Other Disposition
Alternativ eResponseInv estigation -Nonv ictimInv estigation -Victim
Oklahoma
-
20,000
40,000
60,000
80,000
1998 1999 2000 2001 2002
Other Disposition
Alternativ eResponse
Inv estigation -Nonv ictim
Inv estigation -Victim
NCANDS and differential response(Schusterman, Hollinshead, Fluke & Yuan, 2005)
Slide 33
NCANDS and differential response(Otiz, Schusterman, & Fluke, 2008)
Slide 34
Substantiation and differential response
• Elements of differential response from the National Quality Improvement Center on Differential Response in Child Protective Services
– Use of two or more discrete response pathways for screened in reports;– Establishment of discrete response pathways is codified in statute, policy, or
protocols;– Pathway assignment depends on an array of factors defined in policy/procedure;– Original pathway assignment can change based on new information;– Services are voluntary on a non-investigation pathway:
• families can choose to receive the investigation response, or• families can accept or refuse the offered services if there are no safety concerns;
– Families are served without a formal determination of child maltreatment; and– Name of the alleged perpetrator is not entered into the central registry for those
individuals who are served through a non-investigation pathway.
Slide 35
Safety and Differential Response -Methodology
• Trajectory analysis (NCANDS data)– A type of Event History Analysis
• Identified the first report in 2004• Followed each unique child for 12 months• Any subsequent report counted as a rereport• Identified track assignment and victim status
37
Initial Report
Subsequent Report within 12 Months
All Children in Maltreatment
Reports136,209
Alternative Response
38,824
72%
Investigation97,385
71%
Nonvictim70,259
Victim27,126
15%82% 3%14%84%
2% 10%84% 6%
29%
29%
None
Nonvictim2,104
Victim1,852
Alternative Response
462
Investigation3,956
47%53%
None
Nonvictim7,814
Victim2,796
Alternative Response
1,745
Investigation10,610
26%74%
None
Nonvictim2,587
Victim1,439
Alternative Response
2,314
Investigation4,026
36%64%
Reports of Any Maltreatment in Five States
38
Initial Report
Subsequent Report within 12 Months
All Children in Maltreatment
Reports93,576
Alternative Response
30,357
68%
Investigation63,219
70%
Nonvictim44,394
Victim18,825
16%81% 3%15%83%
2% 11%83% 6%
32%
30%
None
Nonvictim1,501
Victim1,389
Alternative Response
310
Investigation2,890
48%52%
None
Nonvictim5,236
Victim1,956
Alternative Response
1,169
Investigation7,192
27%73%
None
Nonvictim2,117
Victim1,227
Alternative Response
1,885
Investigation3,344
37%63%
Reports of Neglect in Five States
39
Response to Initial Reports
FFY 2004All Children in
Maltreatment
Reports136,209
Alternative Response
38 ,824
72%
Investigation97 ,385
71%
Nonvictim70 ,259
Victim27 ,126
29%
29%
All Children in
Maltreatment
Reports of Neglect
93 ,576
Alternative Response
30 ,357
68%
Investigation63 ,219
70%
Nonvictim44 ,394
Victim18 ,825
30%
32%
40
Subsequent Report within 12 Months
Initial Report During FFY
Event History AR in Five States
Alternative Response
38,824,
10% 6%
None
Nonvictim2,587
Victim2,439
Alternative Response
2,314
Investigation4,026
36%64%
84%
NeglectAll Maltreatment Types
Alternative Response
30,357
11% 6%
None
Nonvictim2,117
Victim1,227
Alternative Response
1,885
Investigation3,344
37%63%
83%
41
Initial Report During FFY 2004
Investigation63,219
70%
Nonvictim44,394
Victim18,825
16%81% 3% 15%83% 2%
30%
None
Nonvictim1,501
Victim1,389
Alternative Response
310
Investigation2,890
48%52%
None
Nonvictim5,236
Victim1,956
Alternative Response
1,169
Investigation7,192
27%73%
Subsequent Report within 12 Months
Children with Investigations Following Initial Reports of Neglect
in FFY 2004
Funding Sources (US)
• State funds only• Prevention funds
– CBCAP– Children’s Trust Funds– Child Welfare Services Funds
• Justice Department• Grants or foundations