U.S. CWS Redesign – 1.7 Protect Our Kids Act of 2012 Commission Report and Redesigned CWS

 

United States Child Welfare System Redesign

Strategic Action Plan

 

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1.7 Protect Our Kids Act of 2012 Commission Report and Redesigned CWS

 

The Protect Our Kids Act of 2012 garnered broad, bipartisan support in the House, passed the Senate unanimously, and was signed by President Barack Obama on January 14, 2013. One of the key provisions of the act was the establishment of the Commission to Eliminate Child Abuse and Neglect Fatalities (CECANF), whose mission is to develop a national strategy and recommendations for reducing fatalities across the country resulting from child abuse and neglect. It will do this by:

  • Raising visibility and building awareness about the problem
  • Reviewing data and best practices to determine what is and is not working
  • Helping to identify solutions
  • Reporting on findings and making recommendations to drive future policy.

CECANF engaged with states, tribes, localities, the military, national organizations and the public to find solutions that eliminate fatalities and protect kids.

 

Commission Report

On March 17, [2014,] the Commission to Eliminate Child Abuse and Neglect Fatalities (CECANF) released its final report, Within Our Reach: A National Strategy to Eliminate Child Abuse and Neglect Fatalities.” Of key emphasis the commission report highlights:

  • Infants and toddlers are at high risk of an abuse or neglect fatality compared to other age groups. They require special attention.

 

  • A call to a child protection hotline, regardless of the disposition, is the best predictor of a later child abuse or neglect fatality. This points to the importance of the initial decision to “screen out” certain calls. Screening out leaves children unseen who may be at a high risk for later fatality.

 

  • Involvement of health care and public health agencies and professionals is vital to safety for children. Well-coordinated interagency efforts are essential.

 

  • The importance of child protection workers’ access to real-time information about families cannot be overestimated.

 

  • It is critical to have an accurate national count of child protection fatalities. Better data allow us to begin to understand what works and what doesn’t.

 

  • The Nurse-Family Partnership program has been demonstrated to save lives.

 

The report highlighted the difficulty within the introduction when Commission head David Sanders told readers:

“Unfortunately, although we found that we know a lot about what puts children at risk, there are relatively few promising or evidence-based solutions. In fact, we were able to identify only one practice with research evidence showing a reduction in fatalities—Nurse- Family Partnership. Likewise, we found only a handful of communities that identified reduction of child abuse and neglect fatalities as a goal, implemented efforts to achieve that goal, and demonstrated progress. Despite evidence that overall safety for children is improving, these fatalities are not declining. My conclusion is that achieving a reduction in child abuse and neglect fatalities requires a different set of approaches altogether from those that are being successfully used to improve overall safety.” Source: https://www.cwla.org/commission-releases-final-report-on-child-fatalities/

 

 

Redesigned Child Welfare System

Recommendations for the Redesigned Child Welfare System are greatly aligned with the intent of the Family First Act. The Redefined Child Welfare System:

  • Infants and toddlers: The NIS-4 report in Section 2.1 Prevention: NIS-4, indicates far fewer reports for children ages zero through two and up to 4 years old, due to fewer eyes on the child before the child enters school. In addition, many states report infants and toddlers, aged zero through 4 as the highest percentage of child mortalities caused by abuse or neglect. “Special attention” is required and one action step is provided in Section 2.1.

 

  • No screening-out of reports: Although screening-out reports has been one of the major core issues resulting in this Redesign of the Child Welfare System, a great case against screening-out is made in the NIS-4 report found in Section 2.1 Prevention: NIS-4.

 

  • Health care and public health: The Family First Act report, found in Section 1.6 Family First Act and Redesigned CWS, explained the importance of mental and physical care for child who have been abused or neglected. The Redesigned Child Welfare System strategy detailed in Chapter 1 describes the importance of the visit to the hospital following removal from the home, to assess the physical and mental challenges and prescriptions and proscriptions for therapeutic respite care homes to help the child recovery from the trauma

 

  • Real-time information: Chapter 1 describes the need for synchronized databases between Law enforcement and the Child Welfare System because of the importance of real-time information.

 

  • Child fatalities: Chapter 2: Prevention: Data to Action Analysis describes the proactive action steps that can be taken by the Child Welfare System, based on data provided from the post-mortem review of child fatalities, whether involved with CWS or not.

 

  • Nurse-Family Partnership program: Nurse-Family Partnerships was the first, but no longer the only, program recommended from the Family First Act, as detailed in Section 1.2 New In-Home Services.

 

From the Commission Head: “My conclusion is that achieving a reduction in child abuse and neglect fatalities requires a different set of approaches altogether from those that are being successfully used to improve overall safety.”  That is exactly why the Redesigned Child Welfare System uses a totally different set of approaches, and places the child in the center of every action taken.

 

 

The Dissenting Report of The Honorable Judge Patricia M. Martin, CECANF Commissioner, March 14, 2016.

 

Please Note: rather than repeat this long section to provide the action taken by the Redesigned Child Welfare System, comments regarding the Redesigned CWS will be placed in brackets following the paragraph to which the comment relates. In addition, all bolding has been added for emphasis, and explanatory information (e.g., definition of initials) are included in brackets within the text. All remaining text is from the Dissenting Report.

 

In early 2014, The Commission to Eliminate Child Abuse and Neglect Fatalities met … to begin a process that would examine the state of affairs surrounding prevention of child abuse and neglect fatalities. … Two years and $4 million later, the Commission has produced a Consenting Report that, on the whole, has failed to realize those hopes or to fulfill the Commission’s charge.

Through a systematic evaluation of individual professional observations, research reports, as well as the expert and practical testimony heard throughout 11 separate hearings in different parts of the country, certain conclusions can be reached as to what are the next steps in eliminating child abuse and neglect fatalities. This report captures those conclusions and proffers 19 applicable recommendations to create a clear national strategy for combating CAN fatalities.

Statistics show, in 29 reporting states, that only 12.2 % of the CAN fatalities were known to CPS in the prior 5 years immediately preceding the deaths. Extrapolated, that would suggest that 87.8% of those CAN deaths were of children never reported to CPS [or were screened-out from CPS]. … the Child Welfare System in our country is reactive and somewhat ineffective in the prevention of child abuse and neglect fatalities. … the current Child Welfare System has no primary prevention function; it is designed to reactively manage family crises. … elements which could give the system a preventive light and reform the Child Welfare System to include a primary prevention approach to child abuse and neglect … include reducing poverty, home visiting, addressing disparities, implementing coordinated multi-disciplinary efforts, data sharing, and continued effective data collection on CAN fatalities and near fatalities.

[Included in the Redesigned Child Welfare System]

[S]ome states have “birth match” programs. These programs make it mandatory for hospitals to report births of children born to parents who have a previous termination of parental rights (TPO). The result is that services for these families begin immediately. This is a good example of a coordinated multi-disciplinary response where … the prevention begins immediately. Because we know that a prior report to CPS, regardless of its disposition, is the single strongest predictor of a child’s potential risk for injury death (intentional or unintentional) before age 5, we can ill afford not to embrace birth matching.

[Included in the Redesigned Child Welfare System]

RECOMMENDATION 1.1: Congress, in partnership with the Administration and State Child Welfare Directors, should develop a more thorough and universally agreed upon definition(s) of child abuse and child neglect to be included in the next CAPTA reauthorization.

[Included in the Redesigned Child Welfare System]

RECOMMENDATION 2.1: Congress should require that all states report CAN [child abuse or neglect] deaths to NCANDS [National Child Abuse and Neglect Data System].

[Included in the Redesigned Child Welfare System]

RECOMMENDATION 3.1: Congress, in consultation with the Administration and State Child Welfare Directors should develop a universally agreed upon data sharing plan that would allow real time risk and protective factor assessment of children beginning at birth to be included in the next CAPTA reauthorization.

[Included in the Redesigned Child Welfare System]

Other players in the child welfare system include law enforcement, clergy, courts and the medical profession. However, the current paradigm lacks consistent coordination between these entities. … where home visiting is available, there seems to be evidence that it is an effective preventive child abuse and neglect strategy.

[Included in the Redesigned Child Welfare System]

RECOMMENDATION 4.1: Congress and the Administration should mandate that the Bureau of Indian Affairs (BIA), at a minimum, immediately implement the practice of distinguishing child and adult homicide victims when reporting fatalities in Indian Country.

[Included in the Redesigned Child Welfare System]

RECOMMENDATION 5.1: Congress and the Executive Branch should require the FBI to identify key data that tribes could track and that the BIA could collect. At a minimum, the FBI should ask BIA to use the National Incident-Based Reporting System (NIBRS) or request that BIA provide more detailed child-specific information. BIA and FBI data collection about AI/AN [American Indian/Alaska Native] children and child fatalities should be coordinated to be complementary and comprehensive.

[Included in the Redesigned Child Welfare System]

RECOMMENDATION 6.1: Increase reporting upfront to the Bureau of Indian Affairs (BIA) on tribal and state child welfare cases involving AI/AN children.

[Included in the Redesigned Child Welfare System]

RECOMMENDATION 7.1: Congress should mandate the provision of training and technical assistance for tribes around collecting data and building data systems.

[Included in the Redesigned Child Welfare System]

RECOMMENDATION 8.1: Federal policy should provide incentives for states and tribes to increase participation and deputation agreements and other recognition agreements between state and federal law enforcement agencies.

[Included in the Redesigned Child Welfare System]

RECOMMENDATION 9.1: Coordination between and among jurisdictions should be mandated, facilitated, and incentivized.

[Included in the Redesigned Child Welfare System]

RECOMMENDATION 10.1: The federal government should mandate the recognition of tribal criminal jurisdiction in Indian Country in cases of child abuse and neglect, regardless of the perpetrator’s race and/or ethnicity.

[Included in the Redesigned Child Welfare System]

RECOMMENDATION 11.1: Congress and the Administration should address the ability within tribes to support child/family/tribal access to needed services, supports, early literacy services, home visiting, and education by, at a minimum, promoting access to services, supports and education outside of the standard 9 a.m. to 5 p.m. service hours.

[Included in the Redesigned Child Welfare System]

RECOMMENDATION 12.1: Congress and the Administration should explore the development and implementation of educational curricula connecting youth to their cultural traditions, particularly around native language renewal and positively presented Native American history, to be used at all levels of pre-collegiate education.

[Included in the Redesigned Child Welfare System]

RECOMMENDATION 13.1: Congress and the Administration should mandate the implementation of service approaches that prioritize keeping children within their tribes as a primary alternative to out-of-home placement.

[Included in the Redesigned Child Welfare System]

RECOMMENDATION 14.1: Conduct longitudinal research about the leading factors related to child abuse and neglect fatalities of AI/AN children, 18 and under. It may be possible to integrate a longitudinal research component in the Tiwahe Initiative (a partnership between HHS, DOJ, and DOI) currently being piloted in four tribes.

[Included in the Redesigned Child Welfare System]

RECOMMENDATION 15.1: The federal government should promote and facilitate peer-to-peer connections around examples of well-formed efforts focused on AI/AN children and families.

[Included in the Redesigned Child Welfare System]

“I think we need to look at abusive head trauma and why it is according to much of the research that abusive head trauma cases are misdiagnosed for white kids. I think that suggests that we really need to go back in and look at that data and it is possible that implicit bias could be contributing to that misdiagnosis of abusive head trauma with regard to white kids and that might give us information that will allow us to move forward.” – Dr. Rita Cameron Wedding CECANF Testimony – New York 

 

Implicit bias can impact decision-making related to minority children being overrepresented and possibly other children being underrepresented in the child welfare system. For example, it has been established that when an African American child is seen for a head injury in the emergency room, a CT scan is the protocol at a much higher rate than for a Caucasian child presenting the same symptomology. Thus, corresponding data would suggest a need to overcompensate intervention and prevention efforts when observing African American children and undercompensate when observing Caucasian children. … It could be that disproportionality is a double-edged sword that directly disparately treats African Americans while inadvertently depriving Whites of proper assessments and diagnoses. … Child abuse and neglect fatality data available through NCANDS tell us that while African American children are approximately 15 percent of the child population nationally, they are 33 percent of the child abuse and neglect fatalities, which is approximately three times greater than white children (NCANDS 2014). … It is conceivable that such loss in the minority community may contribute to a cycle that ravages families, decimates neighborhoods, increases poverty, and produces an overall environment of hopelessness due to an overload of negative and/or unfair interaction with the child welfare system. As a result, mistrust of the system becomes established in the community disposition. Child abuse and neglect increases or goes unattended. Children in minority communities die at a disproportionate rate.

[Included in the Redesigned Child Welfare System]

“We have oftentimes identical risk factors for black families and white families but when the risk factors are identical, white families are more likely to get family and home support and black families are more likely to have their children removed. And families know that. So they’re not going to stick around. They’re not going to tell us things. They’re not going to give us information, critical information that we need to have in order to save their children, to help them save their children.” Dr. Rita Cameron Wedding CECANF Testimony – New York

 

A climate of distrust of the very system that should be a tool to assist families in unification, health, and wholeness has been developed due in large part to the way information is processed and shared. Thus, African American families, particularly in emergent healthcare situations, avoid utilizing the social support system for fear of the professionals’ bias. It is necessary to rebuild the trust in these communities. … The system will never be able to stop the preventable deaths of children due to child abuse and neglect if a serious and concerted effort is not made to remake it both in policy and practice. Policies that ignore the multicultural nature of our society must be redressed.

[Included in the Redesigned Child Welfare System]

“[S]ee poverty as a condition and not as a character flaw” – Dr. Renee Canady – CECANF Testimony, New York

[Included in the Redesigned Child Welfare System – poverty is not child abuse r neglect]

Poverty first happens to a community and is then manifested in an individual. Poverty therefore is a lack of resources translated into a lack of quality social services, products, and opportunities. … Where we have seen potential improvement in outcomes related to disproportionately represented populations, there has been a direct correlation between an all hands on deck community response of mandatory reporters from various sectors including clergy, care providers, law enforcement, educators, and doctors.

[Included in the Redesigned Child Welfare System]

RECOMMENDATION 16.1: Congress should mandate that all organizations receiving federal funding or benefits for the purpose of serving children have at least one responsible party who is registered in a federal registry, and that said party be trained in the nuances of mandatory reporting of child abuse and neglect. In the case of faith-based organizations, clergy should have the ability to report under the shield of anonymity.

[Included in the Redesigned Child Welfare System]

RECOMMENDATION 17.1: Congress and the Administration should promote the standard that all CPS cases consider the total well-being (physical, mental, and emotional) of (1) the child, and (2) the nuclear family and shall proceed with the presumption of preserving the holistic health of the family in anticipation of reunification and/or kinship care where practicable.

[Included in the Redesigned Child Welfare System]

RECOMMENDATION 18.1: Congress should encourage increased emphasis on teen pregnancy prevention, especially for young men and women in high poverty areas and those in foster care. There needs to be more attention given to young men in the development of effective teen pregnancy programs.

[Included in the Redesigned Child Welfare System]

RECOMMENDATION 19.1: The Administration should bolster efforts to involve probation officers and parole officers in the multi-disciplinary outreach to monitor the safety of children where parolees and those on probation reside.

[Included in the Redesigned Child Welfare System]

RECOMMENDATION 20.1: Congress should incentivize the establishment of Family Preservation Court or Intact Family Court demonstration projects that feature a multi-disciplinary team approach in order to promote the survival of healthy families and communities otherwise decimated by disproportionate incidence of child abuse and neglect and child abuse and neglect fatalities. This approach should not be limited to federal funds, but could be implemented through public/private partnerships.

[Included in the Redesigned Child Welfare System]

 

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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.

Blessings,

Jo Calk