Differential Response and the Role of the Child Advocacy Center

NCA Leadership ConferenceJune 2013

Differential Response

• Definitions:– Alternative Response– Differential Response– FAR (Family Assessment Response)– Multiple Track Response

• Developed with other child welfare reforms to incorporate family centered, strengths based practice.

• 38 states in some stage of implementation

Who’s Doing Differential Response?

Why Differential Response?

• Impetus for Differential Response– Out of home care rates are high– State budgets for child welfare soar– Outcomes not improved when child enters care– States being sued for poor CW

• Current concerns: – CPS agencies believe they rely on practices that are

inflexible, adversarial, unnecessarily intrusive (investigation/fault finding)

– Believe current approach limits CW ability to engage and get needed change with families

What’s the History?

• 1974 CAPTA- states needed to develop a response to allegations of abuse; adopt definitions

• Historically removed many “at-risk” children to manage safety

• Federal funding supported out-of-home care placement but not in-home services (IV-E funding)

• Late 1970’s and 80’s—Research determined that foster care unstable, inherently traumatic for many kids

• Outcomes were poor - Multiple placements, poor independent living skills, no connections when leaving system (Sound familiar?)

What’s the History?

• “Foster Care Drift” resulted in Adoption Assistance and Child Welfare Act (1980)– Large scale reform focus on permanency, reasonable

efforts to prevent removal, and expedite reunification, kinship care

– Developed home based services, prevention efforts, family centered practice, solution focused interventions- “home builders model”

– 1997 Adoption and Safe Families Act-expanded current efforts, clarified reasonable efforts and ensured that health and safety were paramount

What’s the History?

• Child welfare system expanded• In 1990’s greater emphasis placed on

Multidisciplinary Team re: child abuse investigation– Law enforcement’s role increased– Prosecutors specialized in child abuse– Medical evaluations were used– Forensic interviews were used on SA cases

What’s the History?

• Child and Family Service Reviews (CFSR) included SAFETY as a primary outcome indicator for child welfare (2000)

• Implemented $$ sanctions for not demonstrating results

• Federal audits required improvement plans (PIP) to address shortcomings…and there were a lot of them

The BalancingChallenge

• Child welfare now mandated to again focus on safety and simultaneously maintain focus on engagement, strengths, empowerment

• Most states saw this as having to make a choice – and chose safety

• Many struggle with the balance between investigation and engagement

Balance of Safety and Support

1970 1980 1990 2000 2010 20200

2

4

6

8

10

12

SafetySupport

Is it Possible for Child Protective Services to…

Investigate an incidentAND

Engage the family to change their behaviors?

We Need Investigations That:

• Address the immediate allegation• Focus on fact-finding• Determine what went wrong• Remove suspects from hurting children• Even occasionally remove children from

unsafe environments

We Also Need a Response That:

• Focuses on developing rapport with families• Works in collaboration with families• Provides/implements services• Asks, “How can I help you?”• Builds on family strengths to keep children

safe• Takes the long view of family situations

(realizes problems don’t get solved overnight)

Is it possible to keep a child safe and simultaneously enrich the

child’s wellbeing?

Video Clip

The Promise of Differential Response (DR)

• Began in the late 1990’s. Slow to move across the US even though Federal efforts have been supporting 4-E waivers (moving $$ from out-of-home support )

• Believed to be an evidence based practice • National Advocates/Foundations support the model• Proposes to serve families with different needs in

different service tracks• Proposes to allow CPS to use authority when

indicated and not when it is not necessary

The Promise, Continued

• Believed to be the solution to strengthen support, family centered approach without compromising safety

• Believed to address the disparity of poverty issues and over representation of minorities in the child welfare system

• Believed to re-engage CPS workers in doing “social work”

• Believed to retain CPS workers as employees

Research About DR

• Much of the research about DR is conducted by researchers who have contracts with states implementing DR

• Journal Article/Research: Issues in Differential Response (2012) Hughes, R.C., Rycus, J.S., Saunders-Adams, S.M., Hughes, L.K., Hughes, K.N.

Findings

• DR programs do not adhere to a uniform standardized practice model, nor are programs implemented consistently across the sites– Different tracks

– Investigation and an Assessment Track– Some had 3 tracks (included screened out cases)– Some added primary prevention track (referral to community)

– Differences in HOW families were assigned to tracks

Findings

• Most States used the hotline information as the only source for track assignment

• Considerable variation in the % of cases assigned

• Differences among jurisdictions as to when the track assignment was made

• Inconsistent use of assessment protocols• Inconsistencies in how services were delivered

Findings

• Methodology problems in DR research• Difficult to know if practice changes were due to

DR• Insufficient data to confirm the safety of children

served in alternative tracks• DR Programs appear to prioritize allocating services

and resources to families in alternative tracks• DR literature misrepresents Traditional CPS to

enhance an alternative model

What Have CACs Done for Child Welfare?

• Assisted with investigation while providing support to children, families, & professionals– Enhanced the focus on safety– Introduced stronger “investigation” skills– Strengthened coordination via the MDT – Professionalized “forensic” interviews– Expanded competency in medical evaluations– Emphasized support and advocacy for families

What are CACs doing with DR?

• More than 80% have limited to no involvement with DR

• Many Responses were very negative about DR where implemented– Georgia--Seeing a decrease in accepted cases for

assessment—major decrease in state wards (17,000-6,000)

– Some believe it is to resolve the disproportionate representation of minorities but have not seen any changes

What are CACs Doing with DR?

• Several states report that Sexual Abuse Cases do not make it to the CAC

• One State (Tenn) CAC was involved in legislative work, case review of sex abuse

• Ohio—allows for families to go down AR track with the ability to flip to the traditional track

• Most reported –if Sexual Abuse- then we are involved– if not– we don’t know about it.

Growth of CACs in the United States1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004

Associate 57 66 76 82 88 93 114 150 168 184Accredited 22 45 57 61 97 148 190 245 259 278 294 330 367

0

100

200

300

400

500

600

700

800

1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Accredited

Associate

What should be the Role of CACs in Differential Response?

• Strengthen the investigation• Promote team decision-making at the time

the hotline call comes in• Enhance advocacy and support services • Use the MDT to review DR cases• Promote outcome research about DR

What if…?

Hotline Call

Team Review

Investigation

Differential Response

Instead of this…. How about this?

Expanding the Role of the CAC

• CACs are structured to investigate and engage– Forensic interviewers gather facts– Advocates engage families

• CACs recognize that child safety and wellbeing are equally important but require different skill sets

• CACs can lead the way toward transforming the response to child abuse and neglect

Expanding the Role of the CAC

• CACs are a powerful group with evidence based approach

• Is DR here to stay? If so—we need to be involved– CACs should be at the planning table of DR– CACs should be helping write legislation– CACs should be reviewing and providing input to

4-E waivers.

Questions/Comments

Gene Klein, LCSWExecutive Director

Project Harmony Child Advocacy Centergklein@projectharmony.com