Atlantic Canada Child Welfare Forum III – Differential Response

1. Atlantic Canada Child Welfare Forum III – Differential Response John Fluke Child Protection Research Center American Humane Association March 25th & 26th, 2010 Oak Island Resort, Nova Scotia

2. Part I: Differential Response Models: What is Differential Response? Origins Status Practical Challenges Limitations Promise and Potential

3. 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

4. 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

5. Core Elements • 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.

6. Exit System Unsubstantiated Families NOT Appropriate for DR Traditional Investigations Exit System Substantiated investigation Formal cases / child removals All reports accepted as potential child maltreatment Track change Track Assignment Accepts voluntary services Agency or community services / formal or informal cases Families Appropriate for DR Family Assessments Declines voluntary services or no services needed ExitSystem ExitSystem Two Track SystemsCourtesy of Institute of Applied Research

7. Core Elements • 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.

8. 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

9. 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

10. 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

11. 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

12. Website • http://www.differentialresponseqic.org/

13. US Funded National Quality Improvement Center for Differential Response in Child Protective ServicesPhase II (2010-14): Activities 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

14. 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

15. 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

16. 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

18. 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

19. 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

20. 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

21. 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

22. 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

23. 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

24. 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.

25. 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

26. 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

27. 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

28. Part II: Going forward: Prospects for strengthening child protection Adaptive value of differential response

29. Overview • Trends in DR Reporting to NCANDS • Safety Data • Funding and Cost Slide 29

30. 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.

31. 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

32. NCANDS and differential response(Schusterman, Hollinshead, Fluke & Yuan, 2005) Slide 32

33. NCANDS and differential response(Schusterman, Hollinshead, Fluke & Yuan, 2005) Slide 33

34. NCANDS and differential response(Otiz, Schusterman, & Fluke, 2008) Slide 34

35. 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

36. 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. Reports of Any Maltreatment in Five States 37

38. Reports of Neglect in Five States 38

39. All Children in Maltreatment Reports 29 % 72 % 136,209 Alternative 71 % Investigation Response 97 , 385 38 , 824 % 29 Victim Nonvictim 27 , 126 70 , 259 All Children in Maltreatment Reports of Neglect 32 % 68 % 93 , 576 Alternative 70 % Investigation Response 63 , 219 30 , 357 % 30 Victim Nonvictim 18 , 825 44 , 394 Response to Initial Reports FFY 2004 39 39

40. Event History AR in Five States Alternative Alternative Response Response , , 38,824 30 357 6 % 6 % 10 % 11 % 84 % 83 % Alternative Alternative Investigation Investigation Response Response 4 , 026 3 , 344 None None 2 , 314 1 , 885 64 % 63 % 36 % 37 % Nonvictim Victim Nonvictim Victim 2 , 587 2 , 439 2 , 117 1 , 227 All Maltreatment Types Neglect Initial Report During FFY 40

41. 70 % Investigation 63 , 219 30 % Victim Nonvictim 18 , 825 44 , 394 Initial Report During FFY 2004 81 % 3 % 15 % 2 % 16 % 83 % Alternative Investigation Investigation Alternative None Response 7 , 192 2 , 890 Response None 1 , 169 310 73 % 48 % 27 % 52 % Nonvictim Victim Nonvictim Victim 5 , 236 1 , 956 1 , 501 1 , 389 Children with Investigations Following Initial Reports of Neglect in FFY 2004 41

42. Funding Sources (US) • State funds only • Prevention funds • CBCAP • Children’s Trust Funds • Child Welfare Services Funds • Justice Department • Grants or foundations