Birth Match, Tool to Prevent Abuse and Neglect, Slow to Spread in U.S.

The Commission to Eliminate Child Abuse and Neglect Fatalities (CECANF) has heard from experts and stakeholders around the country and has prepared a draft of its recommendations. Among them is the suggestion that states expand a practice called “birth match,” which can identify at birth children who are at risk of child abuse and neglect.

This recommendation should be highlighted and strengthened.

Richard Barth, a highly regarded child welfare scholar, discussed Maryland’s birth match law in testimony during a CECANF hearing in July of 2014. This law was adopted after several children were killed by parents whose parental rights had been terminated for previous children.

Infants born to parents with a prior termination of parental rights (TPR) are not an insignificant group. Barth found that they made up over 10 percent of entries into foster care in Maryland in 2013.

Maryland’s law requires that birth records be matched against a list of parents who had their parental rights terminated within the last five years due to abuse or neglect. The families thus identified receive a visit from a social worker to assess for safety and risk to the infant.

States have a choice in how to intervene with the families they identify through birth match. In Maryland, these families receive a visit from a social worker to assess the family. If the parent refuses the visit, a case can be opened “only if abuse or neglect is suspected.”

Michigan is more aggressive in dealing with high-risk families. Identification of these families results in the opening of a case unless there is a waiver. That seems a more effective way to ensure a child’s safety than allowing families to opt out of the screening.

Identifying only parents with prior TPRs is a very conservative strategy that does not even capture all parents who lost a child permanently due to abuse or neglect. To identify all of those parents, a state would have to include parents who lost a child to guardianship as well as adoption.

To target a broader swath of parents at risk of harming a child, a state could identify all parents who had a prior finding of child abuse or neglect or a child placed in foster care. It could also target teenage mothers who themselves were victims of child abuse and neglect. One study found that 40 percent of children of California teen mothers who were found to be the victims of abuse or neglect as children will be reported for child maltreatment by age five.

Birth records could also be matched with data other than child welfare administrative records. A groundbreaking study of all 2002 births in California shows that “objective data collected at birth can be used to identify those children in a given birth cohort who are at greatest risk of future CPS contact.”

Among the most important risk factors were a mother’s low education level, a mother’s young age, three or more children in the family, and for U.S. born mothers, Medicaid coverage of the birth.

Despite the promise of this approach, few systems have embraced it. Barth told CECANF that “virtually all states have the option to share birth records with child welfare agencies,” but very few states do; to his knowledge, the only states that do are Minnesota, Maryland and Michigan.

According to Barth, the main obstacle to implementing birth match in other states is the reluctance to trigger CPS involvement with families that may not be maltreating their children.

Clearly, it would be distressing for a family to be contacted by CPS when they have not done anything wrong. And by no means am I suggesting that all, or even most, of the parents identified through birth match are incapable of caring for a child.

However, the opportunity to save a child from serious abuse or neglect should take precedence over the inconvenience to families of undergoing an assessment.

We need more research on birth match programs to identify the outcomes of intervening early in families identified as high-risk. How many families are identified and what is the result? Do child fatalities decrease after the adoption of such a policy?

CECANF’s recommendation that states “expand birth match programs such as those operated in Michigan” should be strengthened and elevated to the federal level. The commission might recommend that the federal government establish a pilot program providing grants to states that adopt and evaluate birth match programs.

Information from this pilot could be used to develop a federal requirement for all the states to match birth and child welfare records.

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Marie K. Cohen
About Marie K. Cohen 68 Articles
Marie K. Cohen (MPA, MSW) is a child advocate, researcher, and policy analyst. She worked as social worker in the District of Columbia's child welfare system for five years. She is a member of the Citizen's Review Committee for the DC Child and Family Services Agency and the DC Child Fatality Review Commission and a mentor to a foster youth. Follow her blog at fosteringreform.blogspot.org, on Facebook at Fostering Reform or on Twitter@fosteringreform.