The Eckerd Rapid Safety Feedback Process (ERSF) is an approach to child welfare practice that combines predictive risk modeling (PRM) with real-time quality assurance and staff coaching during a ...child protective services investigation. During the case investigation, quality assurance (QA) reviewers provide guidance to staff by assessing key dimensions of their investigative practices and providing coaching sessions as needed.
To determine to what degree ERSF reduced the incidence of children who experienced high severity physical, sexual, or neglect maltreatment (HS-CAN) among children known to a state child welfare agency, within 12 months of the agency's involvement in a previous investigation.
This multi-year quasi-experimental study evaluated the impact of the ERSF Process on risk of repeat high severity maltreatment among children and youth identified by a PRM algorithm as high risk for experiencing repeat maltreatment and receiving the additional QA intervention, compared to those receiving the usual standard of care.
The ERSF Process did not lower the rate of HS-CAN among children identified as high risk. The joint odds ratio for receiving ERSF given being high risk was 1.05, i.e. a point estimate indicating higher probability of future HS-CAN.
In this statewide implementation of ERSF, we did not find a positive effect of this particular PRM-based intervention. Future maltreatment, even within 12 months of a prior investigation, may be too distal an outcome for a PRM and QA process designed to produce a high-quality CPS investigation and safety plan.
•Applications of data analytics in the form of predictive risk modeling are increasingly being used in child welfare.•Evaluation of predictive risk modeling approaches, particularly in child welfare, is sparse.•There is no evidence the Eckerd Rapid Safety Feedback approach reduces the incidence of subsequent severe child maltreatment.
Among nearly 400,000 children in US foster care, an estimated 10 % are medically complex. Yet, population-level data about children with medical complexity (CMC) served by the child welfare system, ...both for prevention and foster care services, are largely unavailable.
To understand how US child welfare agencies define, identify, and track CMC.
Child welfare agencies across the US.
Agencies were recruited to complete a survey as part of a larger study exploring how CMC are served by the child welfare system. Survey responses related to defining, identifying, and tracking CMC were included in analysis. Descriptive statistical analysis was conducted with Stata. Qualitative content and thematic analysis were applied to free text responses.
Surveys were completed by agencies from 28 states and 2 major cities. Nearly half of the agencies did not have a clear definition to identify CMC; those that did have a definition often lacked standardization. The majority of agencies could not easily identify CMC or access CMC-related data within data systems. Agencies described lack of a clear definition as a barrier to collecting population level data.
Many US child welfare agencies lack a clear definition to identify and track CMC, impacting the ability to tailor care and service delivery to meet their unique needs. To address this, a clear definition for CMC should be developed and consistently applied within child welfare data systems. Once CMC are identifiable, future research can collect population-level data and provide recommendations for best practices and policies.
The Family Intensive Treatment (FIT) team model provides intensive team-based, family-focused, comprehensive services to families in the child welfare system with parental substance misuse issues. ...The current evaluation study examined the effect of FIT on child safety, permanency, and parental wellbeing. A longitudinal quasi-experimental design with a two-group comparison using propensity score matching was used. Compared to a group of similar parents/caregivers receiving child welfare services (N = 2976), parents/caregivers who received FIT (N = 3025) were less likely to have new allegations of child maltreatment within 6 and 12 months after participating in the FIT program. There was no significant association between FIT receipt and recurrence of verified (i.e., substantiated) maltreatment: the rates of verified maltreatment were very similar for the parents/caregivers in the FIT group and the parents/caregivers in the comparison group. Similarly, no significant differences were found when the rates for foster care reentry were examined. In contrast, children of parents/caregivers who received FIT achieved permanency faster and at a greater rate compared to their counterparts. In addition, participation in the FIT program predicted improvement in parental/caregiver emotional protective capacity and overall protective capacity and showed a positive tendency in improvement of parental/caregiver behaviors related to their protective role. Finally, parents/caregivers who received FIT demonstrated significant improvements over time in several wellbeing domains including Daily Living Activities, Mental Health and Addiction, and Adult and Adolescent Parenting.
ABSTRACT
This paper presents data about the emotional, behavioural and substance abuse disorders of youth in foster care and former recipients of foster care (‘alumni’) in the USA. The prevalence ...rates of these groups are compared to those of the youth and young adults in the US general population. The implications of these data for policy and program design are discussed.
There are few social, vocational, educational, and mental health programs that are specifically designed for the challenges facing transitional-age youth (TAY). This Clinical Perspectives will ...illustrate multiple pitfalls facing TAY transitioning from foster care to adulthood.
This study evaluated the intermediate and long-term effects of family foster care on adult functioning using a sample of 659 young adults from two public and one private child welfare agencies, case ...record reviews, structured interviews, and a survey response rate of 76%. Foster care alumni completed high school at a rate comparable to the general population, but a disproportionately high number of them completed high school via a GED. Alumni completion rates for postsecondary education were low. Consequently, many alumni were in fragile economic situations: one-third of the alumni had household incomes at or below the poverty level, one-third had no health insurance, and more than one in five experienced homelessness after leaving foster care. Two foster care experience areas were estimated to significantly reduce the number of undesirable outcomes in the Education outcome domain: positive placement history (e.g., high placement stability, few failed reunifications), and having broad independent living preparation (as exemplified by having concrete resources upon leaving care). For the Employment and Finances outcome domain, receiving broad independent living preparation (as exemplified by having concrete resources upon leaving care) was estimated to significantly reduce the number of undesirable outcomes.
This study utilizes a quasi-experimental propensity score matching design to assess the causal impact on child welfare outcomes when parents facing an abuse or neglect case in the New York City ...Family Court were provided interdisciplinary law office representation as opposed to a standard panel attorney. The interdisciplinary law office approach includes social work staff and parent advocates for the parent, and salaried attorneys working in nonprofit organizations. Using administrative child welfare data, the study assesses the foster care and safety outcomes of 9582 families and their 18,288 children. The propensity score matched results do not indicate a preventive effect toward foster care entry nor any difference in children's likelihoods of experiencing a subsequent substantiated report of maltreatment. However, when children's parents received the interdisciplinary representation and those children did enter foster care, children spent 118 fewer days on average in foster care during the four years following the abuse or neglect case filing. Subsequent competing risk models show that children whose parents received the interdisciplinary law office model achieved overall permanency, reunification, and guardianship more quickly. These results provide evidence that interdisciplinary law office parental representation is an effective intervention to promote permanency for children in foster care.
•Interdisciplinary lawyers for parents hasten permanency for children in foster care.•Interdisciplinary parental representation does not impact child maltreatment rates.•Interdisciplinary parental representation may save millions of government dollars.•Children who entered foster care spent 118 fewer days on average in foster care.•Children achieved reunification and guardianship more quickly.
To assess the accuracy of an International Classification of Diseases (ICD) code-based operational case definition for abusive head trauma (AHT).
Subjects were children <5 years of age evaluated for ...AHT by a hospital-based Child Protection Team (CPT) at a tertiary care paediatric hospital with a completely electronic medical record (EMR) system. Subjects were designated as non-AHT traumatic brain injury (TBI) or AHT based on whether the CPT determined that the injuries were due to AHT. The sensitivity and specificity of the ICD-based definition were calculated.
There were 223 children evaluated for AHT: 117 AHT and 106 non-AHT TBI. The sensitivity and specificity of the ICD-based operational case definition were 92% (95% CI 85.8 to 96.2) and 96% (95% CI 92.3 to 99.7), respectively. All errors in sensitivity and three of the four specificity errors were due to coder error; one specificity error was a physician error.
In a paediatric tertiary care hospital with an EMR system, the accuracy of an ICD-based case definition for AHT was high. Additional studies are needed to assess the accuracy of this definition in all types of hospitals in which children with AHT are cared for.
Purpose:
This article describes how a worker fidelity assessment measure was developed for Signs of Safety®—an approach to assessing safety and risk in child protective services that is being ...implemented in the United States and over 11 other countries.
Methods:
We applied the Delphi Survey process with 70 experts from nine countries to identify key practice elements that could be assessed by supervisors. Then, 435 frontline staff were assessed by 285 supervisors from six countries.
Results:
Factor analyses of the 28 items yielded four distinct factors. These data were then used to refine the fidelity assessment.
Discussion:
The majority of supervisors reported that the assessment helped them to identify worker strengths and areas for refinement within the dimensions of Signs of Safety and overall child protective services practice. The value of developing similar tools for parents and workers was endorsed by the study participants.
•We studied NYC's interdisciplinary law office approach to parental representation.•We interviewed nearly 60 NYC Family Court stakeholders.•We identified 3 mechanisms through which the ...interdisciplinary law office operates.•We provide recommendations to consider the viability of implementing NYC’s model.
Prior research demonstrates that the interdisciplinary law office approach to parental representation in child welfare, used in the New York City Family Court, speeds up the time to permanency for children in foster care with no effect on child safety. Interrogating these findings further, this study utilizes a qualitative interview-based design to understand how the model works in practice to impact the outcomes of families’ cases. We interviewed 42 practitioners in the New York City Family Court and 17 parents who had had a recent child protection case in the New York City Family Court. Practitioners included judges, court attorneys, attorneys who represent parents in these cases, attorneys who represent children in these cases, and attorneys for the child welfare agency. Based on our analysis of these interviews, we identify three elements critical to the success of the interdisciplinary law office case practice approach: 1 uniform high-quality representation, 2 interdisciplinary practice, and 3 paying attention to the client’s well-being. These results shed light on why interdisciplinary law office parental representation effectively hastens reunification for children in foster care as compared to a solo practitioner attorney.
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