U.S. CWS Redesign – 1.4 Intervention: Redesigned CWS – Removed to Recovery Care


United States Child Welfare System Redesign

Strategic Action Plan


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1.4 Intervention: Redesigned CWS – Removal to Recovery Care

“This is not about the intentions of those who developed the system we have. It is about listening to the people it harms.”[1]


Reasons for Removal from Home to Foster Care in the Current Child Welfare System

Reasons Child Removed from Home
Reasons Child Removed from Home

The above chart is based on information provided by one of the states in their annual reports from 2009 through 2019.



Data for the years 2009-2011 demonstrate a normal fluctuation in reasons children are taken from their home following a CPS assessment. Although the actual numbers and percentages vary over the years, there are 5 main reasons for removal in 2009-2011:

  • Child neglect abuse,
  • Parent drug abuse,
  • Child physical abuse,
  • Parent alcohol abuse, and
  • Child behavior,
  • with Inability to cope and
  • Inadequate housing not far behind.

However, there is a sudden and dramatic change to the data in 2012. From 2012 to the latest annual report in 2019, there are only 2 main reasons for removal of a child from their home: Child neglect abuse and Parent drug abuse.

Critical Notes:

  • The highest main reason for removal in 2009-2011, child physical abuse, has dropped significantly from the data. Child physical abuse now hovers been fifth and sixth as the reason for removal.
  • Child neglect moved from fourth to a significantly higher first reason.

Ways to View the Dramatic Change:

There are two ways to look at the dramatic change in 2012.

  • The first is to believe that child physical abuse, parent alcohol abuse, and child behavior are no longer issues. A CPS program or service introduced to families in 2012 reduced those three previously main occurrences to practically trivial, in comparison to the huge spikes in child neglect abuse and parent drug abuse. In addition, that new CPS family program or service has been continued steadily from 2012 through 2019 and probably exists today.
  • The second way to view the data is that a major shift in counting and tracking reasons for removing a child was introduced within CPS in early 2012. That change in counting resulted in a pattern that has been repeated every year since 2012. It is not because child physical abuse, parent alcohol abuse, child behavior, ability to cope, and inadequate housing suddenly disappeared from the majority of the families simultaneously in 2012 and continuously after that. It is more likely that those conditions still exist in families assessed by CPS, but CPS caseworkers are focused on two main conditions – or lump other conditions under two main conditions – child neglect abuse and parent drug abuse.


Up through 2011, there were five major areas that needed to be addressed by CPS, plus two more areas that deserved more attention. In one year, the areas needing to be addressed were reduced from five or seven to only two. Given the reduction of areas to be addressed, it would make sense that CPS would focus family programs and services on those two areas. However, data from 2013-2019 indicate no change – perhaps even a slight increase – in these two areas. If family in-home programs and services were, indeed, implemented between 2012-2019, they have not been effective.

In 2012, the state introduced a new automated system, SACWIS (State Automated Child Welfare Information System).  From the 2012 annual report: “There are changes in the content … due to data conversion issues and changes in reference values. This may impact the inclusion of, or comparability to, data reported in prior years.” [bolding for emphasis]


Redesigned Child Welfare System

Distinguishing Child Abuse and Neglect from the Family’s Socioeconomic Status

Do not remove a child who has not been abused or neglected from the home SOLELY due to non-abuse socioeconomic situations such as poverty, unemployment, parent drug/alcohol addiction, or inadequate housing. Help the family recover from those situations, while regularly checking on the welfare of the child, primarily looking for any new threat of harm, child abuse, or neglect. The socioeconomic status of the family, in and of itself, is not grounds for removal of the child from the home.

Don’t remove the child, help the family.

The Child Welfare System, through its partnerships with other state agencies and federal assistance, can provide help and support to the family to improve the family’s socioeconomic situation in the interest of prevention of child abuse or neglect. This is an example of combining an assessment – no current child abuse or neglect – with data-informed prevention – specifically from the NIS-4 study, “Children in low socioeconomic status households experienced some type of maltreatment at more than 5 times the rate of other children; they were more than 3 times as likely to be abused and about 7 times as likely to be neglected” – as the reason for the Child Welfare System to take action on behalf of the family as prevention against potential future child abuse and neglect of the child. See Section 2.1 Prevention: Fourth National Incidence Study of Child Abuse and Neglect (NIS-4) for more details on the NIS-4 study.


Current Foster Care System

Foster care appears to be based on the belief that once an abused or neglected child is removed from the abusive home, the child is suddenly whole, well, and happy. Some couples become foster parents with that concept firmly implanted. The child should be grateful that they have been saved from the toxic environment of their birth family. These “rescuer” couples are often surprised and even shocked when the child is not grateful; in fact, the child is angry, defiant, abusive, or depressed, frightened, and doesn’t want to be touched. Too often the child is removed from the “rescuers,” due to the child not living up to their ideal of a grateful child, happy to be saved. The “rescuers” may try again and again to find a grateful, happy child. Sometimes they find one and all is well. Sometimes they never find one and stop fostering.

Some couples understand the trauma the child suffered and show compassion and love towards a child. They provide for professional therapy for the child and treat the child as their own biological child. Often, these “nurturers” provide the hope, help, and love the child needs to develop a different, more compassionate and loving view of themselves and their world. Some of these “nurturers” adopt the child they fostered, to continue the family of choice. These are the success stories.

Unfortunately, what appears to be the majority of the foster care homes recognize the economic value of providing a room and food for a child, with minimal contact or interaction with the child. These “warehousers” are the common view of foster care in the United States. The traumatized child, taken from the only home they know, is placed in a warehouse, told to stay in the room, and not to bother anyone. The child receives the message loud and clear: Here is further proof that their life doesn’t matter, that they are being punished, that they are not lovable, and no one cares.

As bad as the “warehousers” are to the traumatized child in their home, there is one more type that could be considered even worse. These are the “abusers”: couples who are in it for the money and for the child on whom they can take out their own rage or sexual fantasies. The child, already traumatized by an abusive home, finds another abusive home awaiting them. Their “abusers” take advantage of the child’s low self-esteem, lack of self-worth, and worldview of victimhood. Often, the child is faced with an even more horrific home than the one they left. Not all children survive this type of foster home; those who do are scarred by the experience for life.

Number of Children Maltreated in Foster Care 2018
Number of Children Maltreated in Foster Care 2018


No mention is made of the “institutions” where some victims of child abuse or neglect are now sent. These are not foster care; these are prisons where the child is stripped of any sense of self-worth or safety. This is children being punished for being victims. This type of “foster care” does not exist in the Redesigned Child Welfare System. Neither do the “rescuers,” the “warehousers,” nor the “abusers.” Only therapeutic “nurturers” of traumatized children have a place in the Redesigned Child Welfare System. These “nurturers” are themselves supported by agencies, nonprofits, and volunteers. Foster care is no longer considered a stepchild of the Child Welfare System. Foster care is one step in the process of recovery for the traumatized child; an opportunity for the child to experience a different worldview of caring and compassion they had never received and a growth in self-esteem, self-worth, and self-respect.

Foster care becomes a temporary recovery step while the members of the family receive their own healing and are provided options to their past behavior and their violent worldview. Reunification of the child and the family is one goal, when the family and child both want it to be. When the child’s parent(s) no longer want the child, or the child no longer wants the family (for those old enough to make that choice), then immediate action is taken to transfer custody of the child to the state temporarily, while adoption or guardianship options are immediately started. No longer will a child have to wait three or four years for an adoption to be finalized. The child remains in the therapeutic foster care home until helped and ready to be adopted. Adoptive parents visit the child regularly in the foster care home, to gradually make the transition easier for both new parents and child.

[1] Let’s Root Out Racism in Child Welfare, Too, by Martin Guggenheim, https://imprintnews.org/child-welfare-2/lets-root-out-racism-child-welfare-too/44327?fbclid=IwAR3yXiYm9qZD6J1LlCXH8qcpNW_E1w7XKspeqnKiZnKX_4w6mVQK981d9SU


Redesigned Therapeutic Respite Care System

Removal of a child from their home is a traumatic event for an already traumatized child. The Placement Worker must have compassion and understanding of the many forms this trauma may be displayed by the child and the family. If the family is volatile, Law Enforcement will have remained in the home until the Placement Worker arrives. In some cases, Law Enforcement may have removed the offending parent from the home, but the child also needs to be removed from the home for physical, mental, and/or emotional treatment. The Placement Worker may enter into a chaotic home filled with CPS Caseworker(s), Law Enforcement personnel, uncooperative family members, and the traumatized child or children. Calm, composed, yet compassionate behavior is of benefit to the Placement Worker. In addition, planning, as well as spontaneous contingency planning, must be a forte.


1.22 Placement Worker arrives at the location

The Placement Worker has multiple schedules to prepare while on route to the home or location of the child. An ambulance must be requested, the hospital must be notified, and a Therapeutic Recovery Home must be found for the child – all in the appropriate sequence. The Therapeutic Recovery Home search could be conducted by a specialist at the office, knowledgeable of the type and availability of Therapeutic Recovery Homes in the area, and alerting a TRH that the Placement Worker will be in contact about the status of the child and the potential arrival time at the TRH.


1.23 Placement Worker accompanies the child on an ambulance taken to the nearest equipped hospital

Every child removed from the home is to be taken by ambulance to the nearest hospital equipped to conduct a complete physical exam and a psychological assessment. The Placement Worker is responsible for receiving detailed physical injury reports and prescribed actions, medications, and treatments from the physician, plus detailed psychological profiling, medications, and treatments from the psychologist or psychiatrist on call at the hospital. The hospital visit is required even if no physical signs of abuse are present; often the trauma has resulted in psychological issues that need to be addressed by a professional. Although not possible in every city or county in the U.S., a children’s hospital, or a hospital with a quiet wing for the physical and psychological exams would reduce the child’s further trauma after the experience of being removed from home.

The Placement Worker stays as close to the child as possible, to reassure the child that they are there to help the child, not further terrify the child.


1.24 Placement Worker takes child to Therapeutic Recovery Home by ambulance

In addition to the mandatory visit to the hospital for a child removed from the home, the most significant change in the Out-of-Home-Placement process is the definition and structure of the place to which the child is taken. Instead of Foster Homes, the traumatized child is taken to a Therapeutic Recovery Home (TRH), with one or both “parents” trauma-informed and trained to understand the behavior that may be presented by child victims of abuse or neglect. The entire intent of the TRH is to provide a safe, warm, friendly home where the child is welcomed and nurtured. The “parents” are made fully aware of both the physical and psychological treatment plans and follow the treatment plans explicitly. Additional support is provided to the TRH parents, based on the specific needs of the child.

Recovery from the trauma of child abuse and neglect is the first goal of the TRH. The length of time of the recovery depends on the child’s trauma, severity of the abuse, and recommendations of the physician and therapist. Possible reunification with the family is a topic only to be brought up by the child, with the child leading the discussion about the desire to return or not. Introducing the thought of reunification to the child before the child has recovered may result in unintended further trauma for the child. Let the child know that they are in charge of what happens; they first need to focus on recovery. Of course, all of this guidance is age-defined. An infant is not going to understand “reunification” and a defiant 16-year-old may not want to be called a “child” or treated like one.

An important aspect to the Therapeutic Recovery Home is that the child matures at the level expected for a child of that age, mental development, and physical development. For example, a school-age child should be in school (either public school or home-schooled, depending on the child’s needs) at the appropriate grade level for the child’s age, whenever possible. In addition, the child should be taught the usual age-appropriate family chores, such as doing laundry, cooking, cleaning up their room, getting an allowance, budgeting their money, etc. Even children expected to be reunited with their birth family within a short period should be given these “normal” tasks of daily living, so the child returns to the family feeling more empowered.


1.25 Placement Worker visits child weekly

Weekly visits by the Placement Worker are mandatory, and scheduled in the CWS database to ensure adherence to the schedule. If available, a CASA volunteer may be assigned to the child, particularly if legal issues and/or family complications are involved. It is important that the community share in the nurturing of the child’s recovery. It is also critically important that the child be protected from further harm or injury – whether from someone else or the child’s self-injury.

As with the Family Services Worker, there is not a straight sequence of processes or steps to be applied to every child. The main focus is that the child feels in control of their current environment – which may be a totally new concept to a child who has experienced years of abuse in a dysfunctional family.

One additional major change in the Redesigned Child Welfare System involves the funding provided by federal or state grants for the welfare of the child while under the care of the CWS. Funding for children who have been abused or neglected and are placed in Therapeutic Recovery Homes (replacement of Foster Care Homes) is no longer paid directly to the “foster care home” – now Therapeutic Recovery Home. Funding is held in the child’s name and account, to be applied to TRH and all other services required by the child to heal. Funds are paid only when the child thrives.

No longer will foster care parents be paid for abusing a child.

Although it may be argued that, with the replacement of foster care homes with Therapeutic Recovery Homes, there may not be a need to control the funding in that way, it emphasizes to all within the Child Welfare System that the child IS the center, the focus.


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To submit questions or comments, please email Jo@Jo-Calk.com. I welcome all input, ideas, and suggestions. Thank you for caring for children.


Jo Calk