PREVENTION AND EARLY INTERVENTION SERVICES IN ELDORADO
COUNTY: A NEEDS ASSESSMENT
Patricia Ramano
B.A., California State University, Sacramento, 1990
PROJECT
Submitted in partial satisfaction of
the requirements for the degree of
MASTER OF SOCIAL WORK
at
CALIFORNIA STATE UNIVERSITY, SACRAMENTO
SPRING
2011
PREVENTION AND EARLY INTERVENTION SERVICES IN ELDORADO
COUNTY: A NEEDS ASSESSMENT
A Project
by
Patricia Ramano
Approved by:
__________________________________, Committee Chair
Joyce Burris, Ph.D.
Date
ii
Student: Patricia Ramano
I certify that this student has met the requirements for format contained in the University
format manual, and that this project is suitable for shelving in the Library and credit is to
be awarded for the project.
, Graduate Coordinator
Teiahsha Bankhead, Ph.D., L.C.S.W.
Date
Division of Social Work
iii
Abstract
of
PREVENTION AND EARLY INTERVENTION SERVICES IN ELDORADO
COUNTY: A NEEDS ASSESSMENT
by
Patricia Ramano
The inability of child welfare agencies in rural communities to adequately address the
needs of families through prevention or early intervention programs is associated with the
likelihood that these families will be reported in crisis and could possibly lead to the
child’s removal, and being placed in out of home care. Meeting the needs of families
reported to the child welfare system, specifically those in rural communities that lack
stable employment and housing, childcare, and support systems, and transportation has
proven to be challenging. Family well being, in rural communities, such as El Dorado
County, depends on services being available and accessible. A survey was administered
to twenty-two professional, with experience working with child welfare clients. Findings
revealed that prevention and early intervention services, currently available, are unable to
meet the needs of low risk children and families. Further, the major challenge continues
to be funding which limits services to children and families believed to be at greatest risk.
__________________________________, Committee Chair
Joyce Burris, Ph.D.
____________________________
Date
iv
TABLE OF CONTENTS
Page
List of Figures .................................................................................................................. viii
Chapter
1. THE PROBLEM .............................................................................................................1
Introduction ..............................................................................................................1
Statement of the Research Problem .........................................................................4
Purpose of the Study ................................................................................................4
Theoretical Framework ............................................................................................5
Definition of Terms..................................................................................................5
Assumptions.............................................................................................................9
Justification ..............................................................................................................9
Limitations .............................................................................................................10
2. REVIEW OF LITERATURE ........................................................................................11
Introduction ............................................................................................................11
History of Child Welfare .......................................................................................12
Differential Response.............................................................................................21
Nevada Differential Response ...............................................................................26
Minnesota Differential Response ...........................................................................28
Missouri Alternative Response ..............................................................................29
California Differential Response ...........................................................................30
v
Another Road to Safety in California ....................................................................32
Collaboration..........................................................................................................34
Conclusion .............................................................................................................39
3. METHODS ....................................................................................................................40
Introduction ............................................................................................................40
Research Question .................................................................................................40
Study Design and Population .................................................................................40
Protection of Human Subjects ...............................................................................42
Data Gathering Procedures ....................................................................................42
Limitations of Study ..............................................................................................44
4. STUDY FINDINGS ......................................................................................................45
Introduction ............................................................................................................45
Demographics of Sample .......................................................................................45
Professional Experience Working with Child Welfare Clients .............................46
Implementing Differential Response .....................................................................46
Prevention and Early Intervention Services ...........................................................47
Collaborative Relationships ...................................................................................56
Major Challenges ...................................................................................................57
Summary of Findings and Discussions ..................................................................58
5. SUMMARY ..................................................................................................................61
Conclusion .............................................................................................................61
vi
Recommendations ..................................................................................................64
Implications for Social Work Practice ...................................................................65
Appendix A. Consent to Participate in Research ...............................................................68
Appendix B. Community Needs Assessment for Prevention and Early Intervention .......70
References ..........................................................................................................................75
vii
LIST OF FIGURES
Page
1.
Figure 1 Mental health prevention versus early intervention ................................48
2.
Figure 2 Individual/family counseling prevention versus early intervention ........49
3.
Figure 3 Domestic violence prevention versus early intervention.........................50
4.
Figure 4 Substance abuse prevention versus early intervention ............................51
5.
Figure 5 Parenting prevention versus early intervention .......................................52
6.
Figure 6 In-home parenting prevention versus early intervention .........................53
7.
Figure 7 Infant/child health care training versus early intervention ......................54
8.
Figure 8 Advocacy/mentoring prevention versus early intervention .....................55
viii
1
Chapter 1
THE PROBLEM
Introduction
Each year, in California, county child welfare agencies receive over half a million
reports of abuse and neglect. Of those reports, 65% met the state mandate and there was
sufficient information to proceed with an investigation to determine if a child had been
abused or neglected, and whether services could prevent further maltreatment, and if the
child could safety remain in the home, or needed to be removed from the home
(California Department of Social Services [CDSS], 2004).
All states have some form of reporting laws that require certain professionals
(e.g., social workers, teachers, doctors and law enforcement) to file a report immediately
when they suspect child abuse or neglect. In 2003, the U.S. Children’s Bureau reported
that over half (56%) of all reports to Child Protective Services (CPS) came from
mandated reporters, while the rest came from neighbors, relatives, friends, and
anonymous callers. Every community has a child abuse hotline. When a call is received,
it is screened by a social worker who must decide which calls merit an investigation and
which should be screened out, to not receive a response from CPS.
CPS varies from state to state since each determines the legal basis for intervening
and definitions of child maltreatment (i.e., physical abuse, sexual abuse, neglect,
emotional abuse, or neglect). The federal government sets minimum standards that must
be incorporated in the definitions of maltreatment in state laws for the state in question, to
2
receive federal funding through the Child Abuse Prevention and Treatment Act
(CAPTA). With limited resources child welfare agencies have no choice but to target
services to those children with the greatest risk of maltreatment.
Sadly, families struggling with problems not considered to be abusive or
neglectful are turned away, perhaps only to return to the system in crisis with bigger
problems. While there are many reasons children and families are reported to CPS, there
appears to be four focus areas: 1) a parent has a substance abuse problem 2) a parent
experiences a mental health problem 3) parents are involved in a domestic violence
relationship, or 4) physical abuse of a child, by parents (Pecora et al., 2009). Further,
family problems may stem from lack of resources such as employment, housing, or
transportation. These factors affect the family’s ability to provide for the basic needs of
their children.
Given the fact that the child welfare system works from a narrow mandate of
federal, state, and local laws, it is apparent that traditional practices have accomplished
little in the way of prevention and early intervention services to help children and
families in need. The need for improvement in the child welfare system is evident and
reform efforts are currently underway. One such promising reform is to intervene at the
first sign of trouble, to engage and strengthen families through a new intake process that
diverts low risk families to supportive services and programs in their communities.
In 1998, Waldfogel examined the effectiveness of Child Protective Services and
found five major problems. The first problem is over inclusion of low risk families who
3
are in the system and should not be there. Secondly, under inclusion would account for
families who should be involved with CPS, but are somehow overlooked, not reported or
those that ask for voluntary service, yet are denied. The third problem is the number of
families involved with CPS exceeds the capacity. The last two problems involve service
delivery and orientation. Either families do not receive the services they need, or they do
not receive the appropriate services for their needs.
Further, Waldfogel’s (1998) critique argued that CPS “tends to overreact in the
direction of either family preservation or child protection,” (p. 84) just to switch back to
an overemphasis on child protection rather than family preservation. Ultimately,
Waldfogel proposed a new paradigm, where child protection is the responsibility of the
community as well as the state. The new approach, or alternative response, also called
dual track, multiple track, or differential response provided a broader, or more
customized response based on the individual needs of the family which involved a
community system, integrating both formal and informal “helpers.” This approach
focuses on the belief that over time an increase in community responsibility for the
protection of children, as well as a more appropriate use of resources and interventions
would be realized.
Over the past decade the idea of differential response has spread nationally as
well as internationally. A shifting paradigm has taken hold with prevention and early
intervention services and supports to keep children from entering out of home care being
the focus. Yet, implementation has taken on many forms with varied results.
4
Nevertheless, a differential response, as it is called in California, has promise in
reforming a broken system.
Statement of the Research Problem
The inability of child welfare agencies in rural communities to adequately address
the needs of families through prevention or early intervention programs is associated with
the likelihood that these families will be reported in crisis and could possibly lead to the
child’s removal, and being placed in out of home care.
Meeting the needs of families reported to the child welfare system, specifically
those in rural communities who lack stable employment and housing, childcare and
support systems, and transportation has proven to be challenging. Family well being, in
rural communities, such as El Dorado County, depends on services being available and
accessible.
Purpose of the Study
The purpose of this study is to identify barriers to implementing a successful
differential response model in El Dorado County that would target low risk families for
prevention and early intervention programs and services that would keep families intact
and promote family functioning. It is hoped that the results of the needs assessment will
provide a bridge between Child Protective Services and the community from which
implementation of differential response can be better facilitated.
5
Theoretical Framework
The ecological systems perspective provides a framework for viewing human
behavior in the social environment. Individuals exist in environmental relationships of
reciprocal exchanges (Bronfenbrenner, 2004). The interaction affects the individual,
family and community. Through the ecological perspective the researcher examines the
community resources for which the individual and family depends. By utilizing such a
system the researcher is allowed to look beyond the office and into the home and
community of individual families to consider presenting problems and family level of
need. Thus, the role of preventive services is to address stressful environmental factors
as well as those related to the individual.
Further, ecological theory suggests that causes and solutions to child maltreatment
include forces outside the individual (Bloom, 1979). Research indicates that families
have multiple needs which require a variety of services that are not time-limited to
prevent out of home care (Pecora et al., 2009). Moreover, the ecological perspective
places an emphasis on collaborations between organizations for increasing the
effectiveness of existing resources, identifying gaps in services, and for creating a shared
vision for decision-making and delivery of services.
Definition of Terms
Alternative Response (AR)
Also called dual track, multiple track, and differential response. A broader set of
responses to reports of possible child abuse or neglect, including prevention and
6
early intervention, engaging families to address issues of safety and risk, and
improving access to services, including allowed voluntary access by families.
Assessment
A systematic and informed approach to gathering and evaluating specific
information about a child and/or family for the purpose of making decisions
regarding allegations of maltreatment, protection of the child, services to the
family, and family progress.
Child Protective Services (CPS)
County organization that provides intervention services for abused and neglected
children and their families.
Community Partners
Public and private community based organizations, family resource centers, and
faith based organizations that provide services to children and families.
Community Based Organizations (CBO)
Non-profit agencies that have the expected qualifications to work with child
welfare agencies in implementing differential response and can address the needs
of vulnerable children and families.
Differential Response (DR)
California’s adaptation of alternative response. A broader set of responses to
reports of possible child abuse or neglect, including prevention and early
7
intervention, engaging families to address issues of safety and risk, and improving
access to services, including allowed voluntary access by families.
Family Assessment
A systematic, informed professional approach to gathering and evaluating specific
information about a family that has been reported to the child welfare agency.
The use of information gathered from initial screening, safety assessment, risk
assessment, and various other sources of information that shed light on family
connections and capacities. This assessment includes family interactions and
relationships, strengths and supports, developmental issues, physical and mental
health, educational history, social adjustment, substance use or abuse, domestic
violence, the environment, culture and the community, and any other factors that
affect the family’s ability to resolve concerns that led to involvement with CPS.
Hotline screening tool
A tool that is used by staff that take reports of possible child maltreatment; often
consists of a form to collect key pieces of information and a checklist of criteria
for the conditions or actions that constitute child abuse or neglect. On the basis of
types and number of conditions/actions checked, the staff determines whether the
report matches the state’s criteria for child abuse or neglect, the severity of the
potential maltreatment, and the required amount of time for a response and what
type of response is warranted.
8
Investigation track
An approach utilized by the CPS agency when a report is immediately recognized
as presenting serious safety issues for children and/or potential criminal charges.
Low Risk Families
A low risk family is one that there are no safety concerns, assessed when the
initial report is received by the hotline screener. A low risk family may have
certain identified stressors or associated risks.
High Risk Families
A high risk family is one that has been identified and assessed to have safety
concerns present that require an investigation by the child welfare agency.
Maltreatment
An act or failure to act by a parent, caregiver, or other person as defined under
state law that results in physical abuse, neglect, medical neglect, sexual abuse, or
emotional abuse. Or an act or failure to act that presents an imminent risk of
serious harm to a child.
Risk Assessment
A structured process that is used to assist in determining the future risk of harm to
a child and in key decision-making processes in child abuse and neglect
situations.
9
Safety Assessment
This is a formal assessment that assists in determining whether a child is currently
safe, and if not, what needs to happen to ensure safety. It focuses on the potential
harm to the child that could be immediate or in the near future.
Assumptions
Voluntary services and programs for the purpose of prevention and early
intervention would protect children and strengthen families within their community. Low
risk families would benefit from an assessment approach that solicits their input on what
they need. The researcher makes the assumption that while public and private employees
currently working with child welfare clients realize the potential for community
development and utilization of a differential response model, that service availability and
access is limited. Another assumption is made that a major challenge in implementing
differential response services in El Dorado County, is building effective collaborations
between agencies, community partners, and families to support goals, values and the
sharing of information and authority.
Justification
With so many children entering the foster care system within the state of
California, and more specifically El Dorado County, there is an increasing demand to
assess and evaluate the needs of low risk families, in order to develop and implement
preventative and early intervention strategies that will successfully reduce the likelihood
of these families coming into the child welfare system. This study will assist social
10
workers in identifying the unique needs of low risk families throughout El Dorado
County, which will result in the successful development of a differential response
program focusing on prevention and early intervention, thus reducing the rate children
enter the child welfare system in El Dorado County.
If the research findings confirm the lack of prevention and early intervention
services to meet the needs of low risk families then development of such programs should
occur prior to implementation of differential response. This study may further indicate
the need to focus on building collaborative relationships within the community.
Limitations
The participants that took part in the survey for this research study all have
experience working with child welfare clients in El Dorado County. Therefore, the
information gleaned from such research may represent only El Dorado County, or similar
size rural counties. In addition this study lacks input from families residing in El Dorado
County which is critical to understanding the needs of low risk families.
11
Chapter 2
REVIEW OF LITERATURE
Introduction
The long, rather notable history regarding child welfare is a combination of facts,
values, and social circumstances. There exists an extensive array of literature from which
to proceed. Yet, for the purpose of this study the review of the literature will be divided
into three relevant themes. The first theme will explore the historical and legislative
overview of child welfare to provide an understanding of where we are and how we got
here. This section will include the major forces shaping child welfare services in this
country and how they have significantly shifted over time.
The second theme examines differential response, an effort to improving the child
welfare system. Differential response, also called alternative response, dual track, or
multiple track allows child welfare agencies to sort reports of abuse and neglect, into
levels of risk. Instead of a “one size fits all” approach, differential response provides a
broader set of responses to ensure that children are safer and families are stronger.
Families who previously would have been “screened out” with the traditional model of
child welfare would receive an individual assessment and referral to resources in their
community.
The third section will present current research on developing collaborative efforts
between child welfare agencies and their communities, specifically rural communities.
The collaborative relationship for the implementation of prevention and early
12
intervention programs geared to build healthy functional families by means of
community services and supports and keep children from entering out of home care.
History of Child Welfare
In the 17th and 18th centuries a child welfare system did not exist. Children served
as an economic resource for their families, in that at an early age they were expected to
start contributing by helping with the household chores, caring for younger siblings and
providing farm labor. Informal resources such as family, friends, neighbors, or the
church attended to the needs of children who were orphaned or abused and neglected.
There was no clear distinction between children who were poor and those who were
maltreated.
While there was no formal child welfare system these two groups of children
came to the attention of authorities: orphans and children of paupers (Mallon & Hess,
2005). Town officials allocated small stipends, as “outdoor relief” to provide financial
assistance to the poor (Myers, 2006). Outdoor relief was granted to poor people living in
their own homes. In addition, officials had authority to remove children from their
parents and place them in apprenticeships, to learn a trade as well as receive food,
clothing, shelter, religious instruction, and a “modicum of book learning.” The term
indentured servant was also used to describe a child who agreed to serve a number of
years in exchange for bed and board, with perhaps the possibility of learning a trade.
When “outdoor relief,” proved inadequate to address the needs of the infirmed
elderly, the mentally ill, the retarded, the poor, the seriously and terminally ill, and
13
dependent children, colonists built almshouses, also called the poor house, the
workhouse, or the county farm (Myers, 2006). Almshouse care, or “indoor relief,” where
some residents worked, or learned a trade, while others were cared for by staff and by
each other, was deemed “the most disgraceful memorials of public charity….Filth,
nakedness, licentiousness, general bad morals…gross neglect of the most ordinary
comforts and decencies of life were rampant,” by the New York Senate committee, in
1856 (as cited in Myers, 2006, p. 13). The call for the removal of children from
almshouses led to the increased need for orphanages.
Orphanages gave refuge to children abused, neglected and abandoned as well as
to orphans. In 1853, Loring Brace, founder of the Children’s Aid Society of New York,
recruited large numbers of free foster homes in the Midwest and Upper New York
believing that the best way to save poor children was to place them in Christian homes in
the country, where they would receive a “solid moral training,” and learn good work
habits (Mallon & Hess, 2005, p. 14). Trainloads of children, called orphan trains, had
sent 40,000 children to rural communities by 1879, marking the beginning of foster care
(Mallon & Hess, 2005). Foster families expected children to pay for their up keep
through their labor.
The beginning of societal intervention on a child’s behalf came to light after the
case of Mary Ellen Wilson was widely reported by the press in 1874, after she was found
to be abused by her caregivers. Etta Wheeler, a friendly visitor, sought to free Mary
Ellen from her abusers through various social services agencies in New York City, to no
14
avail. Etta Wheeler turned to Henry Bergh, founder of the American Society for the
Prevention of Cruelty to Animals ASPCA, and leader of the animal humane movement in
the United States, to obtain legal assistance, which resulted in Mary Ellen’s rescue and
the prosecution and incarceration of her abuser (Brittain & Hunt, 2004).
That same year, 1874, the New York Society for the Prevention of Cruelty to
Children (SPCC) was founded, as were similar societies throughout the country. The
SPCC focus was on child rescue paralleling the animal welfare movement in removing
children from cruel and abusive caregivers (Waldfogel, 1998). New York was the first
state to pass legislation to protect and safeguard the rights of children as part of the
Protective Services Act and the Cruelty to Children Act (Katz, Ambrosino, McGrath, &
Sawitsky as cited in Pecora et al., 2000; Schene as cited in Pecora et al., 2000).
The entry of the federal government into child welfare occurred in 1912 with the
establishment of the U. S. Children’s Bureau, three years after the first White House
Conference on Children. The Children’s Bureau was given very small funding, yet a
large mandate.
Investigate and report…upon all matters pertaining to the welfare of children and
child like among all classes of our people, and …investigate the questions of
infant mortality, the birth rate, orphanage, juvenile courts, desertion, dangerous
occupations, accidents and diseases of children, employment, legislation affecting
children in the several states and territories. (U.S. Statutes as cited in Mallon &
Hess, 2005, p. 20)
15
This was an adversarial approach, which relied heavily on investigation and criminal
prosecution.
It was not until 1935; with the passage of the Social Security Act that federal
funding was authorized under Title V to provide for child welfare services (Child
Welfare League of America [CWLA], 2003). In addition, federal matching funds to
states for fatherless families was provided through Title IV, Grants to States for Aid to
Dependent Children which was later named Aid to Families with Dependent Children
(AFDC) and included families with a permanent and disabled or unemployed parent
(Mallon & Hess, 2005). A series of amendments expanded what child welfare services
could be paid out of federal funds including services that supplement or substitute for
parental care (Mallon & Hess, 2005). In 1958, Title V was amended to require states to
match federal funds in order to receive funding.
By 1946, the term “battered” children was brought to light by pediatric
radiologists who brought attention to the issue of child abuse (Caffey as cited in Percoa,
Whittaker, Maluccio, Barth, & Plotnick, 2000). The medical community and child
welfare professional’s efforts to recognize and publicize the “battered child syndrome,”
lead to the passage in 49 states of mandatory reporting laws requiring certain
professionals to report child abuse and neglect (Pecora et al., 2000).
In 1974, the Child Abuse Prevention and Treatment Act (CAPTA) defined child
abuse and neglect, as well as helped states develop programs for identification and
prevention of child abuse and neglect, and authorized government research. Further,
16
CAPTA established a National Center on Child Abuse and Neglect (NCCAN) to monitor
research, maintain a clearinghouse on child abuse programs, and compile and publish
training materials for persons working in the field (PL 93-247).
During the 1970s, the rising number of children in out of home placements and
the associated cost raised concerns that child welfare agencies should serve only those
children that required intervention to ensure a “minimal level of care” and protection
(Waldfogel, 1998). What followed was an amendment to the Social Security Act,
including a new section, Title XX, to provided services for low-income children,
families, and adults. Title XX also gave state governments much more authority and
discretion over how to spend federal dollars.
The Indian Child Welfare Act (ICWA) of 1978 was enacted to address the
removal of, as many as 25 to 35% of Native American children from their families and
placed in foster homes, adoptive homes, or institutions (Myers, 2006). During the late
19th century the government established Indian boarding schools to educate Native
American children according to Euro-American standards. Native American children in
these schools were forced to speak English, attend school and church, as well as abandon
their tribal traditions.
ICWA gave authority over children residing on reservations to tribal courts to
determine abuse and neglect. While Native American children who do not live on a
reservation, state juvenile courts are allowed to make decisions regarding the removal of
a child; however, the child’s tribe must be notified and the tribe has the right to intervene.
17
Child abuse reporting laws and an enhanced level of awareness, resulted in the
passage of the Adoption Assistance and Child Welfare Act of 1980, hailed as the most
important piece of legislations enacted in three decades (Mallon & Hess, 2005). The
concern for a rising number of children entering foster care during this time translated
into law that states seeking foster care funds make “reasonable efforts” to avoid removing
children from their homes. States were required to serve children in their own homes,
prevent out of home placements, and facilitate family reunification services following
placement (Mallon & Hess, 2005) Family preservation was the dominant paradigm of
child welfare in the 1980s. The outcome of this legislative was the redirection of funds
from foster care to preventive and adoptions services, required courts to review child
welfare cases on a regular basis and established federal procedures regarding child
welfare case management, and permanency planning (Myers, 2006).
Critics of interracial adoption during the 1970s and into the 1980s led by the
National Association of Black Social Workers were effective in persuading adoption
agencies to enact some policies which dropped transracial adoption numbers drastically
nationwide (Myers, 2006). Unfortunately, children of color were disproportionally
represented in the foster care system. Minority children make up about 39% of the U.S.
population but approximately 59% of the children in the child welfare system (U.S.
Department of Health and Human Services [DHHS], 2004).
Not until Congress passed the Multiethnic Placement Act (MEPA) in 1994 were
child welfare agencies prohibited from delaying or denying adoptive placements on the
18
basis of race (Myers, 2006). The goal of MEPA was to reduce the time that children wait
for adoptive placement; however, this legislation provided no additional funding for
implementation. Further, no evidence has been presented that placing children in samerace homes had substantially impeded the adoptive placements of children of color
(Mallon & Hess, 2005).
In 1997, the passage of the Adoption and Safe Families Act (ASFA) amended the
Adoption Assistance and Child Welfare Reform Act (AACWA) of 1980, requiring that
child safety be the paramount concern in making service provisions, placement, and
permanency planning decisions (Mallon & Hess, 2005). Although ASFA did not
abandon family preservation, it specified a number of circumstances under which states
were not required to make “reasonable efforts.” It ensured that a child in out of home
place receive a permanency hearing at twelve months time and every twelve months
thereafter, and required states to file a termination of parental right petition in cases in
which a child had been in out of home care for 15 of the past 22 months.
In 2000, the Child Abuse Prevention and Enforcement Act (PL 1006-77) was a
result of concern about inadequate response to reports of child maltreatment. This
legislation allowed the use of Federal law enforcement funds by States to child welfare
agencies, organizations, and programs that are engaged in the assessment of activities
related to the protection of children, including protection against child sexual abuse, and
placement of children in foster care. In the same year the U.S. Congress passed the
Intercountry Adoption Act (PL 106-279) to ratify the Hague Convention on Protection of
19
Children and Cooperation which set minimum standards and procedures for adoption
between implementing countries that prevent abuses, such as abduction or sale of
children; ensured proper consent for the adoptions; allowed for the child’s safe transfer to
the receiving country; and established the adopted child’s status in the receiving country
(Mallon & Hess, 2006).
Promoting Safe and Stable Families Amendments were passed in 2001 (PL-107133) which amended the definition of family preservation services to include infant safe
haven programs and strengthened parental relationships and the promoting of healthy
marriages as allowable activities (Mallon, 2006). The John H. Chafee Foster Care
Independence Program, the Foster Care Independence Act and the Education Training
Voucher Act offers assistance to help current and former foster care youths achieve selfsufficiency, by providing services and funding to prepare youth for living in the
community (Pecora et al., 2009).
In order to promote the federal government’s agenda of change and improvement
in child welfare, the Child and Family Service Reviews (CFSR) were implemented in
2000 to examine child welfare practices nationally (Mallon & Hess, 2005). The U.S.
Department of Health and Human Services (DHHS) completed the first reviews in March
2004.
McGowan (2005) concluded that there are a few lessons to be learned from the
history of child welfare. That social forces and trends shape child welfare services which
contribute “modestly and imperfectly, but consistently,” (p. 43) to the well-being of
20
children. Moreover, society grudgingly invests in such programs so that consensus from
the community, parents, and children will never adequately be resolved. Further, the
needs of children and families changes over time, yet social responsibility remains
constant.
As illustrated by the previous historical overview the current policy challenges to
child welfare are numerous. Yet a number of trends and promising approaches have
emerged around the country where states continue to pass legislation to address policy
gaps and needs in the hope of improving outcomes for children and families. One such
reform involves making child protection less adversarial by focusing less on investigation
and more on assessing the individual needs of families through a shared responsibility
between Child Protective Services and community partner agencies.
In 2000, California Governor Davis directed the Department of Social Services to
assemble a group of child welfare stakeholders to review the child welfare services
system and make recommendations for its improvement. The California Legislature
established the Child Welfare Service (CWS) Stakeholders Group consisting of
approximately 60 individuals, representing all aspects of the child welfare community.
The California Child Welfare Redesign, a three-year planning effort to reenvision child welfare services recommended a shift to differential response (Conley,
2007). Since September 2003, 11 counties in California have received funding and
technical assistance to implement differential response while a majority of counties have
21
started testing and implemented components of differential response (Schene,
Oppenheimer, & Senderline, 2005).
Differential Response
An alternative response approach to the investigation, also called dual track,
multiple track, or differential response grew out of efforts to manage the overwhelming
reports of child maltreatment, the severity of cases and limited resources. The concerning
issues that the alternative response approach addresses regarding the traditional practices
of Child Protective Services are over included families they should not have, or not
include families that warranted inclusion (Waldfogel, 1998). Thus, consensus grew
around the idea that not all families who were reported to child welfare agencies required
an investigation.
What was needed was a service system for low risk families where there was
insufficient evidence of maltreatment, but a clear need for services (Conley, 2007).
Under alternative response, agencies sort families by risk levels. Each family would be
provided with a customized approach, based on their assessed level of risk and service
needs. Low risk families, under the traditional system previously, would be screened out
of services. An alternative response would allow cases that did not require an
investigation to be referred to community partners whereby families would receive
services on a voluntary basis.
In addition, alternative response, or as it is referred to in California, differential
response, has the capacity to reduce the adversarial nature of the relationship between
22
agency social workers and families (Myers, 2006). Many families perceive the child
welfare agency as a threat instead of a resource, thus challenging the system to reduce its
coercive approach would attract families rather then drive families away (Gambrill,
2008).
As of 2003, 20 states had identifiable policies related to differential response,
while eleven had implemented services (DHHS, 2003). Compared to traditional child
welfare services many researchers found that child safety is preserved and that families
and staff prefer the differential response model (Conley, 2007).
In Washington State, in the 1980s a well publicized child death escalated the call
for reform to increase accountability for public child protective services and improve
assessments (English, Winard, Marshall, Orme, & Orme, 2000). By 1988, Washington
developed a community-based alternative response systems (CBARS) that would serve
“at risk, non-serious harm” families on a voluntary, non-coercive basis. High-risk child
abuse and neglect investigations would continue to be handed by CPS.
A study completed by Washington State Department of Social and Health
Services (2000) examined the characteristics and outcomes of “low risk” families
referred to CBARS found that children in families with greater economic resources and
lower stress were less likely to be re-referred to CPS. Although, the majority of the
families studied did not re-refer to CPS whether they agreed to voluntary assessment
services or not, those who did were more likely to have had prior referrals to CPS. In
addition, it was noted that while most of the re-referrals were at the lower end of the
23
severity levels for physical abuse and neglect, there was a statistically significant number
of re-referrals at the higher severity levels. The study determined that the group with the
highest re-referral rate came from cases where domestic violence was identified as an
issue. The researchers concluded that some families were reported to CPS who should
not have been while other families were referred to a CBARS that they should not have
been. Further, the study stressed the importance of the criteria for inclusion in
community-based programs be clearly articulated and defined.
The Virginia Department of Social Services issued a fifth report in 2004, on the
status of implementation of differential response. The evaluation spanned a full 12month period from January to December 2003. The report concluded that 60% of
referrals are placed on the family assessment track, however, track assignment were not
consistently made among agencies. Virginia reported that about a third of the families
had some identifiable service needs with most families receiving some services. If a
family did not receive services it was because they declined to do so. Several
discrepancies were found, such as gaps in documentation, sometimes a failure to respond
in a timely manner as well as failure to identify service needs. On a positive note, the
report stated that families included in assessments and service planning and about half the
families received services. Families with multiple referrals were found to receive a
higher percentage of founded investigations.
Similarly countries, including Australia, Canada, and New Zealand, have reforms
resembling alternative responses based on preliminary results in the U.S. (Child Welfare
24
Transformation, 2005). In a study conducted in Australia, researchers examined family
support services by non-government or voluntary agencies providing information and
referral, counseling and mediation, parenting skills training and other educational skills
development, advocacy, home visiting and other in-home support (Australian Institute of
Health and Welfare, 2001). Study participants were categorized as self-referrals, (21.2%)
child welfare referrals (10.1%), other human service referrals (14.8%), health service
referrals (10.1%) with the remainder referred by family, friends, schools or day care or
other unknown. The study was essentially descriptive in that it sought to understand
family support at a system-wide level using a performance measurement framework
(Tilbury, 2005). Survey results revealed a narrow range of services for families with
transient problems, requiring limited duration and low intensity. Tilbury concluded that
if family support is to be a “genuinely alternative response to concerns about the care of
children, it must be capable of making an observable difference in the lives of families
experiencing serious difficulties” (p. 14).
The Australian Institute of Health and Welfare (AIHW) reported in 2008, that
over the last ten years the number of children in out-of-home care rose by almost 115%,
from around 14,500 children in 1998 to 31,166 children in 2008. The number of child
protection reports increased over the last four years by 26% and nationally the number of
substantiated reports increased by more than 30% from 46,154 in 2004-05 to 60,230 in
2006-07 before a fall to 55,120 in 2007-08. The AIHW speculates the decline in
25
substantiations could be attributed to the success of family support services offered in
certain jurisdictions as an alternative response for “less serious incidents.”
In one region in British Columbia, Marshall, Charles, Kendrick, and
Pakalniskiene (2010) compared two groups, family differential responses (FDR) and
investigations (INV) and found that they did not defer regarding re-referral. Similarly,
the safety of the children did not differ, but fewer children in the FDR group were
removed from the home when compared with children in the INV group.
Canada adopted a differential response system in 2007 that was implemented in
Ontario and relied on classifying cases into varying levels of risk (Child Welfare
Transformation Plan, 2005). The Government of Ontario, guided by the belief that early
intervention would reduce the need for more intrusive and costly public services later
subsequently found that such timely services led to better outcomes for children and
youth when provinces adopted a two-pronged approach. Children at high risk of
maltreatment will continue to receive a full investigation while lower risk children will
receive a modified response, which will focus on engaging families during the
investigation, rather than just gathering evidence. Notably, the Child Welfare
Transformation Plan made no provisions for any additional funding, for staff, training, or
programs.
New Zealand developed and integrated service system (ISS) as a model for
reform in response to an overwhelming increase in child abuse and neglect reports
(Connolly & Smith, 2010). ISS includes differential response as a component of an
26
overall change in how they do business. It is interesting to note that New Zealand does
not have mandatory reporting laws, but relies on people to recognize the signs and
symptoms of abuse and report their concerns. Further, a progressive child welfare law
was established in 1989, the family group conference (FGC) meeting as a tool that
includes both the child’s family and extended family members (Connolly & Smith,
2010).
New Zealand’s differential response model is in alignment with current practice
employing a two pronged approach: families needing a statutory response receive one
and families assessed to need a more “general family support service receives an
alternative response” (Connolly & Smith, 2010, p. 21). As part of Connolly and Smith’s
review of ISS the Child Welfare Information Gateway (CWIG) is cited as evidence to
support differential response as an effective tool.
Nevada Differential Response
The State of Nevada initiated a differential response model in February 2007 in
two service zones in Clark County (National Quality Improvement Center on Differential
Response in Child Protective Services, 2009). Through a series of stages Nevada
implemented differential response, which now includes all of Nevada with the exception
of six very rural counties representing 2% of the state’s population. The Nevada DR
model is unique in that there is immediate and direct involvement of community partners
(IAR) Local Family Resource Centers (FRC) were indentified early on in the
implementation of differential response, taking on assessment and case management
27
functions, from start to finish that in other states have been handled primarily by state or
county agencies. Only Nevada employs FRCs as differential response staff to complete
the initial safety and risk assessment as well as provide services until case closure.
As in most states, Nevada has found an overrepresentation of poor and working
poor families reported to child welfare agencies. Not only do these families struggle with
chronic life situations, but often times issues arise as to the care and treatment of their
children that make them appropriate for the differential response. The report indicates
that differential response families have fewer subsequent reports of child maltreatment
that led to an investigation in comparison families who received a traditional CPS
investigation. Furthermore, it is suggested that differential response families will have
fewer subsequent reports of any kind.
Nevada’s analysis has led to two concerning issues regarding differential
response. One being that employing FRCs for the sole purpose of differential response
limits the use of FRC services to a small portion of child welfare families.
Consequently, many families that would benefit from differential response services do
not received them. Specifically, families that receive an investigation by CPS, but are
closed after it is determined that the children are not at risk, do not receive any services.
Nevada concluded that the FRC as solely responsible for differential response being
underutilized of its capacity and currently expanding differential response as part of the
state’s child protection system is being considered.
28
Minnesota Differential Response
Some form of differential response has been in practice in Minnesota for the past
ten years. Twenty Minnesota counties participated in a differential response project
which was evaluated in 2004 (Institute of Applied Research) and determined that
differential response families were less likely to be re-reported for abuse and neglect than
control families (27.2% versus 30.3%). The evaluation used random assignments for
families that were screened in for alternative response, however, only half the families
were referred to community services while the other half received a traditional CPS
investigation. It was also noted that fewer of the differential response families had
subsequent child placements when compared to the control families (10.9% versus
13.2%).
Minnesota’s alternative response is two-pronged. An investigative response or
immediate intervention is required when there are allegations of serious harm. The
Family Assessment Response, a less intrusive, strength-based response sets aside finding
fault and focuses on a collaborative, non-adversarial family engagement process, to
ensure child safety and well-being.
By 2004, Minnesota implemented differential response statewide, this action
resulted in nearly half of all child abuse and neglect reports (46.5%) receiving a
differential response (Minnesota Department of Human Services, 2007). A comparison
of the families receiving a differential response to the control group that received a
traditional investigation found that differential response families were less likely to have
29
new maltreatment reports then the control families. In addition, Minnesota’s differential
response found no evidence that this approach compromised child safety. Differential
response cost were initial greater for services to families and workers time, however,
Minnesota concluded that differential response has the potential to reduce long term
public costs if upfront investments are made.
Missouri Alternative Response
In 1994, the Missouri State Legislature passed Senate Bill 595 which required that
the Department of Social Services implement a more flexible response to reports of child
abuse and neglect (CA/N) (Institute of Applied Research, 2004). Missouri’s alternative
response approach to child maltreatment reports fell into two categories: investigation or
family assessment. The investigation response adhered to state law that specifically
defined certain kinds of incidents due to the severity and the potential to involve criminal
violations. Incidents that were screened for a family assessment response sought to
engage the family in non-accusatory and supportive relationships from which to
collaborate on the needs and solutions for the family.
Missouri concluded their findings that the family assessment approach was
positive but “modest.” It was felt that the newness of the approach, as well as no
additional funding and reliance on untapped resources in the community contributed to
the lack of statistical significance.
The findings of the Ohio Alternative Response Pilot Project, prepared by the
American Humane Institute of Applied Research Minnesota Consultants (2010) indicate
30
that the replacement of traditional child welfare investigations by differential response
family assessment does not comprise child safety. Therefore, Ohio was advised that the
state should proceed with implementing an alternative response system throughout the
state. In a comparison study the experimental group that received an alternative response
family assessment was less likely to have new reports of child abuse then the control
group that received a traditional investigation.
California Differential Response
A relatively new system in California, Differential Response (DR) enables
counties to respond in different ways to reports of child abuse and neglect. Families who
come to the attention of child welfare are offered a “broader set of responses,” to ensure
child safety by engaging families and identify solutions (Casey Family Programs, 2007).
Differential response was implemented in California through a partnership between
California Department of Social Services (CDSS), the Foundation Consortium for
California’s Children & Youth, the East Bay Community Foundation, the Marguerite
Casey Foundation and Casey Family Programs called the breakthrough series
collaborative (BSC), a system for promoting rapid change.
California’s differential response approach has three paths. After a call or report
is received by the child welfare agencies the intake or hotline social worker will assign
the referral to one of three paths based on the information received and the initial
assessment.
31
Path #1 Community Response
A report that is determined to not meet statutory definitions of abuse or neglect
will receive a community response. The initial assessment at intake indicates that the
family is experiencing some problems that could be addressed through community
services. The child welfare agency refers the family to a community partner. In the
traditional child welfare system these families do not receive an investigation, but are
“evaluated out,” and may or may not receive some type of referral to a community
agency.
Path #2: Child Welfare Services and Agency Partners Response
A report that the allegations meet the statutory definitions of abuse and neglect,
yet involves families in which the children are at low to moderate risk. A family is likely
to make the necessary progress to ensure the child safety and mitigate risk with targeted
services. Family engagement in services is voluntary; however, the juvenile court could
be utilized to protect the child. This path focuses on a teamwork approach between the
child welfare agency, and community partners.
Path #3: Child Welfare Services Responses
This path is chosen when the report indicates the child is not safe. The risk to
child safety is moderate to high and the family received a traditional child welfare
response. Action is taken to protect the child with, or without the family’s consent and
law enforcement and the court system may be involved.
32
Another Road to Safety in California
In Alameda County, Another Road to Safety (ARS) was the first pilot differential
response program in California. ARS is unique when compared to other states and
California counties regarding funding. The program is jointly funded by the county
social service agency and Alameda County First 5. Additional, ARS is highly tailored to
the neighborhood it serves since it is conducted by a different agency in each community
(Conley, 2007). Certain aspects of the ARS model, in the Conley study (2007) were
found to support the literature while others, there is doubt. The study suggests that
families living in chaotic and violent environments were harder to keep in programs,
thus, voluntary service pose a challenge. While no profound evidence for the entire
program assumptions of the ARS model were found, the programs can achieve some
positive outcomes (Conley, 2007).
The Results Group, under contract with the California Department of Social
Services, Children and Family Services Divisions conducted a multi-year evaluation of
Child Welfare Pilot Projects in 11 counties, and issued a preliminary report in March
2007. The findings showed family engagement and commitment are improved with an
increase in how the community views the child welfare agency as a resource. Several
counties noted that an improved perception may increase referral and cases as community
members are more willing to report, as well as families self reporting in order to gain
access to services. While the recurrence of maltreatment decreased statewide the pilot
counties experienced a decrease of 1.6% vs. 1.0% within three-six months and 1.9% vs.
33
0.9% at 12 months time in comparison to other counties. In addition, pilot counties
realized that sources of funding are limited; however, to fully implement DR an upfront
investment is necessary to get the program up and running. Of further consideration is
the workload for CPS social workers who have found in the pilot counties that they serve
fewer families, but the families have more complex needs.
Clarisa Simon Soriano (2005), as part of the BASSC Executive Development
Program, evaluated ARS program in Alameda County for possible replication in San
Mateo County. The focuses of the study were on the steps taken for implementing the
program. Soriano conclude that it was critical to implementation of the program to
utilize a standardized means of family assessment. The developments of three key
components were identified: in-home family survey, asset maps for each community in
the county, and a web-based integrated cross-agency system.
Carmen O’Keefe (2005), another participant in the BASSC Executive
Development Program assessed collaborative relationships between child serving
agencies utilizing Sonoma County as a model to make recommendations for San Mateo
County. O’Keefe recommended San Mateo start with surveying staff regarding
collaboratives. One of the three strategies identified by San Mateo County, System
Improvement Plan (SIP) includes developing a differential response that includes
community partners.
34
Overall, counties report positive results after implementation of differential
response. The literature illustrates the notion that differential response offers a flexible
system of services that child welfare agencies customize to the needs of their community.
Collaboration
There is a building premise that collaboration between child welfare agencies and
community based service providers will improve outcomes for vulnerable children and
families. Collaborations, also referred to as partnerships or coalitions, come together
regarding a common issue and are comprised of both public agencies and nonprofit and
for profit organizations. Yet a review of the literature reveals that little is known about
relationship building between CPS and the community. In addition, CPS is perceived as
an adversarial organization that limits the flow of information which communities believe
impedes the helping process.
One study examined a $1 million, five-year demonstration project, Dorchester
CARES, an alternative to the existing child welfare system.
The project was to develop family-strengthening services through a collaboration
of strong agencies already located in the target community to maximize existing
resources; reduce service fragmentation; and link children and parents to
preventive, culturally sensitive service in their own neighborhoods. (Mulroy,
1997, p. 262)
Mulroy (1997) found that including community residents as partners was essential to the
development, implementation and acceptance of neighborhood service networks. Upon
35
completion of Milroy’s’ study she offers these insights to successful collaboration:
develop a culture of mutual trust, fund an administrative infrastructure, and start small
with a shared vision.
Hetherington and Barstow (2001) reported findings of a European cross-country
comparison of cooperation between services for community mental health and child
protection in 11 states which indicated certain factors, when present supported positive
outcomes: communication and cooperation through informal contact, adequate
resources, shared knowledge, and a network of universal services.
Emshoff and Erickson (2007) investigated the outcomes of system changes and
conditions under which collaborations were likely to cause changes by examining a
statewide network of 157 collaborative serving the 159 counties in Georgia. They found
collaborations were more able to institute change as they aged. Activity level was also an
indicator for change in that the more active collaborations were the more likely they were
to engage in system change. In 2009, Nowell surveyed and collected data from 48
different collaborative and the findings indicated that strong stakeholder relationships
were more likely to be understood as more effective at improving coordination and
advancing wider system change. Nowell (2009) noted that there was finding that having
shared ideology had one of the strongest effects on systems change outcomes which led
one to believe that effective collaborations require a shared ideology, or vision to bring
about positive change. Berardo (2009) studied informal collaborations and its effect on
organizational success, which confirmed his hypothesis that collaborative efforts are
36
more likely to succeed when the lead organization can obtain assistance from a larger
number or partners who provide valuable resources.
In rural counties collaborations may face more challenges then their urban
counterparts. Rural counties may lack economic opportunities for families, limited
service providers, transportation barriers and confidentiality concerns (Templeman &
Mitchell, 2002). Capacity poses a significant barrier to getting families needs meet when
referred to community based service providers (Zielewski & Macomber, 2007). Overall,
Zielewski and Macomber’s study of both urban and rural counties in Oklahoma and
Kentucky suggested that rural areas have long established relationships between agencies
which facilitate collaboration and case management. Particularly in rural areas an
alternative response system confirms the notion of a flexible system based on the needs
of children and families.
The Community-based Family Resource and Support Program (CBFRS) was
created in 1996, to fund State efforts to
develop, operate, expand and enhance a network of community-based,
prevention-focused, family resource and support programs that coordinate
resources among existing education, vocational rehabilitation, disability, respite
care, health, mental health, job readiness, self-sufficiency, child and family
development, community action, Head Start, child care, child abuse and neglect
prevention, juvenile justice, domestic violence prevention and intervention,
37
housing, and other human service organizations with the State (DHHS, n.d.a,
para. 1)
by amendment of the Child Abuse Prevention and Treatment Act [CAPTA].
Grants are awarded annually by statutory formula based on the number of children under
the age of 18 in each State and require the receiving State provide a 20% match of funds.
In 2009, CAPTA reported awarding 60 grants to States and that 37% of programs
funding were either “evidence-based” or “evidence informed (Child Welfare Information
Gateway, n.d.).
The FRIENDS National Resource Center for Community-Based Family Resource
and Support (CBFRS) Programs provides training, technical assistance, and information
to state lead agencies is a service of the U.S. Department of Health and Human Service.
FRIENDS under a cooperative agreement between Family Support American and the
Office on Child Abuse and Neglect assists States, tribes and tribal organizations, migrant
programs, and local programs in the development of community-based family resource
and support programs and statewide prevention networks throughout the U.S.
In 2009, The Annie E. Casey Foundation, the largest private foundation in the
nation provided $138 million in grants to various organizations and projects. The
Foundation was established in 1948, with a primary mission to foster public policies,
human-service reforms, and community supports to more effectively meet the needs of
today’s vulnerable children and families. In 1999, the Foundation committed to funding
community efforts to strengthen families by investing $60 per year (Percora et al., 2000).
38
This neighborhood based family support model, addressed key issues such as community
safety, jobs, housing, and schools, as identified by families in support of improving
conditions. As cited by English et al. (2000) the majority of families considered “low
risk” CPS referrals and referred to a community based alternative response could be
associated with “lack of resources or with inadequate parenting skills” (p. 386).
In order to meet the diverse needs and problems of families’ two program models
have emerged: family preservation and family support. To prevent the placement of a
child out of home family preservation services were designed to offer short-term
intensive services. Family support was designed specifically to provide a range of
services to improve family functioning to those families seeking services. Core elements
of family support programs as proposed by Comer and Frasher (1998) were: home
visiting, child development and screening, parent education and training and social,
emotional, and educational support for parents.
Although collaboration is a promising approach to the delivery of services within
a given community, it has proven to be challenging. For example, the availability of
resources within a community is often a factor in meeting families’ needs. Often time’s
services simply are not available. In addition, families may have multiple and
overlapping problems while service delivery is fragmented, by different providers at
different locations. While conditions in some communities provide support and services
that strengthen families while others place families at high risk. Thus, the role the
community plays impacts the family on multiple levels.
39
Conclusion
A review of the literature demonstrates that historically child welfare has evolved
from a helping profession seeking to improve the lives of poor disadvantaged children
and families, to an intrusive investigative agency directed at identifying children most at
risk. The research indicates that differential response is a less intrusive, strength based
approach to engage low risk families in a collaborative effort within their community
without compromising child safety. While the literature revealed limited research
regarding collaboration between CPS and the community; support for such collaborations
from public and privates agencies is evident.
40
Chapter 3
METHODS
Introduction
The purpose of this project is to develop a better understanding of the prevention
and early intervention services available to vulnerable children and families, in El Dorado
County. This research will provide information on the challenges within the community
regarding implementation of differential response for identified “low risk” families who
would receive prevention and/or early intervention services. This chapter identifies and
explains the research question, study design and population, data gathering method, the
protection of human subjects, and limitations of the study.
Research Question
What is needed to develop a shared responsibility between the child welfare
system and the community to better address the needs of vulnerable children and families
in El Dorado County? Can prevention and early intervention services be provided to
“low risk” families at the first sign of trouble, which would divert them from the child
welfare system? Does El Dorado County have the appropriate prevention and early
intervention services currently available?
Study Design and Population
This is a descriptive study seeking to identify prevention and early intervention
services in El Dorado County, specifically to address the needs of “low risk,” children
and families in the hope that voluntary participation by the family will divert them from
41
coming into the child welfare system. The design is appropriate to clarify available
services within a given community to address specific needs. Similarly, studies that have
been conducted by other counties, in California, regarding differential response, have
been county specific. Although the information gleaned from said studies is specific to
the individual county, it allows further studies a knowledge base from which to build.
The researcher utilized snowball sampling by recruiting one person meeting the
criteria for participation and requesting that person identify other people like themselves
who would be eligible and willing to participate. The researcher requested that the
participant identify additional participants, giving them a brief description of the study
and the researcher’s phone number. The researcher advised participants that participation
was voluntary and only those willing to participate should telephone the researcher.
Inclusion criteria required that participants have at least a Bachelors Degree, and
work experience in the private sector as a community service provider, or an employee of
a public agency with knowledge of the problems and needs of child welfare clients. This
method required that participants meeting the criteria and willing to participant contact
the researcher by phone to initiate the process. The researcher informed the potential
participant of the study, and invited them to participate by completing a research survey.
There were no incentives provided to participants in this research study. Each participant
had the option at any point in the process to decline to participate, and were not required
to identify other people like themselves for participation.
42
Protection of Human Subjects
The researcher was required to submit “The Protocol for the Protection of Human
Subjects,” to the Division of Social Work Human Subjects review committee for
approval. After reviewing the research proposal and survey the review committee
requested several minor changes which were made and then the review committee
approved (approval #10-11-051) the study as “no risk.”
Participants were required to sign an informed consent prior to completion of the
survey (see Appendix A). Voluntary participation was explained and all participants
were instructed that they could withdraw their consent at any point in the process and/or
decline to answer any of the survey questions. The researcher was available to answer
questions regarding the survey, for the participants. Participants were also guaranteed
complete confidentiality in that their identity would be protected and the researcher
would be the only person with access to the completed survey. The surveys and informed
consent were separated and kept in a locked filing cabinet throughout the duration of the
study then destroyed at the completion of the project.
Data Gathering Procedures
The instrument used for this study was a questionnaire developed by this
researcher. The Community Needs Assessment for Prevention and Early Intervention
was designed specifically for El Dorado County, consisting of 18 items which included
demographic information, experience with families that have come to the attention of the
43
child welfare system, and the quality of existing prevention and early intervention
programs that would target vulnerable children and families (see Appendix B).
The first participant was selected by the researcher and provided with verbal
instructions as to the completion of the survey and a solicitation for additional
participants to contact the researcher by telephone. The researcher sought to query
twenty participants for this study. The researcher received 24 responses from potential
participants; however, two participants were unable to meet with the researcher and
mailed their surveys to the researcher after the researcher had completed the data
analysis.
The entire process from the researcher’s explanation of the study, signing an
informed consent form, and completing the survey took approximately 30 minutes. On
average the questionnaire was completed in 15 minutes and did not contain identifying
participant information. Once the goal of 20 participants was reached, the researcher
ceased to solicit additional participants.
The researcher organized and analyzed the data after all the questionnaires were
completed. The data was analyzed using statistical analysis. Frequency distributions
were used to analyze the Likert-type scale questions. The researcher utilized Microsoft
Excel to determine what questions participants agreed or disagreed with and to what
degree, as well as how important the statement was perceived. In addition, participants
were asked to rate prevention and early intervention services in El Dorado County and
44
were allowed to formulate their own suggestions for prevention and early intervention
services to “low risk” families.
Limitations of Study
The main limitation of this study is that it represents only El Dorado County and
the sample population included only those participants who had experience working with
child welfare clients and were willing to volunteer. Results cannot be generalized to
other rural counties in California due to the differences between counties. In addition, the
results would likely be different if sample size was increased and participants without
experience working with child welfare clients were included.
45
Chapter 4
STUDY FINDINGS
Introduction
A review of the literature indicates that differential response, or some form of an
alternative response has become a more widely accepted practice within child welfare
agencies. Prior research suggests that low risk, or no risk families may have better
outcomes when receiving an assessment and referral to voluntary services, versus a
traditional CPS investigation. Thus, a crucial element for the success of differential
response is identifying and providing the services and supports to meet the needs of low
risk, or no risk families.
That being said, the data collected by this researcher is limited to interpreting the
needs, in the rural community of El Dorado County, in the hope that providing prevention
and early intervention services at the first sign of trouble will strengthen families,
promote family well-being, and eliminate out of home care.
Demographics of Sample
The sample consisted of 22 professionals who have experience working with
child welfare clients in a public or private agency, in El Dorado County. Fourteen
participants were employed by a public agency while eight participants worked in the
private sector. Six participants (27%) had over 11 years of experience working with
child welfare clients; seven (32%) had over six years experience, four (18%) participants
46
had three to five years experience, and five (23%) participants had less they two years
experience working with client welfare clients.
El Dorado County is comprised of several communities that are geographically
dispersed over 2,000 square miles, with two major cities, Placerville and South Lake
Tahoe. The majority of the 178,447 population (U.S. Census Bureau, 2009) reside in
Placerville, South Lake Tahoe, El Dorado Hills, Cameron Park and Shingle Springs
areas. The more rural and least populated areas of the county include, Camino,
Georgetown, Grizzly Flat, Lotus, Pollock Pines, and Somerset. All 22 participants of this
study indicated working with clients in the community of Placerville while only six
participants have worked with child welfare clients in the South Lake Tahoe area.
Professional Experience Working with Child Welfare Clients
Three participants (13%) reported rarely working with child welfare clients, nine
(40%) reported sometimes, and eight (36%) reported frequently working with child
welfare clients. Two participants (9%) did not indicate how often they come into contact
with families that have come to the attention of Child Protective Services.
Implementing Differential Response
All 22 participants agreed with and determined an important statement that “the
earlier family issues are identified and addressed, the better children and families do.”
Ninety percent of the participants indicated that when families voluntarily engage in
services they are better able to resolve issues; however, 32% indicated that families do
not know best what they need to improve their lives. Further, 27% of the respondents
47
neither agreed or disagreed with the statement, “consumers of child welfare services need
to be involved in policy development, staff and community partner training, and quality
assurance activities,” while 59% agreed and 14% disagreed.
While all but one participant indicated that it was important that no risk, or low
risk families be linked to effective services and supports in the community in a timely
fashion, 54% indicated agreement that linking families in a timely manner could in fact
take place. The other 46% disagreed that with the statement that families could be linked
to services and supports in a timely fashion.
Prevention and Early Intervention Services
All but three participants indicated that they were aware of both informal and
formal prevention and early intervention resources and services in their community.
Eight-six percent of the participants agreed that an alternative response system would
identify families in need of prevention and early intervention services before they are in
crisis.
Participants were asked to rate “prevention” and “early intervention” services in
their community. Eight services currently provided by child welfare agencies were
presented and participants were asked to assign a numerical score from poor (2) to
excellent (9). For each of the services rated, both prevention and early intervention scores
are illustrated side by side for comparison purposes.
48
Mental Health Services
Sixty-four percent of participants rated Mental Health prevention services 5 or
lower while 36% indicated 6 or higher rating. Seventy-two percent of participants rated
Mental Health early intervention services 5 or lower while 28% gave 6 or higher (see
Figure 1).
Figure 1. Mental health prevention versus early intervention.
Individual/Family Counseling
Sixty-nine percent of participants rated Individual/Family counseling prevention
services a 6 or better while 31% indicated a 5 or lower. Fifty percent of participants rated
Individual/Family counseling early intervention services a 6 or higher while 50% gave a
rating of 5 or lower (see Figure 2).
49
Figure 2. Individual/family counseling prevention versus early intervention.
Domestic Violence Services
Sixty-four percent of participants rated Domestic Violence prevention service 6 or
higher while 36% indicated a 5 or lower. Fifty-four percent rated Domestic Violence
early intervention services 5 or lower while 45% rated 6 and higher (see Figure 3).
50
Figure 3. Domestic violence prevention versus early intervention.
Substance Abuse Programs
Fifty percent of participants rated Substance Abuse prevention programs 6 or
higher while 50% rated 5 or lower. Eight-six percent of rated early intervention
substance abuse programs a 5 or lower while fourteen percent rated a 6 or higher (see
Figure 4).
51
Figure 4. Substance abuse prevention versus early intervention.
Parenting Classes
Fifty-four percent of participants rated prevention parenting classes 6 or higher
while 46% rated 5 or lower. Fifty-four percent of participants rated early intervention
parenting classes 5 or lower while 46% rated 6 or higher (see Figure 5).
52
Figure 5. Parenting prevention versus early intervention.
In-home Parenting
Sixty-eight percent of the participants rated in home parenting prevention services
5 or lower while 32% rated 5 or higher. Seventy-three percent of participants rated early
intervention in home parenting 5 or lower while 27% rated 6 or higher (see Figure 6).
53
Figure 6. In-home parenting prevention versus early intervention.
Infant/Child Health Care Training
Fifty-three percent of the participants rated prevention and early intervention
infant/child health care training 6 or higher while 47% rated 5 or lower (see Figure 7).
54
Figure 7. Infant/child health care training versus early intervention.
Advocacy/Mentoring
Seventy-one percent of the participants rated advocacy/mentoring prevention
services 5 or lower while 29% rated 6 or higher. Seventy-six percent of the participants
rated advocacy/mentoring early intervention services 5 or lower while 23% rated this
services 6 or higher (see Figure 8).
55
Figure 8. Advocacy/mentoring prevention versus early intervention.
Participants were given the opportunity to indicate the four most important
prevention programs that they believed would benefit vulnerable children and families in
their community. While there was considerable variance in responses among
participants, Mental Health Services and Advocacy and Mentoring was indicated by 45%
as the most important prevention program, followed by Substance Abuse programs
(40%), Parenting Programs (36%), In Home Services (27%), Infant Child Care Training
(22%), and Domestic Violence (13%). The prevention programs indicated one time each
were: faith based programs, education, after school activities, public health services, dual
diagnosis services, DARE, Boys and Girls Club, Head Start/Early Head Start, Best
56
Beginnings, housing, library programs, and hospital outreach community support groups
respite care, family based services, and individual services. Community partners Infant
Parent Center, Parent Project, New Morning Youth & Family Services, and Family
Connections were each indicated one time as an important prevention program.
Participants were asked to list the four most important early intervention
programs that would address the needs of vulnerable children and families in their
community. Substance Abuse Programs were identified by 45% of the participants as the
most important early intervention program as was Mental Health (45%). Parenting
Programs were selected by 40% of the participants while 31% choose In Home Services.
Eighteen percent indicated Domestic Violence Services while 13% indicated counseling,
Women and Infant Outreach, and Head Start, respectively. Housing, housing subsidies,
“Bilingual Services,” “Dual Diagnosis,” employment, “Family based,” Wrap Services,
hospital outreach, collaboration, transportation, crisis nursery, parent partners and risk
identification were each reported one time. In addition, community partners New
Morning, Infant Parent Center, and Family Connections were each indicated once as an
early intervention as was “CPS voluntary.”
Collaborative Relationships
All 22 participants indicated that it was important that a collaborative relationship
exist between the child welfare agency and community partners. Seventy-two percent
indicated that a collaborative relationship existed between the child welfare agency and
community partners while 28% disagreed. Sharing decision making and participation in
57
joint training between the child welfare agencies and community partners was indicated
as both necessary and important by all the participants.
Major Challenges
Participants were asked what they believed are the major challenges to
implementing an alternative response approach that would identify low risk families and
refer them to a community partner. Although each participant gave unique well thought
out responses what was evident were three major themes: the lack of funding, correctly
identifying “low risk or no risk” families, and the lack of available services.
Fifty-five percent of participants indicated that funding was a major challenge.
Further, participants indicated while money to pay for prevention and early intervention
services would be the number one problem, it was evident there was additional concern
for staff funding at the child welfare agency, as well as community partners to “get the
program up and running.” Five participants (22%) indicated that after the program was
implemented “identifying the risk” would be problematic in relation to consistency and
permanency. Three participants stated that “personal bias” would interfere with
appropriately indentifying risk.
A lack of available resources within the community and interagency collaboration
was cited by 45% as the major challenge to implementing a differential response. Once
referred to services four participants stated transportation posed a significant barrier.
58
Summary of Findings and Discussions
Study findings support the researchers hypothesis that public and private
employees currently working with child welfare clients realize the potential for
community development and utilization of a differential response model that provides
prevention and early intervention to low risk families that come to the attention of Child
Protective services, but do not meet the criteria for abuse or neglect. All of the
participants agreed with and consider that the earlier family issues are identified and
addressed, the better children and families will do. Further, participants confirmed and
support the practice of families voluntarily engaging in services and the importance of
linking said families to effective services and supports in the community, in a timely
fashion, however, only 56% of the participants believed this could take place.
Although 86% of the participants agreed that a differential response system would
identify families in need of prevention and early intervention services before they are in
crisis, 22% indicated that identifying low risk, or no risk participants would be
problematic in relation to consistency and permanency. The data underscores the need
for risk identification tools specific to differential response, which relies on the ability to
accurately assign families to levels of risk in order to be effective.
Mental Health Services
Forty-five percent of participants viewed both prevention and early intervention
mental health services as the most important service, but the majority of participants
59
(n=14) rated mental health prevention services below five, with a larger number of
participants (n=16) rating early intervention services below five.
Advocacy/Mentoring
Similar to mental health services, 45% of participants viewed advocacy and
mentoring as an important prevention. Participants (n=15) also rated advocacy and
mentoring at the low end of the scale, regarding prevention. Interestingly advocacy and
mentoring was not indicated as an important early intervention service, and a large
majority (n=16) rated these services below five.
Substance Abuse
Forty percent of participants listed substance abuse as one of the four most
important prevention services while 45% listed early intervention substance abuse as one
of the four most important services. Participants were equally split on rating prevention
substance abuse services. Nineteen out of 22 participants (86%) rated early intervention
substance abuse services below five.
Overall, participants report low ratings for the majority of prevention and early
interventions services currently available for children and families identified as low risk
or no risk, in El Dorado County. These findings clearly support the researcher’s
hypotheses that services exits, however, services are not effective or suitable as
prevention, or early intervention programs and support systems.
The study hypothesized that a major challenge in implementing differential
response would be building effective collaborations between agencies and community
60
partners to support goals, values and the sharing of information and authority. Only two
participants commented regarding collaboration indicating, “lack of defined collaboration
process,” and “poor interdisciplinary collaboration. Therefore, the data did not support
the hypothesis that collaboration would be a major challenge. It is evident that
participants viewed collaboration as a necessary component to differential response and
those effective collaborative networks currently exist in El Dorado County between Child
Protective Social Workers and community providers that provide direct service.
Not surprisingly, participants indicated funding was the major challenge. During
a time of budget cuts it is difficult to envision funding such a program as differential
response. The Institute of Applied Research suggest that differential response requires
more up-front service related costs, but results in cost savings or is cost neutral over time
(National Quality Improvement Center on Differential Response in Child Protective
Services, 2009). Federal funding in the form of Title IV-B, Subpart 2, is to support
families and “avert” foster care, community-based family support programs, and allows
time limited service to reunify families and promote adoption (United States Department
of Health and Human Services, 2008). This is a state entitlement capped program which
requires the state to provide a 25% match.
61
Chapter 5
SUMMARY
Conclusion
Supporting and providing services to families that have been reported to Child
Protective Services in El Dorado County, where the risk of harm to the child is low, is a
common sense approach to a beleaguered system. Prevention and early intervention
services give promise to improved responsiveness to child and family needs which may
avert, or avoid a crisis situation further down the road and keep families intact.
Implementation of a differential response model that provides supports and services to
children and families identified as low, or no risk allows CPS and the community based
providers the framework, to build shared values and social capital, to ensure real family
support and child protection.
The data supports a necessary component to implementation of differential
response, being a shared vision and sense of responsibility to provide low risk, families
with prevention and early interventions services within their own neighborhood when
they first come to the attention of CPS, but do not warrant a traditional investigation. A
prevention network relies on the collaborative measures between the public and private
agencies. Prior research and this study indicate that rural areas have well established
collaborative networks due to fewer resources and smaller populations. Thus,
collaborative efforts have the potential to maximize limited resources and target supports
and services to low risk children and families.
62
Although previous studies indicate concerns regarding the importance of staff
“buy-in” (National Quality Improvement Center, 2009) this study found participants
willing and accepting of the differential response model. Interestingly, it is worth noting
that only one participant asked, “aren’t we already doing DR?” The researcher believes
that both public and private participants have had some exposure to working with the
differential response model on some level given the fact that El Dorado County has
sporadically attempted to implement differential response, when monies are available,
however, prevention and early intervention has only minimal been discussed and no
formal protocol currently exist.
The strength of the differential response approach relies on the availability and
access of services and programs within the community. Findings from this study
supported the researcher’s hypothesis that prevention and early intervention services
currently available in El Dorado County are unable to meet the needs of low risk children
and families. Further, the services available to low risk families are the same services
provided to families “screened in” to the CPS traditional investigation model. This
researcher believes that clearly one of the most significant barriers to providing low risk
children and families services in El Dorado County is not the lack of services, but the
lack of services developed specifically for prevention and early intervention and accounts
for the low ratings of existing services, with the exception of Individual and Family
Counseling and Domestic Violence Services.
63
The data indicates that a prevention focus on mental health, advocacy and
mentoring, substance abuse, and parenting would most benefit children and families in El
Dorado County while early intervention services need to focus on substance abuse,
mental health, parenting and in home services. Although evidence to support in home
services has been recognized, gaps in knowledge exist and may not work for all
populations. Nevertheless, in-home services are promising in rural counties and may be
an effective component of service delivery where transportation is a barrier to access.
Overwhelmingly, the major challenge is lack of funding. In a time of severely
reduced budgets, limiting services to only children and families believed to be at greatest
risk may continue to be the norm. Yet, despite funding constraints and the complexities
that a reallocation of funding requires, the long run prognosis is that prevention and early
intervention services and supports could lead to savings from a decrease in child
maltreatment and foster care.
The National Quality Improvement Center on Differential Response in Child
protective Services conducted an online survey of State Differential Response Policies
and Practices (2009) and found that funding for differential response programs typically
comes out the general federal, state and local CPS funds, indicated by 10 responses from
18 states. All 18 states indicated that they had implemented differential response
statewide. In the eight remaining states where differential response is not implemented,
statewide funding was provided by foundation or children’s trust fund monies. Clearly,
funding will remain a challenge for implementing differential response, which will
64
require collaboration and innovation on the part of the stakeholders, child welfare agency,
community partners, families and the community.
Recommendations
The dual mandate of CPS to protect children while preserving families has shifted
over time, yet continues to remain the gateway to services and supports for families.
Moreover, most services and supports are designed to be corrective, after problems have
occurred. Differential response is not intended to increase child welfare cases, but
provide a response to engage families in their community to provide services and
supports for well-being. Therefore, collaborative development in the community is
necessary to bring forth an array of prevention and early intervention services and
supports appropriate for El Dorado County.
It is the researcher’s belief that a coalition of private non-profit agencies, modeled
after the Napa Valley Coalition of Non-Profit Agencies (NVCNPA) is needed to combine
resources and unify efforts for the service delivery of prevention and early intervention
services, in El Dorado County. The Napa Valley Coalition was form in 1995, and is
comprised of multiple committees that advocate for change and provides a forum for
interagency collaboration, which addresses service gaps and fragmentation. Coalitions
have the ability to promote creative ways that are more responsive to the community and
cost effective.
In addition, El Dorado County is in need of a family resource center, to integrate
services at a “one stop shop.” A family resource center is located in the community and
65
focuses on preventing problems. Family resource centers are family oriented and familydriven, providing direct services along a developmental continuum. Although family
resource centers vary dramatically based on families needs, community assets and
priorities, centers typically may provide public awareness, skills-based curricula, parent
support groups, and home visitation, respite and crisis care programs. The family
resource center is unique to the community and responsive to the needs of its members
with a goal to empower families to raise safe, healthy and productive children.
Implications for Social Work Practice
The purpose of this study was to identify barriers to implementing a successful
differential response model in El Dorado County that would target low risk families for
prevention and early intervention programs and services that would keep families intact
and promote family functioning. Yet, the literature reveals limited studies regarding the
efficacy of prevention and early intervention programs and their impact on child
maltreatment.
By implementing the ecological perspective the practitioner agrees that the person
and environment mutually influence each other and that over time human behavior is a
product of this interaction between the developing individual and their environment.
Thus, development of prevention and early intervention services that will have the
greatest potential to promote family well-being will focus on the reciprocal nature of the
relationship.
66
The ecological approach necessitates that said services and supports be
implemented over the life course. In essence, child and family needs will change over
time and will require the practitioner, the community, and family to adapt to said changes
and the social work helping process to reevaluate and implement services and programs
that continue to promote well-being.
The shifting of resources from “family preservation,” to prevention and early
intervention has the greatest potential to promote well-being for vulnerable children and
families. It is pertinent that professionals engage in the development and utilization of
formal and informal resources in the community specifically geared to prevent future
child maltreatment.
67
APPENDICES
68
APPENDIX A
Consent to Participate in Research
You are being asked to participate in research which will be conducted by Patricia
Ramano, a Master of Social Work student at the Division of Social Work, California
State University, Sacramento. The study will investigate the participant’s perspective of
what community based public and privates services and supports are currently available and/or
unavailable that would address the needs of vulnerable children and families that have come to
the attention of child welfare.
Procedures: After reviewing this form and agreeing to participate, you will be given the
opportunity to set up a time at your convenience to complete the research survey. A copy of the
“Consent to Participate in Research” will be provided for your records. The survey should take
approximately, (15) minutes to complete. The survey is composed of Likert Scale and open
ended questions. The survey is confidential and no names will be recorded. The survey will be
documented by the researcher and upon completion of the project, all documentation will be
destroyed. As a participant in the study you can decide at any time not to answer a specific
question or stop the survey.
Risks: The study is considered to have no risk of harm or discomfort to the participants, as the
questions are not personal in nature. The questions are related to professional work and activities
for the participants who have received educational and professional training.
Benefits: The research gained by completing this survey will provide a better understanding to
both child welfare and community partners on how best to meet the needs of vulnerable children
and families that have come to the attention of child welfare, yet do not meet the criteria for
abuse/or neglect.
Confidentiality: All information is confidential and every effort will be made to protect your
privacy. Your responses to the survey will be reported in the aggregate. Information you provide
on the consent form will be stored separately from the survey, and kept in a secure location at the
researcher’s home. The final research report will not include any identifying information. All of
the data will be destroyed approximately one month after the project is submitted with Graduate
Studies at California State University, Sacramento, in June of 2010.
Compensation: Participants will not receive any kind of fiscal compensation.
Rights to withdraw: If you decide to participate in this survey, you can withdraw at any point,
or elect to not answer questions.
I have read the descriptive information on the Research Participation cover letter. I
understand that my participation is completely voluntary. My signature or initials indicate that I
have received a copy of the Research Participation cover letter and I agree to participate in the
study.
69
I
Signature or initials:
, agree to participate.
Date:
If you have any questions you may contact the researcher: Patricia Ramano (916) 293-1849,
pr423@saclink.csus.edu or, if you need further information, you may contact the researcher’s
thesis advisor: Joyce Burris, PhD. c/o California State University, Sacramento (916) 278-7179,
dub@saclink.csus.edu
70
APPENDIX B
Community Needs Assessment for Prevention and Early Intervention
1.
How long have you been working with child welfare clients?
0 to 2 years
2.
3 to 5 years
6 to 10 years
11+ years
In what community do you, or did you work?
Placerville Georgetown Grizzly Flat Somerset El Dorado Hills Cameron Park
Camino Pollock Pines Lotus Coloma Kybruz South Lake Tahoe
3.
In what professional capacity do you currently work with child welfare clients?
Public Agency :
4.
Private Agency:
As part of your employment how often do you come in contact with families that
have come to the attention of Child Protective Services that in your opinion are low
risk families?
Never
5.
Rarely
Sometimes
Frequently
The earlier family issues are identified and addressed, the better children and families
do.
Disagree
1
2
3
4
5
6
7
8
9
Not Important 1
Important
2
3
4
5
6
7
8
9
6.
Agree
Very
Families can resolve issues more successfully when they voluntarily engage in
services, supports, and solutions.
Disagree
1
2
3
4
5
6
7
8
9
Not Important1
Important
2
3
4
5
6
7
8
9
Agree
Very
71
7.
Families that are determined to be “no risk or low risk” can be linked to effective
services and supports in the community in a timely fashion.
Disagree
1
2
3
4
5
6
7
8
9
Not Important1
Important
2
3
4
5
6
7
8
9
8.
Very
Families know best about what they need to improve their lives and their input is
essential and their perspectives and insight are key to crafting plans.
Disagree
1
2
3
4
5
6
7
8
9
Not Important1
Important
2
3
4
5
6
7
8
9
9.
Agree
Agree
Very
Consumers of child welfare services need to be involved in policy development, staff
and community partner training, and quality assurance activities.
Disagree
1
2
3
4
5
6
7
8
9
Not Important1
Important
2
3
4
5
6
7
8
9
Agree
Very
10. A collaborative relationship exists between the child welfare agency & community
partners.
Disagree
1
2
3
4
5
6
7
8
9
Not Important1
Important
2
3
4
5
6
7
8
9
Agree
Very
11. The idea of sharing decision making between the child welfare and community
partners at the beginning when a family first comes to the attention of the child
welfare agency will result in better decisions about families’ strengths, and needs.
Disagree
1
2
3
4
5
6
7
8
9
Not Important1
Important
2
3
4
5
6
7
8
9
Agree
Very
72
12. Including community partners and agency partners in joint trainings on alternative
responses will enhance the relationship and expand the capacity of the community to
protect children and support families.
Disagree
1
2
3
4
5
6
7
8
9
Not Important1
Important
2
3
4
5
6
7
8
9
Agree
Very
13. A shift in values and beliefs about both families and the role of the community in
child welfare must occur for alternative responses to be effective as a tool for
prevention and intervention.
Disagree
1
2
3
4
5
6
7
8
9
Not Important1
Important
2
3
4
5
6
7
8
9
Agree
Very
14. You are aware of both formal and informal resources and services that exist in your
community that provide prevention and intervention services for children and
families.
Disagree 1
2
3
4
5
6
7
8
9
Not Important1
Important
2
3
4
5
6
7
8
9
Agree
Very
15. An alternative response system, where child welfare agencies sort families by risk
level will identify families in need of prevention or early intervention services before
then are in crisis?
Disagree
1
2
3
4
5
6
7
8
9
Not Important 1
Important
2
3
4
5
6
7
8
9
Agree
Please rate the following “Prevention “services in your community:
Mental Health
Poor
2
3
4
5
6
7
8
9
Excellent
Very
73
Individual/Family Counseling
Poor
2
3
4
5
6
7
8
9
Excellent
Domestic Violence Services
Poor
2
3
4
5
6
7
8
9
Excellent
Substance Abuse Programs
Poor
2
3
4
5
6
7
8
9
Excellent
Parenting Classes
Poor
2
3
4
5
6
7
8
9
Excellent
In Home Parenting
Poor
2
3
4
5
6
7
8
9
Excellent
Infant/Child Health Care Training
Poor
2
3
4
5
6
7
8
9
Excellent
Advocacy/Mentoring
Poor
2
3
5
6
7
8
9
Excellent
4
Please rate the following “Early Intervention “services in your community:
Mental Health
Poor
2
3
4
Individual/Family Counseling
Poor
2
3
4
5
6
7
8
9
Excellent
5
6
7
8
9
Excellent
Domestic Violence Services
Poor
2
3
4
5
6
7
8
9
Excellent
Substance Abuse Programs
Poor
2
3
4
5
6
7
8
9
Excellent
Parenting Classes
Poor
2
3
4
5
6
7
8
9
Excellent
In Home Parenting
Poor
2
3
4
5
6
7
8
9
Excellent
74
Infant/Child Health Care Training
Poor
2
3
4
5
6
7
8
9
Excellent
Advocacy/Mentoring
Poor
2
3
5
6
7
8
9
Excellent
4
16. What do you believe are the top four prevention programs that would benefit
vulnerable children and families in your community?
1.
2.
3.
4.
17. What do you believe are the top four early intervention programs that would benefit
vulnerable children and families in your community?
1.
2.
3.
4.
18. What do you believe are the major challenges to implementing an alternative
response approach that would identify low risk families and refer them to community
partners?
75
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