A Proactive Approach to Child Welfare and Safety

Too often, state and local child welfare agencies find themselves in crisis mode, spurred on perhaps by a tragedy in the headlines, budget shortfalls, or overwhelming caseloads.

This reactive approach has been a staple across the U.S. for so long that there is a startling lack of evidence-driven best practices or research to support practice and policy.

That is why I was so pleased to see the report issued by the federal Commission to Eliminate Child Abuse and Neglect Fatalities, which came out last March. Informed by two years of extensive study, their findings and recommendations offer a concrete roadmap for child protective services that takes a proactive and preventive approach.

Their findings call for decision-making grounded in better data and research, greater leadership and accountability, and cross-agency support for families. These steps add up to a public health approach that will lead to stronger supports and more focus on preventing tragedies before they occur.

Widespread system reform does not happen overnight. That is why the federal commission highlighted specific steps that agencies can take today to save lives. For example, according to their research, a call to a child protection hotline, regardless of the disposition, is the best predictor of a later child abuse or neglect fatality. Young children and infants are at the highest risk of abuse or neglect compared to other age groups.

This past July, Indiana’s Department of Child Services (DCS) changed its non-assessment policies statewide to reflect this data and recommended all children who had not yet reached their third birthday be assessed for any report of child abuse and neglect. DCS works in partnership with private agencies to provide home-visiting programs that have proven successful, not just in identifying children at risk, but in providing the supports that families need to stay together and ensure their children are safe.

The commission also highlighted in its report a promising program in use by Hillsborough County, Florida. Eckerd Rapid Safety Feedback (ERSF) is a unique process relying on real-time data analytics to flag high-risk child welfare cases for intensive monitoring and caseworker coaching. Eckerd analyzed data from 1,500 open cases in Hillsborough County in which children were abused or neglected. From that data emerged a profile of those cases with the highest probability of serious injury or death. The research also identified child welfare practice skills critical to keeping kids in this high-risk category safe – including things like frequency of home visits.

While risk factors may vary based on geography – Indiana for instance has faced a high incidence of opioid abuse – families in which a fatality or serious injury occurred do often share multiple risk factors, including families with a child under three years of age; young parents; a paramour or unmarried partner in the home; intergenerational abuse; and domestic violence, substance abuse, or mental health problems. Those families with risk factors can then be matched with special interventions, including home visiting and substance abuse and mental health treatment services. The private sector provides these services through contracts with DCS.

This combination of both data and intervention offers a new approach to child safety and one we are proud to embrace in Indiana. Over the coming months, Indiana will be launching its own initiative with Eckerd to develop the data to support intervention for children most at risk.

Indiana is not a newcomer to many of these child welfare and safety initiatives. Indiana was one of the first states to receive a Title IV-E waiver to use funds flexibly to provide services to promote family preservation and reunification. Thanks to the efforts of DCS Director Mary Beth Bonaventura, Indiana Supreme Court Chief Justice Loretta Rush, and Indiana’s legislature, we have actually been ahead of the curve. In July 2013, the Commission on Improving the Status of Children in Indiana was established and signed into law. This commission, which consists of leadership from all three branches of state government, has worked for the last several years on key supports for vulnerable youth, including access to and availability of services; information sharing; promoting best practices, policies, and programs; and studying and making recommendations regarding pending legislation. The Indiana commission has also focused on the reduction of infant mortality and youth suicides.

The Indiana Association of Resources and Child Advocacy (IARCA), which has 88 member agencies who serve about 4,400 children every day in foster homes, group homes, and residential treatment facilities, is proud to partner with DCS and other key stakeholders to foster a greater commitment and shared interest in improving the lives of children across agencies and different branches of government. Collaboration is at the heart of our approach to child welfare. We currently serve an additional 8,100 children in their families’ homes and, of the 4,852 children discharged from services in 2015, over 77 percent had a positive educational outcome and 63 percent achieved their required permanency plan. At six months follow-up, 98 percent of children had not suffered new abuse or neglect; and 85 percent had not been involved with the courts for new offenses. Clearly, we are moving in the right direction.

There will be challenges ahead. It remains to be seen whether the new non-assessment policies or the Rapid Safety Feedback data will increase an already rising caseload among child welfare agencies. The bottom line is, if the public and private sectors can work together to follow a roadmap that enhances a safety culture for our kids and provides families the supports they need, if we can be proactive rather than reactive, our children will be better off.

Cathleen Graham 
has been IARCA’s executive director since August 2000, and she is former deputy director of Indiana’s child welfare system.

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