Differential Response 101 American Humane’s 2010 Conference on Differential Response

1. Differential Response 101American Humane’s 2010 Conference on Differential Response Amy Rohm, MSW Brenda H. Lockwood, MA American Humane Association November 9, 2010 Anaheim, California

2. American Humane Association’s Involvement in Differential Response • Publications • Annual Conference • Training/Technical Assistance/Consultation • Bureau of Indian Affairs • California • Colorado • Illinois • Montana • New York • Ohio • Saginaw Chippewa Tribe (MI) • Wisconsin • Disseminate Information • Lead for National Quality Improvement Center on Differential Response

3. Goals for this Session • Provide an overview of differential response, including history, values and practice elements • Share current research & evaluation on differential response • Answer your questions and provide you with resources

4. What is Differential Response? • Alternative to traditional child protection investigative response and one of several responses within a differential response system • Sets aside fault finding and substantiation decision • Usually applied to reports that do not allege serious and imminent harm • Focuses less on investigative fact finding and more on assessing and ensuring child safety • Seeks safety through family engagement and collaborative partnerships • Allows and encourages agencies to provide services without formal determination of abuse or neglect

5. Murky Waters: What makes it so difficult to understand ‘Differential Response’ • Different terminology • Different definitions • Different models • Different services • Different service providers • Continuous evolution of the practice

6. History of Child Welfare and the Purpose of Differential Response

7. Purposes of Differential Response and Child Protection • CPS was established to respond to all reports of suspected child maltreatment, but numbers overwhelm available resources • Systems either screen out or do not open for services more than half of reports, yet many children are vulnerable

8. Purposes of Differential Response in Child Welfare • Traditional investigatory practice is often adversarial & alienates parents • DR is a way to respond to more reports (screened in) at an earlier stage by engaging families in a non-adversarial process of linking them to needed services

9. Why Implement Differential Response?

10. Why ImplementDifferential Response? Recent Study on CP Investigations : • Do little to reduce risk • Do not result in long-term improvement in family functioning or child behavior • Are associated with increased depression among mothers “Child Protective Services Has Outlived Its Usefulness” Dr. Kristine Campbell, Assistant Professor of Pediatrics at the University of Utah Published in The Archives of Pediatrics and Adolescent Medicine Oct. 2010

11. Why Implement Differential Response? “A lot of times the [family] situation calls for the formation of a healing relationship so the very act of going there in an investigatory mode impairs the ability [for workers] to form a meaningful relationship in which parents can be open, ask for and get help” ~Dr. Bruce Perry, M.D., Ph. D Senior Fellow Child Trauma Academy www.childtrauma.org

12. Why Implement Differential Response? Increasingly, concerned citizens and organizations are realizing that the best way to prevent child abuse is to help parents develop the skills and identify the resources they need to understand and meet their children's needs and protect them from harm

13. Why ImplementDifferential Response? According to National Study of Child Protective Services Systems and Reform Efforts (2003), 20 states identified one of 3 purposes as reason for DR system: • child safety (55%) • family preservation or strengthening (45%) • prevention of CA/N (20%)

14. The Core Elements of Differential Response

15. Core Elements of Differential Response • Use of two or more discrete responses to reports of maltreatment that are screened in and accepted • Assignment to response pathways determined by an 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 investigatory response

16. Core Elements of Differential Response • Establishment of discrete responses codified in statute, policy, protocols • After assessment, services are voluntary for families who receive a non-investigatory response (as long as child safety is not compromised) • No substantiation of alleged maltreatment and services are offered without formal determination that child maltreatment has occurred • Use of central registry is dependent upon type of response

17. Differential Response in the U.S.

18. Principles and Assumptions of Differential Response

19. Principles and Assumptions of Differential Response • The circumstances and needs of families differ and so should the response • The majority of reports do not need an 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

20. Principles and Assumptions of Differential Response • Effective assessment tools can be put in place to assure safety and 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 course/paths when situation requires

21. Practice Framework and Assumptions • The primary goal of non investigative approach is child safety • Most families want to address threats to child safety • Most families can be partners in achieving child safety • Families are more than the presenting concerns • Family protective factors can assist in keeping children safe • Families are helped through connections with community services and resources

22. Comparing Traditional Child Protection Models and Differential Response

23. Traditional Child Protection Practice Model Investigation model is rooted in the determination of whether: • A child has been harmed • A child is at risk of being harmed • An individual is culpable for this conduct.

24. Model for Differential Response Differential Response System focusing on a child in need of protective services and support and engagement of the family.

25. Commonalities of Differential Response and Traditional Pathways • Focus on establishing safety not blame • Safety through engagement of family strengths and community resources • Parent as partner using collaborative practices • Non-judgmental, honest & attentive responses • Child safety addressed within context of family well-being • Services not surveillance [Loman, 2005]

26. Factors Determining Response • Statutory limitations • Severity of the allegation • History of past reports • Ability to assure the safety of the child • Willingness and capacity of the parents to participate in services

27. Differential Response and Child Welfare Casework Practice

28. Differential Response and Casework Practice Protecting Children From Harm Building Safety Around Children

29. Differential Response and Casework Practice • Move from agency expert driven compliance approach to safety focused partnership with families and communities • Focus on securing child safety through family engagement • Recognizing and applying family and community strengths and resources; honoring family wisdom about their circumstances, strengths and needs, as well as culture

30. Differential Response and Casework Practice • Engagement practices: • Communicate with families strategically • Avoid drop in visits • Ask parental permission to see children • Stay separate from law enforcement • Be transparent in purpose & process • Honor family decisions unless they compromise safety

32. Differential Response Research and Evaluation

33. Research Designs • Missouri Family Assessment and Response (FA): • Comparative study • Minnesota Family Assessment Response (FAR): • Random assignment • Ohio Alternative Response (AR): • Random assignment

34. Screened out Inappropriate for DR TR Traditional Investigations A Child Maltreatment Reports Initial Screening For CPS The Evaluation EOutcome/Impact Analysis Control Group Control Cases B D DR Pathway Assignment Random Assignment • Pool of Reports Eligible for DR AcceptedReport (Screened in) C Experimental Group Cases offered DR DR-appropriate DR Family Assessments Random Assignment

35. Differential Response Evaluation Missouri [began implementation 1995] • Child safety not diminished • Family engagement under DR • CPS staff reacted positively • Services to families and children increased and changed • New CA/N reports and later placements of children reduced • Short-term costs greater, long-term costs reduced

36. DR Evaluation: Family Satisfaction • When asked if parents felt more able to care for their children now than at the time of last contact, the percentage of experimental parents replied increased from 42% to 62%. The percentage of control parents responding in the positive decreased from 49% to 42% • On an overall satisfaction scale of 1-24, families that received FAR services scored 19.3 as compared to 17.4 for control families Minnesota (More than 10 years DR Experience)

37. DR Evaluation: Family Satisfaction • Nearly half (47.5%) of the alternative response families said they were very satisfied with services received or offered, compared with 34.4% of control families • In answering the question, “If you received some help or services,0 was it the kind you needed?,” 56.2% of the experimental families answered affirmatively compared to 46.4% of control families Ohio [10 pilots launched July 1, 2008, 10 additional counties October 2010]

38. DR Evaluation:Level of Involvement in Decision Making (MO)

39. DR Evaluation:Family Cooperativeness

40. DR Evaluation: Services Provided • Missouri: • Over 60% of supervisors and administrators said that DR had given their workers greater flexibility, had improved their effectiveness and increased the appropriateness of services provided to families and children • 45% thought children and/or families probably had been given services or assistance because of DR that they would not have otherwise received • Minnesota: • Among families that received services, the mean number of services received was 1.6 for DR versus 0.9 for control families • Ohio: • DR workers directly assisted with 83.3% of DR families for services in the category “help with rent or house payments” compared to 30.0% for traditional response workers • Similar differences were found for other related categories, such as basic household needs and emergency food

41. DR Evaluation:Percentage of Families Receiving Concrete Services

42. DR Evaluation:Child Abuse and Neglect Report Recurrence • Missouri • 60.7% of demonstration families had a new FCS case opened during the five-year follow-up period compared to 75.7 % of comparison families • Minnesota • 39.8% of control families had received one or more CPS report in the follow-up period vs. 37.5% of experimental families • Researchers calculated the risk of child removal under investigation versus DR to be 28% higher, when controlling for length of time to follow-up and past CPS reports • Ohio • Among families entering the study during the first 360 days, 13.3% of control families had a new report compared to 11.2% of experimental families

43. DR EvaluationSubsequent Foster Care Placement/Home Removal • Missouri • 28.2% of demonstration families had one or more children subsequently placed versus 25.7% of comparison families • Minnesota • Researches calculated the relative risk of a child being placed out-of-home of the median follow-up period of 3.6 years as being twice as likely for control families • Ohio • Within the control group 3.7% of children had been removed while 1.8% had been removed in the experimental group, a statistically significant difference

44. DR Evaluation: Cost Analysis • Missouri • A goal of the DR demonstration was to make it cost-neutral to the traditional system; thus, no additional funds were made available or tracked for implementation of the pilot • Minnesota • Experimental average cost per family $3,688 vs. $4,968 for control families • Total cost savings for DR is $1,280 – or 35% • Ohio • Combining direct and indirect costs for the entire period from initial report through the follow‐up on each family, mean costs of $1,325 were found for experimental cases under AR compared to $1,233 for control families in traditional investigations

45. Questions?

46. Resources • American Humane Association • www.americanhumane.org/differential • Quality Improvement Center on Differential Response • www.DifferentialResponseQIC.org • Institute of Applied Research • www.iartstl.org • Resource Table at Conference

47. Presenter Contact Information Amy Rohm, MSW American Humane Association amyr@americanhumane.org Phone: 303-925-9413 Brenda H. Lockwood, MA American Humane Association brenda.lockwood@americanhumane.org Phone: 612-886-1183

48. References Loman, A., Filonow, C., & Siegel, G. (2010). Ohio alternative response evaluation: Final report www.americanhumane.org/assets/docs/protecting-children/PC-DR-Ohio-Section2-Final-Evaluation-Report.pdf Loman, A., & Siegel, G. (2004a). Differential response in Missouri after five years. St. Louis, MO: Institute of Applied Research. www.iarstl.org/papers/MODiffResp2004a.pdf Loman, A., & Siegel, G. (2004b). Minnesota Alternative Response Evaluation: Final Report. St. Louis, MO: Institute of Applied Research. www.iarstl.org/papers/ARFinalEvaluationReport.pdf Loman A., & Siegel, G. (2005). Alternative response in Minnesota: Findings of the program evaluation in Differential Response in Child Welfare. Protecting Children, 20(2&3), 78-92. www.iarstl.org/papers/ARinMNfromProtectingChildren.pdf Siegel, G., & Loman, A. (2000). The Missouri Family Assessment and Response Demonstration impact evaluation: Digest of findings and conclusions (Updated). St. Louis, MO: Institute of Applied Research. www.iarstl.org/papers/MoFamAssess.pdf