New Jersey to foster parents: thanks but no thanks!

Foster Parents Needed As COVID-19 Pandemic Strains Families is a typical headline these days, as illustrated in an article from Illinois. The pandemic has imposed new impediments to recruiting and retaining foster parents, including fears of exposure to COVID-19, loss of employment and income, and concerns about supervising virtual schooling. But these issues do not seem to be affecting New Jersey, where prospective foster parents are told that they are not needed, thank you very much! While the state credits its efforts at child abuse prevention and family preservation for its lack of need for foster parents, the explanation seems to lie elsewhere. Over the course of five years, the state has cut in half its rate of confirming allegations of abuse and neglect–resulting in a similar fall in the number of children entering foster care. This is a big change, and one that demands explanation in order to ensure that the agency is continuing to fulfill its mission of ensuring children’s safety in New Jersey.

Would-be New Jersey foster parents who click on “Be A Foster Parent” on the website of the Department of Children and Families (DCF) are greeted with the following message: “Thank you for your interest in becoming a resource parent to children and youth in state care.  Due to the COVID19 Pandemic and its impact on operations, DCF has suspended all new inquiry submissions at this time. Please continue to check our website for any updates.” This is an odd message indeed, as it seems to imply that the pandemic has made recruitment and licensing impossible. But agencies around the country have adapted quickly to move vetting and training online in order to enable new foster parents to enter the pipeline. Not so New Jersey.

When we asked DCF why foster parents are being turned away, we received the following reply from DCF Communications Director Jason Butkowski. “[W]e did experience a 19.17% reduction in out-of-home placements from 2019 to 2020.  This is attributable both to New Jersey’s statewide prevention network and our ongoing work to preserve families and keep children and parents together in their homes while receiving services.”

Interestingly, a message sent earlier to prospective foster parents gave a different answer. In May, 2020, would-be foster parents received a message saying, “In New Jersey, the number of youth in foster care continues to be reduced each year because we are focusing first on kinship placements,” as quoted in an article by Naomi Schaefer Riley. We asked Mr. Butkowski which explanation was more accurate–prevention and family preservation or kinship placements–but received no answer.

So what is going on in New Jersey? Certainly, foster care numbers have been decreasing. According to the data portal maintained by Rutgers University, annual entries to foster care fell from 5,504 in 2013 to 2,525 in 2019, as shown in the chart below. The rate of decrease in foster care entries became even steeper between 2018 and 2019, with a decrease of 23.7 percent in the number of entries in that one year alone. The total number of children in foster care dropped from a high of 7,775 in May 2014 to 4,463 in February 2020–before the pandemic closures occurred. So what could be causing this drastic decline in foster care placements and caseloads?

Source: NJ Child Welfare Data Hub, available from https://njchilddata.rutgers.edu/portal/entering-placement-reports#

One possibility might be a decline in child abuse and neglect, which Butkowski is implicitly assuming by attributing part of the fall in foster care cases to DCF’s “statewide prevention network.” In that case, one might expect reports to child abuse hotlines to decline significantly. But according to monthly state reports, calls to child abuse hotlines hardly changed between 2014 and 2019, decreasing very slightly from 165,458 to 164,417. Of course we cannot be sure that reports are an accurate measure of child maltreatment; but one might expect a significant reduction in hotline calls if a large reduction in maltreatment were occurring.

DCF’s Butkowski also credited the agency’s work to “keep children and parents together in their homes while receiving services” as a reason for declining foster care entries. It is true that most substantiations of abuse or neglect do not result in foster care. Instead, DCF works with many families in their homes to help them avoid future maltreatment. But DCF has been emphasizing in-home services for years. Of all the children who were under DCF supervision in foster care or in-home services, the percentage receiving in-home services rather than foster care was 84.7 percent in May 2014 and 90 percent in February 2020. So children were somewhat more likely to receive in-home services in 2020 than in 2014, but the difference was small and not likely to explain the big fall in the foster care rolls.

So with hotline calls basically unchanged, and only a slight increase in the emphasis on in-home services, how did New Jersey manage to reduce its foster care entries by almost half in six years? One can think of the child welfare process as a funnel, starting with referrals, the child welfare term for hotline calls. As we discussed, those have fallen only slightly. Only some referrals are screened-in and accepted for investigation; many are rerouted or receive no action because hotline workers determine that they do not concern abuse or neglect. But a reduction in screened-in referrals is not part of the explanation for New Jersey’s drop in foster care placements. New Jersey reported that 60,934 referrals were screened in in FFY 2019, compared with 59,151 in FFY 2013–a slight increase.

The next step in the child welfare funnel is investigation, and here the count shifts from the number of referrals to the number of children. According to data submitted to New Jersey to the Administration for Children and Families (ACF) and published in Child Maltreatment 2019, the number of children receiving an investigation in New Jersey increased slightly from Federal Fiscal Year (FFY 2015) to FFY 2019–from 74,546 to 78,741. However there was a stunning drop in the proportion of these children who were found to be abused or neglected (known as “substantiation” in the child welfare world). In FFY 2015, 13.0 percent of the children who received investigations (or 9,689 children) were found to be abused or neglected. In FFY 2019, only 6.5 percent of the children receiving investigations (5,132 children) were found to be victims of maltreatment. In other words, among the children who were involved in investigations, the proportion who were found to be maltreated dropped by half. Similarly, the number of children found to be maltreatment victims dropped by 47 percent. (This is very similar to the 44.6 percent decrease in foster care entries between those years shown in the Rutgers data portal cited above).

Note: The substantiation rate is the number of children found to be maltreatment victims divided by the number of children who were the subject of CPS investigations. Data are from Child Maltreatment 2019, available at https://www.acf.hhs.gov/sites/default/files/documents/cb/cm2019.pdf

It turns out that aside from Pennsylvania, which is not comparable to other states because it does not report on most neglect allegations, New Jersey had the lowest rate of substantiation per 1,000 children of all the states in FFY 2019. Only 2.6 children per 1,000 were found to be maltreated, compared to a national rate of 8.8 children per 1,000. In FFY 2015, this rate was 4.9 per 1,000 children in New Jersey–almost twice as high.

How did the number and percent of children found to be victims of child maltreatment drop so much in New Jersey over a four-year period, despite little decline in hotline calls? We asked DCF this question but received no reply. In the notes it submitted to ACF with its 2019 data, DCF acknowledged a decrease in the number of substantiated victims of maltreatment and stated that this is consistent with a continued trend–but provides no explanation. Perhaps policy or practice has changed to make it more difficult to substantiate abuse or neglect, through a change in definitions or in the standard of proof, or perhaps in training or agency culture. But such a change was not mentioned either by Butkowski or in DCF’s submission to ACF.

Let us revisit DCF’s previous message to foster parents saying that “In New Jersey, the number of youth in foster care continues to be reduced each year because we are focusing first on kinship placements.” This is an interesting statement because it implies that these kinship placements are not through the foster care system. It is important to understand that children can be placed with relatives in two ways. A child can be found to be a victim of maltreatment and placed with a relative, who becomes licensed as a foster parent. In New Jersey, 1,619 foster children (or 41 percent of the 3,951 children in foster care) were living with licensed kinship foster parents in November 2020. But these children are included in the state’s count of children in foster care, so they cannot account for the caseload drop. DCF must have been referring to something else.

Perhaps DCF’s earlier message to foster parents referred to the agency’s increasing use of a practice called “kinship diversion.” As described in an issue brief from ChildTrends, kinship diversion is a practice that occurs during an investigation or an in-home case when social workers determine that a child cannot remain safely with the parents or guardians. Instead of taking custody of a child, the agency facilitates placing the child with a relative. If this occurs in the context of an investigation, kinship diversion may result in a finding of “unsubstantiated” even when abuse or neglect has occurred, on the grounds that the child is now safe with the relative. We have no idea how widespread this practice is in New Jersey or nationwide since neither New Jersey nor other states report the number of these cases. However, the system of informal kinship care created by diversion has been called America’s hidden foster care system and nationwide it appears to dwarf the provision of kinship care within the foster care system.

There are many concerns about kinship diversion, as described in an earlier post: caregivers may not be vetted or held to the same standards as foster parents; they and the children they are caring for do not receive case management and services; they do not receive a foster care stipend and may have to depend on much-lower public assistance payments; there is nothing preventing caregivers giving children back to the parents without any assurance of safety; and parents are not guaranteed the due process rights and help with reunification that come with having their children in foster care. Because of the various concerns around kinship diversion, litigation has been filed in several states challenging this practice.

There is one other possible explanation that comes to mind for DCF’s foster parent surplus–dropping foster care rolls due to the COVID-19 pandemic. We removed data from the time of the pandemic from the above discussion to avoid confounding its effects with those of policy and practice changes but we need to ascertain whether the pandemic’s impact on calls to the hotline has affected entries into foster care. As in most states, hotline calls in New Jersey fell sharply in the aftermath of school closures and other pandemic measures. The number of child maltreatment referrals between March (the onset of school closures and quarantines) and November 2020 (the last month for which data are available on the DCF website) was 98,306, compared to 131,344 in the same period of 2019–a drop of 25 percent, based on monthly reports from DCF. It is likely that fewer calls from teachers now teaching virtually were a major factor behind this drop in hotline calls.

Entries into foster care also fell sharply in the wake of the pandemic. Foster care entries dropped from 1,949 in March through November 2019 to only 1,211 in the same months of 2020–a drop of 37.9 percent–which may have reflected in part the reduction in hotline calls and in part the continuing decrease in foster care entries that we have described. But the number of children in care did not drop nearly as much as entries into care. Between February and November 2020, the total number of youth in care decreased only 11 percent from 4,463 to 3,951. This drop is surprisingly low–in fact it is less than the decrease in the foster care caseload during the same months of 2019 (16.1 percent). The small size of this caseload decline reflects the fact that foster care exits dropped even more than foster care entries. Exits from foster care dropped from 2,754 in March through November 2019 to 1,661 in the same months of 2020. That is a drop of over 1,093, when the drop in foster care entries was “only” 738.[1] As a result, it appears that the number of children in foster care was higher, rather than lower, due to the pandemic. Therefore, it does not appear that the pandemic contributed to the decline in demand for foster parents.

One might expect to hear expressions of concern, or at least interest, in the recent precipitous drop in the number and rate of substantiations and in the foster care caseload from the court-ordered monitor charged with ensuring that New Jersey’s child welfare system is fulfilling its mission of protecting children. Since 2006 New Jersey has been operating under a settlement agreement in a lawsuit filed in 1999. The Court Monitor is Judith Meltzer, Executive Director of the Center for the Study of Social Policy (CSSP). In its most recent report, CSSP praised DCF for maintaining its progress toward meeting all the benchmarks required to exit the lawsuit, despite the challenges posed by COVID-19. Ironically, the report mentions DCF’s progress in “Prioritizing Safety.” The report does not mention the precipitous drop in foster care entries or substantiations before the pandemic or the fact that the state is turning away prospective foster parents.

New Jersey may be the first state to have stopped accepting applications for foster parents, and the reasons cited by DCF do not seem to explain this unusual event. Careful study of DCF data shows that the rate at which allegations of abuse or neglect are substantiated has been cut in half, and that there has been a similar reduction in entries into foster care. This cut in the substantiation rate could be due to policy or practice changes making it harder to confirm child maltreatment or it could be due to an increased tendency to place children with relatives without establishing officially that maltreatment has occurred. Without an adequate explanation from the state, the extent to which either of these factors is driving these trends is unknown. It is imperative to know the explanation of this trend to ensure that DCF’s new policies and practices are not compromising its mission of keeping children safe.

[1]: Reasons for this drop in foster care exits may include court shutdowns and delays and suspension of services parents need to complete their reunification plans.

Declining child abuse? The misuse of data in child welfare

Lowest number of maltreatment victims in five years, crowed the Administration on Children and Families (ACF), summarizing its annual report, Child Maltreatment 2019. Child welfare newsletter The Imprint eagerly repeated the claim, claiming that the Number of Child Abuse and Neglect Victims Reached Record Low in 2019. The venerable Child Welfare League of America followed suit in its Children’s Monitor saying “Data Shows Decline in Child Abuse in FY2019.” It is only by reading the report that one learns that the decline was not actually in the number of victims of abuse or neglect. Instead, it was a decline in the number of children who were found by Child Protective Services (CPS) to be abused or neglected, which is not the same thing at all.

Child Maltreatment, the Children’s Bureau’s annual report on child abuse and neglect, is based on data from the states, the District of Columbia, and Puerto Rico collected through the National Child Abuse and Neglect Data System (NCANDS). Child Maltreatment 2019 is based on data from Federal Fiscal Year (FFY) 2019, which ended September 30, 2019. (Note that these data reflect the year before the inception of the coronavirus pandemic.) Displayed below is a summary of four key national rates reported by ACF between 2015 and 2019. The first indicator shown is the referral rate, which describes the number of calls and other communications describing instance of child maltreatment per 1,000 children. Next is the screened-in referrals rate, which includes referrals that are passed on for investigation or alternative response. Once screened in, only some reports are referred for investigation, and the third set of bars represents children who received an investigation per 1,000 children. The fourth group shows the rate of children found to be abused or neglected–or those who received a substantiation. Let us go over these numbers in more detail.

*Note that Investigation and Substantiation Rates are based on number of children, not referrals
Source: Child Welfare Monitor tabulation of data from Child Maltreatment 2019, available from
https://www.acf.hhs.gov/sites/default/files/documents/cb/cm2019.pdf

Total referrals: A referral is a call to the hotline or another communication alleging abuse or neglect. In 2019, agencies received an estimated total of 4.4 million referrals, including about 7.9 million children. The “referral rate” was 59.5 referrals per 1,000 children in FFY 2019. This rate has increased every year since 2015, when it was 52.3 per 1,000 children. It is worth noting that the referral rate differs greatly by state, ranging from 17.1 referrals per 1,000 children in Hawaii to 171.6 per 1,000 children in Vermont, as shown in the report’s state-by-state tables. These differences in referral rates may stem from cultural differences regarding the duty to intervene in other families, differences in publicity for child abuse hotlines and ease of reporting, or temporal factors like a recent highly-publicized recent child abuse death.

Screened-in referrals (reports): A referral can be either “screened in” or screened out because it does not meet agency criteria. In FFY 2019, agencies screened in 2.4 million referrals, or 32.2 referrals per 100,000 children. This was a decrease in the rate of screened-in referrals per 1,000 children after three straight years of increases. This percentage of referrals that were screened in varied greatly by state, ranging from 16 percent in South Dakota to 98.4 percent in Alabama. States reporting a decrease in screened-in referrals gave several reasons, such as a change in how they combine multiple reports and a decision to stop automatically screening in any referral for a child younger than three years old.

Children who received an investigation (child investigation rate): Once a report is screened in, it can receive a traditional investigation or it can be assigned to an alternative track, which is often called “alternative response” or “family assessment response.” (Two-track systems are often labeled as “differential response.”) This rate represents the number of children who received an investigation as opposed to an alternative response. Only an investigation can result in a finding of abuse or neglect; an alternative response generally results in an offer of services. Like the referral rate, the investigation rate increased from 2015 to 2018 and then decreased in 2019. This rate also varies widely between states and over time. Some states eliminated or expanded their differential response programs in 2019, resulting in more or fewer investigations, as described in the report.

Substantiation: A “victim” is defined in NCANDS as a “child for whom the state determined at least one maltreatment was substantiated or indicated; and a disposition of substantiated or indicated was assigned for a child in a report.” The report’s authors refer to the number of such children per 1,000 as the “victimization rate.” But clearly substantiation does not equal actual victimization. The difficulty of making a correct decision on whether maltreatment has occurred is well-documented. Stories of families with repeated reports that are never substantiated or not confirmed until there is a serious injury or even death are legion. So are reports of parents wrongly found to be abusive or neglectful. Therefore, we have chosen to use the term “substantiation rate” instead of ‘victimization rate.” This rate varies greatly by state, from 2.4 per 1,000 children in North Carolina to 20.1 in nearby Kentucky.[1] The national substantiation rate in FFY 2019 was 8.9 per 1,000 children, down from 9.2 per 1,000 in FFY 2019 and FFY 2015. States reported a total of 656,000 (rounded) victims of substantiated child abuse or neglect in FFY 2019–a decline of four percent since 2015.

So does this decline in the number and rate of substantiations really connote a decline in child abuse and neglect? The range in substantiation rates among states argues against this idea. Unless states differ by almost a factor of 10 in the prevalence of child abuse and neglect, these numbers must reflect factors other than the actual prevalence of maltreatment. And indeed the report’s authors acknowledge that “[s]tates have different policies about what is considered child maltreatment, the type of CPS responses (alternative and investigation), and different levels of evidence required to substantiate an abuse allegation, all or some of which may account for variations in victimization rates.” Changes in these policies and practices can account for changes in these rates over time. Moreover, changes in all the earlier stages of reporting, screening, and assignment to investigation or alternative response contribute to changes in the substantiation rate. In 2019, screened-in referrals and investigations per thousand-children both decreased, which clearly contributed to the decrease in the substantiation rate.

It is interesting to note that while referrals increased every year between FFY 2015 and FFY 2019, both screened-in referrals and investigations decreased in FFY 2019. This suggests a general tendency among states to be less aggressive in responding to allegations of maltreatment, perhaps in accord with the prevalent mindset among child welfare leaders nationally and around the country, as discussed below.

Understanding the difference between “victimization” and “substantiation” and the many possible causes of a decrease in this rate reveals the deceptiveness of ACF’s statement that “[n]ew federal child abuse and neglect data shows 2019 had the lowest number of victims who suffered maltreatment in five years.” Lynn Johnson, the HHS assistant secretary for children and families, is quoted in ACF’s press release as saying that “[t]hese new numbers show we are making significant strides in reducing victimization due to maltreatment.” Unless Johnson and the ACF leadership intended to mislead, it appears they are woefully ignorant of the meaning of these numbers.

Most regular leaders of this blog already know why ACF wants to support the narrative of declining child maltreatment. The current trend in child welfare policy, regardless of political party, is to oppose intervention in families. Republicans who oppose government spending and interference in family life have made common cause with Democrats who think they are reducing racial disparities and supporting poor poor families by allowing parents more freedom in how they raise their children, even if it means leaving children unprotected. Members of both parties came together to pass the Family First Act, which encoded this family preservation mindset into federal law.

Child Welfare Monitor has pointed out many other instances where ACF or by other members of the child welfare establishment in the interests of supporting the family preservation mindset. For example, we wrote about the Homebuilders program, which was classified by a federally-funded clearinghouse as “well-supported” despite never having been proven effective for keeping families together. In fact, Homebuilders had to be classified as well-supported because it was one of the key programs touted by ACF and others in promoting the Family First Act and other policies promoting family preservation.

So if ACF’s “victimization” data do not in fact tell us what is happening to abuse and neglect rates, what else is available? We call on Congress to pass an overdue re-authorization of the Child Abuse Prevention and Treatment Act and include a fifth National Incidence Study of Child Abuse and Neglect. Data for the last study was collected in 2005 and 2006; it is high time for an update which should put an end (at least temporarily) to the misuse of NCANDS data as an indicator of trends in child maltreatment.

President Biden has called for ending a “culture in which facts themselves are manipulated and even manufactured.” We hope that ACF under its new leadership, as well as the rest of the child welfare establishment, will take these words to heart and commit themselves to truth and transparency from now on.

[1]: Pennsylvania has a substantiation rate of 1.8, even lower than that of North Carolina, but in Pennsylvania, many of the actions or inactions categorized as “neglect” are classified as “General Protective Services” and not included in the substantiation rate, making its data not comparable to that of the other states and territories.

[2]: Massachusetts did not provide data on FFY 2019 child maltreatment fatalities.

Illinois’ Intact Family Services: What happens when family preservation trumps child safety?

ChapinHallIllinois’ child welfare services to families that are allowed to keep their children have major systemic flaws that put children at risk. Most importantly, there is extreme reluctance to remove children from their homes and place them in foster care. Those are the findings of a review from Chapin Hall at the University of Chicago that was commissioned by the Governor in the wake of several deaths of children whose families were being supervised by the state.

This report follows an earlier one, discussed in a  previous post,  by the Inspector General (OIG) for the Illinois Department of Children and Family Services (DCFS) stating that child safety and well-being are no longer priorities for the agency.  One problem area identified in that report was Intact Family Services, which are the services provided to families in order to prevent further abuse or neglect without removing the child. OIG’s 2018 annual report included an eight-year retrospective on the deaths of children in Intact Family Services cases, which concluded that in many of these cases the children remained in danger during the life of the case due to violence in their homes, when DCFS should have either removed the children or at least sought court involvement to enforce participation in services,

Increasingly, child welfare systems around the country have been relying on services to intact families (often called in-home or intact family services) in order to avoid placing children into foster care. In 2017, according to federal data, only 15% of children who received services after an investigation or assessment were placed in foster care; the other 85% were provided with services in their homes. These services may become even more predominant with implementation of the Family First Prevention Services Act, which allows federal Title IV-E funds to reimburse jurisdictions for the cost of such services.

It is important for child welfare agencies to be able to work with families that remain intact. This allows the agency to monitor the children’s safety and avoid the trauma of placement in foster care while working to ameliorate the conditions that might lead to a foster care placement. But agencies must be cognizant that not every family can be helped this way, keep a close watch what is going on in the home, and be ready to remove children when necessary to ensure their safety. The deaths of children who have received Intact Family Services in Illinois have raised questions about whether the agency is accomplishing these tasks.

In Illinois, Intact Family Services (referred to below as “Intact”)  are provided mostly by private agencies under contract with DCFS. The Chapin Hall  report found systemic issues that create barriers to effectively serving intact families.

Avoiding foster care placement: Perhaps the most important issue observed by the researchers was the high priority that Illinois places on avoiding placement of children in foster care. As a result of many years of such efforts, Illinois now has the lowest rate of child removal in the country. Intact staff expressed the belief that “recommendations to remove children based on case complexity, severity, or chronicity will not be heard by the Division of Child Protection (DCP) or the Court.” As a result, Intact supervisors are reluctant to reject referrals of families even when they believe a family cannot be served safely in the home.  They are also reluctant to elevate cases for supervisory review when they have not been able to engage a high risk family.

Supervisory Misalignment: In the past, negotiations between DCP and Intact over the appropriateness of a referral occurred on a supervisor-to-supervisor level, allowing Intact to push back against unsuitable referrals. An administrative realignment that placed investigators and Intact under different administrations eliminated this ability of Intact to contest inappropriate referrals. According to the researchers, this resulted in the opening of Intact cases for families with “extensive histories of physical abuse” that Intact staff believed they could not serve effectively.

High Risk Case Closures:  Intact service agencies are expected to work with a family for six months and then close the case with no further involvement by DCFS. The researchers learned that there was no clear pathway for intact staff to express concerns when they been unable to engage a family. As a result, some providers told the researcher that they may simply close the case when a family will not engage.

Staffing Issues: Caseload, capacity and turnover.  The researchers found that DCP investigators are overwhelmed with their high caseloads and are desperate to make referrals to Intact to get families off their caseload as soon as possible. The prescribed caseload limit of 15 cases per worker is very hard to manage, and some workers carry even more cases. Moreover, DCP workers tend to stop managing safety plans and assessments as soon as a referral is made to Intact, which leaves children in limbo until services begin. For their part, Intact workers’ caseloads are often over the prescribed limits and are not adjusted for travel time or case complexity. Moreover, the difficulty of their clientele makes the current caseload of 10:1 difficult to manage. High turnover among Intact workers, investigators and other staff can also contribute to the information gaps and knowledge deficits mentioned below.

Role Confusion: DCP workers and Intact workers seem to have different views of the role of the DCP worker, according to the researchers. DCP workers view their role as making and justifying the decisions about whether to substantiate the referral and remove the child. However, the Intact Family Services policy calls upon them to engage the family and transmit all necessary information to the Intact staff. Cultural differences between the two sets of workers compound the problems.

Information Gaps: Because of the role ambiguity mentioned above, investigators often fail to pass on crucial information to Intact workers. Yet, these workers often cannot access investigators notes or key features of the case history. Moreover Chapin Hall’s reviews of the two recent deaths of toddlers in intact cases found that much of the family’s history was inaccessible because cases were expunged or purged. DCFS expunges most unsubstantiated reports and shreds investigators files and appears to be more aggressive about such expungements than most other states, according to a previous DCFS Director, George Sheldon.

Service Gaps: The researchers also mentioned gaps in service availability, especially long waiting lists for substance abuse prevention, which make it very difficult to engage families as well as providers.

The authors made a number of recommendations for addressing these problems they identified.  These include:

  • Work with courts and State’s attorneys to refine the criteria for child removal in complex and chronic family cases;
  • Develop and refine protocol for closing Intact cases;
  • Direct attention to cases at greatest risk for severe harm; revisit the use of predictive models which should be transparent, based on broad input and be supported by ethical safeguards’
  • Clarify goals and expectations across staff roles;
  • Utilize evidence-based approaches to preventive case work;
  • Improve the quality of supervision;
  • Adjust the preventive services offered through Intact to meet the needs of the population;
  • Restructure Intact Services to address the supervisory mismatch with DCP; and
  • Redesign the assessment and intake process to reduce redundant information, improve accuracy or assessments to support decision-making and improve communication across child serving systems.

We would have liked to see a recommendation to modify Illinois’ policy of expunging and purging all unsubstantiated investigations. At a hearing in May, 2017, the DCFS Director, George Sheldon, expressed his support for allowing DCFS to keep records of all investigations, even if they are unsubstantiated. Research suggests that it is very difficult to make accurate decisions about whether maltreatment has occurred; moreover, unsubstantiated reports are as good as substantiated ones in predicting future maltreatment. Examples of children killed after families have had multiple unsubstantiated reports have been observed all over the country.

This report should be a must-read for all child welfare agencies.  Children in many states have died of abuse or neglect after intact cases have been opened for their families. (Think about Zymere Perkins in New York or Anthony Avalos and Gabriel Fernandez in Los Angeles.) Many of the issues identified by the Chapin-Hall report may have contributed to these deaths as well, particularly the extreme avoidance of child removals that has condemned so many innocent children to death ever since the widespread push to reduce the foster care rolls, supported by a coalition of wealthy and powerful foundations and advocacy groups.

 

Primary prevention of child maltreatment should include family planning

familyplanning
Image: mattapanchc.org

Primary prevention is the phrase of the day in child welfare. As Jerry Milner, Associate Commissioner of the Children’s Bureau of the Department of Health and Human Services put it in a letter attached to the program for the recent NCCAN conference, “Right now, our child welfare system typically responds only after families have lost much of their protective capacity and children have been harmed. We need to create environments where families get the support they need before harm occurs. This calls for an intensified focus on primary prevention and a reconceptualization of the mission and functioning of child welfare systems.”

Primary prevention refers to the prevention of abuse and neglect before it occurs through universal approaches. This is distinguished from secondary prevention, which focus on those at risk for a problem like child maltreatment, or tertiary prevention, which focuses no preventing on recurrence of a problem that has already occurred. (The much touted Family First Act allows funds to be used only for tertiary prevention, which is perhaps why it was not mentioned at the conference and why the Children’s Bureau has been dragging its feet on issuing guidance to states and counties.)

Yet, discussions of primary prevention (including those at NCCAN) often leave out the most primary of all–encouraging people to delay childbearing until they are ready to be parents, to wait at least 18 months between pregnancies, and to curb the overall number of children they have.

The connection between teen pregnancy and child maltreatment is well-known, but adolescence is lasting longer than ever, and even mothers aged 20 to 25 are more likely to abuse or neglect their children than older mothers. California researchers Emily Putnam-Hornstein and Barbara Needell found that babies born to mothers who were under 20 were twice as likely to be reported to child protective services (CPS) by the child’s fifth birthday as those born to mothers 30 or older. Among children referred to CPS by age five, almost 18 percent were born to a teenage mother and 50 percent were born to a mother younger than 25. Among children with no CPS contact, only 8 percent were teen births and 30 percent were born to a mother under 25.

Less well-known or discussed is the consistent evidence that larger family size and closer child spacing are correlated with child maltreatment. The Fourth National Incidence Study of Child Abuse and Neglect found that households with four or more children had a maltreatment rate of 21.2 per thousand, compared with 11.9 per thousand for families with two children. Putnam-Hornstein and Needell found that children who fell third or higher in the birth order were more than twice as likely to be the subject of a maltreatment report as first children.

Not surprisingly, research suggest that the interaction between birth order and maternal age creates the highest risk for a child maltreatment fatality. A study using linked birth and death certificates for all births in the U.S. between 1983 and 1991 found that the most important risk factors for infant homicide were a second or subsequent infant born to a mother less than 17 years old. These infants had 11 times the risk of being killed compared with a first infant born to a mother 25 years old or older. A second or subsequent infant born to 17 to 19-year-old mother had nine times the homicide risk of the first infant born to the older mother.

And setting the research aside for a moment, anyone who has worked for or with CPS, or in foster care, knows the prevalence of larger families with closely-spaced children in the system, often with a mother that started childbearing as a teen. This blogger has observed the same pattern as a member of the District of Columbia’s Child Fatality Review Committee, and it has been observed in other jurisdictions as well.1  

If it is not the lack of research, why do supporters of child maltreatment prevention fail to include family planning and contraception in their suggestions? Judging from the reactions this blogger has received when raising this issue,  it is our country’s shameful history of attempting to restrict childbearing by women of color through means including forced sterilization and the promotion of birth control methods like Norplant.

But advocates for children of color should not allow this racist history to prevent thinking clearly about what is best going forward. There are few if any policies that could be more helpful to the future of black children and the elimination of racial disproportionality in foster care placement than ensuring that black women have access to the most effective methods of contraception so that they can determine their own futures.

Family planning and contraception need to be included in the discussion about child maltreatment prevention. Research suggests that media messaging, better information, and use of more effective contraceptive methods contributed to the drastic decline in the teen birth rate from 61.8  per thousand in 1991 to 18.8 per thousand in 2017. However, it is still high among certain populations, including Black (27.5 per thousand) and Hispanic (28.9 per thousand) teens.

We now have safe, effective long-lasting reversible methods of contraception. Known as LARC’s, for “Long Lasting Reversible Contraceptives, these methods provide long-lasting contraception without requiring action by the user. They include IUD’s and contraceptive implants. But LARC’s are not universally available, and even when available, women desiring these methods may have to return for a second appointment. Moreover, health care professionals are often not trained to address myths and misconceptions concerning longer-lasting contraception. The Colorado Family Planning Initiative improved access to LARC’s by training public health providers, supporting family planning clinics, and removing financial barriers. As a result of this initiative, the state’s teen birth rate was cut in half in just five years.

The Colorado initiative could be adopted nationwide, combined with a mass media campaign to explain the benefits to both children and parents of planning and spacing of pregnancies and births. We know that such campaigns can change people’s health-related behavior, as in the case of smoking cessation and HIV prevention. 

The omission of pregnancy prevention from the primary prevention toolkit is particularly upsetting because very few programs have been shown to be effective in preventing abuse or neglect after a baby is born. Jerry Milner and other proponents of primary prevention in child welfare argue that we should help families before they maltreat their children. How much more efficient and humane it would be to postpone the birth of children who are likely to be maltreated and help troubled adults address their problems before they have a first or subsequent child rather than afterwards?

  1. Testimony of Dr. Angela Diaz, CECANF, August 6-7, 2015), https://slideblast.com/cecanf-nyc-meeting-transcriptfinal_59767e8e1723ddc0e0eedc5d.html 

 

 

 

Feds confuse substantiation with victimization

On January 28, the Administration of Children and Families (ACF) released its annual report on child maltreatment. In its press release, the agency heralded “a decline in the number of victims who suffered maltreatment for the second consecutive year.” There are three problems with this. First, the alleged decrease in victimization between Federal Fiscal Years (FFY) 2016 and 2017 is so small as to be insignificant. Second, what declined was not child maltreatment but rather the number of children who were “substantiated” as maltreated–a decline that may reflect changing state practice rather than declining child maltreatment. Finally, ACF’s presentation appears designed to support a narrative that favors family preservation over child safety rather than to report the data in an objective manner.

The newest edition of ACF’s Child Maltreatment report is based on state data for FFY 2017, which ran from October 2016 to September 2017. The report shows that states received 4.1 million referrals (calls to child abuse hotlines) alleging maltreatment involving 7.5 million children in 2017. The number of referrals as a percentage of the number of children has increased annually since 2013. ACF does not discuss the reasons for this ongoing increase, nor does it present referral numbers by state, but such increases could stem from increased awareness of child abuse and neglect (often due to highly-publicized child deaths), public information campaigns, or other factors.

Of the 4.1 million referrals received nationwide in 2017, 2.4 million  (or 58%), were “screened in” by state or county child welfare agencies, which means they met agency criteria for receiving a response. As a result, 3.5 million children received either a traditional child maltreatment investigation or were assigned to an alternative non-investigative track, as described below. And of these 3.5 million children, an estimated 674,000 or 19% were found to be victims of abuse or neglect. This flowchart, based on data from Child Maltreatment 2017, illustrates this funneling effect from referrals to substantiation.After rounding and a calculation to account for missing data from Puerto Rico in FFY 2016, HHS estimates that the number of children found to be maltreated decreased of 3,000 (or 0.4%) from the previous year. Such a small change is hardly meaningful; it would be more accurate to say that the number was basically unchanged. This difference from one year to the next is so small that the rate of children found to be victimized was the same in 2017 as in 2016–9.1 per 1000 children. In other words, almost one percent of all children were found to be the victims of maltreatment in 2016 and 2017.

But perhaps more important than the small size of the decrease is the fact that referring to a “decline in the number of victims” or the “victimization rate”  is deceptive, which is why I have used cumbersome terms like “found to be victims of child maltreatment.” Most states use the term “substantiation” to connote that they have concluded maltreatment have occurred; some have an additional finding called “indication” that is somewhat less conclusive than substantiation. But as we all know, a finding of maltreatment is not the same as actual maltreatment. Just look back at my columns on Jordan Belliveau in Florida, Anthony Avalos in California, the Hart children in Oregon, and Adrian Jones in Kansas to find cases where horrific abuse occurred but was not substantiated until a child died.

And that is not the only problem. As ACF itself explained, changes in state policy and practice can influence the number of reports that are substantiated. Different states have different evidence thresholds to substantiate an allegation. According to the report, 37 states require a “preponderance of” evidence, 8 states require “credible” evidence, 6 states require “reasonable” evidence and one requires “probable cause.” One state changed its evidence threshold between 2016 and 2017.

In addition to different criteria for substantiation, some states treat all screened-in referrals in the same way while others have a two-track system of responding to reports. In these two-track systems (often called “differential response” or “alternative response”), some allegations receive a standard investigation, but others (usually deemed to be at lower risk of harm) receive less rigorous response, often known as a “family assessment.” The children in these cases are not determined to be victims even if they have been abused or neglected. Instead their families are offered voluntary services. About half of states reported data on children in alternative response programs. As the above flow chart shows, 639,634 children received an alternative response, almost as many as the 674,000 who were determined to be maltreated.

So a given state’s substantiation rate will be influenced by whether it has differential response in all or part of the state. And if the use of differential response in a state was expanding or contracting over a given period, this will influence the change in the number of  children who are determined to be victims of maltreatment. Specifically, if states increased their use of differential response overall, that would have reduced the number of children found to be maltreated.

And indeed, ACF reports that “states’ commentaries suggest the increased usage and implementation of alternative response programs ….may have contributed to the changes noted in the 2017 metrics.” And upon review,  the commentaries, included in an Appendix to the report, do suggest that the number of reports subject to differential response increased between FFY 2016 and 2017. Six states, including New York, and Texas (two of the four states with the highest number of children)1 were ramping up their use of differential response during FFY 2017, while Massachusetts and Oregon stopped using the two-track system in FFY 2016 and 2017 respectively.

ACF also suggests that changes to state legislation and child welfare policies and practices might influence the number of substantiated allegations. The state commentaries reveal that some states experienced such changes, although it is not clear that they trended in one direction. Some states like Pennsylvania reported an increased emphasis on safety resulting in increased substantiations and others like New Jersey reporting reduced substantiations due to new policies.

As all this discussion shows, it is almost impossible to attribute a change in the number or rate of substantiation to an actual change in the amount of child abuse and neglect. Too many other things are influencing this number and rate.

Not only did ACF inaccurately herald a decrease in maltreatment but it went on to contrast this alleged decrease with the increasing number of referrals, stating “We are experiencing increases in the number of children referred to CPS at the same time that there is a decrease in the number of children determined to be victims of abuse and neglect.” Media outlets lost no time in picking up on this alleged contrast. For example,  the Chronicle of Social Change reported that Child Victimization Declines as Reports of it Continue to Rise.

The interpretation of child welfare numbers to paint a picture of decreasing maltreatment in the face of increasing reporting is not an accident. It feeds into the narrative that is currently dominating in most states and on the federal level without regard to party. According to this narrative, almost all children are better off staying with their parents, no matter how egregious the maltreatment. Removals should be prevented at all costs. If maltreatment is decreasing and reporting is increasing, perhaps something should be done to squelch those pesky hotline callers.

The data presented in Child Maltreatment is extremely important. It is too bad ACF did not stick to reporting it accurately so that readers can understand what it means–and what it does not.


  1. Colorado, Georgia, Nebraska and Washington were the other four states that expanded the use of differential response during FY 2017.