Differential Response 101 - American Humane Association

advertisement
Differential Response 101
American Humane’s 2010 Conference on Differential Response
AMY ROHM, MSW
BRENDA H. LOCKWOOD, MA
AMERICAN HUMANE ASSOCIATION
NOVEMBER 9, 2010
ANAHEIM, CALIFORNIA
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

2
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
3
What is Differential Response?
 Focuses less on investigative
 Alternative to traditional
fact finding and more on
assessing and ensuring child
safety
child protection investigative
response and one of several
responses within a
differential response system
 Seeks safety through family
engagement and
collaborative partnerships
 Sets aside fault finding and
substantiation decision
 Allows and encourages
agencies to provide services
without formal
determination of abuse or
neglect
 Usually applied to reports
that do not allege serious
and imminent harm
4
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
5
History of Child Welfare
and the Purpose of
Differential Response
6
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
7
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 nonadversarial process of
linking them to needed
services
8
Why Implement
Differential
Response?
9
Why Implement
Differential Response?
Recent Study on CP
Investigations :
“Child Protective Services Has
Outlived Its Usefulness”
 Do little to reduce risk
Dr. Kristine Campbell,
Assistant Professor of
Pediatrics at the University of
Utah
 Do not result in long-
term improvement in
family functioning or
child behavior
Published in
The Archives of Pediatrics and
Adolescent Medicine
Oct. 2010
 Are associated with
increased depression
among mothers
10
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
11
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
12
Why Implement
Differential 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%)
13
The Core Elements
of Differential
Response
14
Core Elements of Differential Response
1.
2.
3.
4.
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
15
Core Elements of Differential Response
5.
6.
7.
8.
16
Establishment of discrete
responses codified in
statute, policy, protocols
After assessment, services
are voluntary for families
who receive a noninvestigatory 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
Differential Response in the U.S.
17
Principles and Assumptions
of Differential Response
18
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

19
Principles and Assumptions
of Differential Response
 Effective assessment tools
 Only cases of greater
can be put in place to
assure safety and an
informed response
severity need to be on
state central registry
 Cases are monitored
 Frontline staff in CPS and
sufficiently to change
course/paths when
situation requires
other agencies are trained
in strength based and
collaborative
interventions
20
Practice Framework and Assumptions
 The primary goal of non
 Families are more than
investigative approach is
child safety
the presenting concerns
 Family protective factors
 Most families want to
can assist in keeping
children safe
address threats to child
safety
 Families are helped
 Most families can be
through connections with
community services and
resources
partners in achieving child
safety
21
Comparing Traditional
Child Protection
Models and
Differential Response
22
Traditional Child Protection Practice Model
Report screened to
determine appropriateness
of child welfare agency
intervention
Investigation model is
rooted in the determination
of whether:
Investigation
(Is this a Child in Need of Protective Services?)
1. Safety and Risk Assessments
2. Gathering of Evidence
 A child has been harmed
Disposition
Re. Child in Need of
Protective Services
 A child is at risk of being
Unsubstantiated
harmed
Category IV
Voluntary
services
recommended
 An individual is culpable
Category V
No services are
needed
for this conduct.
23
Substantiated
Category I
Removal
required
Category II
Court mandated
services
required
Category III
Services are
needed
Model for Differential Response
Report screened to
determine appropriateness
of child welfare agency
intervention
No
Yes
Alternative Response Screening
Report is screened out.
1. Is there an administrative rule requiring
that the report be investigated?
Referral for other community
services may be made.
2. Are there other factors that would
necessitate an investigation?
Family Assessment
1. Safety and Risk Assessments
No
2. Complete assessment of family
strengths, needs and resources.
Assessment Outcome
No Services
No services
needed
Voluntary Services
Recommended
Family
declines
services
Family and
agency agree
upon services
Yes
Investigation
(Is this a Child in Need of Protective Services?)
1. Safety and Risk Assessments
2. Gathering of Evidence
Family declines
needed services
Services are
Needed
Agency
assesses that
services are
needed to
maintain child
safely at home.
Family
accepts
needed
services
Disposition
Re. Child in Need of
Protective Services
Unsubstantiated
Category IV
Voluntary
services
recommended
Category V
No services are
needed
24
Substantiated
Category I
Removal
required
Category II
Court mandated
services
required
Category III
Services are
needed
Differential
Response
System
focusing on a
child in need
of protective
services and
support and
engagement
of the family.
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]
25
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
26
Differential Response
and
Child Welfare
Casework Practice
27
Differential Response and Casework Practice
Building
Safety
Around
Children
Protecting
Children
From
Harm
28
Differential Response and Casework Practice
 Move from agency expert
 Focus on securing child
driven compliance
approach to safety focused
partnership with families
and communities
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
29
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
30
31
Differential Response
Research and Evaluation
32
Research Designs
 Missouri Family Assessment and Response (FA):
 Comparative study
 Minnesota Family Assessment Response (FAR):
 Random assignment
 Ohio Alternative Response (AR):
 Random assignment
33
Random Assignment
Screened out
Child
Maltreatment
Reports
A
Inappropriate for DR
TR Traditional
Investigations
Initial
Screening
For CPS
The Evaluation
Control Group
B
Accepted Report
D
DR Pathway
Assignment
(Screened in)
DR-appropriate
C
Pool of
Reports
Eligible for
DR
Random
Assignment
Control Cases
E
Outcome/Impact
Analysis
Experimental Group
Cases offered DR
DR Family
Assessments
34
Differential Response Evaluation
 Child safety not diminished
Missouri
[began implementation 1995]
 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
35
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%
Minnesota
(More than 10 years DR Experience)
On an overall satisfaction scale
of 1-24, families that received
FAR services scored 19.3 as
compared to 17.4 for control
families
36
DR Evaluation: Family Satisfaction
Ohio

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
[10 pilots launched July 1, 2008,
10 additional counties October 2010]
37
DR Evaluation:
Level of Involvement in Decision Making (MO)
100
90
80
70
60
50
Family Assessment
40
Traditional Response
30
20
10
0
Great Deal
Some Level
38
DR Evaluation:
Family Cooperativeness
100
90
80
70
60
Minnesota
50
Missouri
40
Ohio
30
20
10
0
More likely to be cooperative than traditional response families
39
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

40
DR Evaluation:
Percentage of Families Receiving Concrete Services
90
80
70
60
50
AR
40
TR
30
20
10
0
Ohio
Minnesota
41
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
42
DR Evaluation
Subsequent 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

43
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
44
Questions?
45
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
46
Presenter Contact Information
Amy Rohm, MSW
American Humane Association
amyr@americanhumane.org
Brenda H. Lockwood, MA
American Humane Association
brenda.lockwood@americanhumane.org
Phone: 612-886-1183
Phone: 303-925-9413
47
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-FinalEvaluation-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), 7892. 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
48
Download