Walter R. McDonald & Associates, Inc.
U.S. Department of Health and Human Services
Administration for Children and Families, Childrens Bureau and
Assistant Secretary for Planning and Evaluation
This report is available on the Internet at:
In 2000, the Office of the Assistant Secretary for Planning and Evaluation in the U.S. Department of Health and Human Services, in cooperation with the Children's Bureau, Administration on Children, Youth, and Families, began a study of State and county child protective services (CPS) systems and reform efforts. The objective of the study is to inform the Federal Government about the current structure and landscape of CPS systems in the United States and the improvement efforts that are underway. A full description of the overall study appears in appendix A.
This literature review has been completed as a part of the larger study. The objective of this review is to summarize the literature that discusses CPS change objectives and initiatives. The review has focused largely on materials that have been published over the past 5 years. The recent literature provides one conceptual framework from which to understand issues facing CPS systems and reform efforts. It also helps to identify demonstrations and initiatives that are being implemented in order to address such issues. The literature does not, however, provide a comprehensive picture of the commonalities and variations in CPS agency policy and practice throughout the country. The other components of the national study will address this gap in knowledge.
The literature review is organized into two main sections: Proposals for Change and Demonstrations of New Approaches. The first section reviews those features of the CPS system that are deemed to need change. The second section describes initiatives currently underway in States and counties around the country. These descriptions demonstrate the range of change initiatives that are being designed and implemented. The bibliography for this review can be found in appendix B. A more complete list of selected readings can be found in appendix C.
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Ever since the establishment more than 100 years ago of agencies that address the issue of child protection, there has been an ongoing goal of improving the service to children who have been maltreated. Private non-profit agencies as well as governmental agencies, communities, and advocates have sought to find the best means of assisting such children. Although there has been general agreement on this goal (see Kadushin, 1974), the appropriate response toward those who maltreat their children has been debated. Should parents who maltreat their children be helped with services that relieve the factors that contribute to their poor parenting; should they be ordered to accept services; or should they be prosecuted as offenders? Should all families receive the same response or should different families receive different responses? These issues seem to underlie many of the proposals for change found in the literature. Before examining these proposals, it is helpful to review the critiques being made in the literature of the "traditional" system.
The following components or activities are generally included as part of a "traditional" CPS system:
This series of activities is questioned by a number of authors who suggest that it may not be appropriate for two reasons. First, over time, changing standards about what constitutes child maltreatment have made the range of family circumstances reported to CPS agencies too broad for a standardized approach. Second, it is hard for a standardized approach to accomplish two potentially contradictory objectives sanctioning perpetrators of maltreatment or providing services to families to remediate the problem.
For example, Waldfogel (1998b) argues that one result of such practices is that some families are inappropriately subjected to invasive CPS investigations. Orr (1999) supports this argument by noting that the percentage of substantiated investigations has dropped from a high of 61 percent of all investigations in 1973 to 31 percent in 1996.
Waldfogel (1998b) also argues that some families do not get access to needed services because the investigation finds that their children are at low-risk of maltreatment. Such families may be referred later with more serious problems. If the system of response does not include adequate assessment techniques, some children may even be at greater risk of having inadequate protection with tragic consequences.
One suggestion for addressing this problem is that the CPS agency should increase its flexibility in responding to families with different needs. For example, agencies could implement a differential response system in which only families with the most serious cases or those at the highest risk are subject to a mandatory CPS investigation, while other families with less serious cases or at low risk would receive a voluntary family assessment and service-oriented response. The American Public Human Services Association [APHSA] presents a more complex differential response schema in its model CPS system guidelines (1999, p.18). This schema has been reproduced in Exhibit 1 below.
|Types of cases||High risk||Moderate||Low risk|
|Responses suggested||Intensive Family Preservation Services, Child Removal, Court-Ordered Services, Foster Care, Adoption, Criminal Prosecution||Appropriate formal services coordinated through family support/safety plans and community support agencies||Early Intervention, family support center, formal/informal services, parent education, housing assistance, community neighborhood advocacy|
|Persons Responsible||CPS/ Law Enforcement||CPS/ Community partners||Community partners|
While general agreement existed among authors that families should not all be responded to in the same way, differences emerged in what families and in what responses the authors' change proposals focused on. Different authors tended to focus on either narrowing the range of children and families who would receive an investigation or broadening the range of children and families who might receive voluntary services.
Suggestions for narrowing the response of the CPS agency have focused on improving the screening of child maltreatment reports with more precise and restrictive definitions of child maltreatment (Besharov, 1998; Orr, 1999; Pelton, 1998). Some models also suggest authorizing different agencies to be responsible for different types of cases. For example, Orr (1999) suggests that allegations of severe child maltreatment should be investigated by law enforcement agencies, and that perpetrators of these abuses should be sanctioned by the criminal justice system. The CPS agency would focus primarily on assisting families-in-need to find appropriate services on a voluntary basis.To the extent possible, distinct paths of involvement with government agencies would be more clearly differentiated for the responsible agencies and the families and children.
Suggestions for broadening the response of the CPS agency have emphasized the need to provide individually tailored remediating services to a wider range of at-risk families (Farrow, 1997; Larner, Stevenson, & Behrman, 1998; Shirk, 1998; U.S. GAO, 1997; Waldfogel, 1998a, 1998b, 2000). Advocates of such changes suggest that community indicators of child safety would improve if families at all levels of risk had better support systems. These models would improve service delivery by collecting more comprehensive information about families and by involving a wider range of informal and formal potential supports in service planning and delivery.
One suggestion for collecting more information and increasing participation is through the introduction of family assessments instead of, or in addition to, investigations. Historically, CPS agencies have considered both investigation and assessment activities as part of the same function. Within this broad framework, State or local agencies tended to emphasize one aspect of the role over the other in the formulation of CPS philosophy, policy, and practice at the local level. An emerging concept is that CPS investigation and assessment functions can be structurally distinct.
In particular, the following authors suggest that service planning should be based on information gathered through family assessments rather than through investigations. In order to draw a distinction between these two approaches, these authors have emphasized that family assessments tend to examine a broader range of topics, focusing on family strengths in addition to or instead of family problems. For example, an assessment would intentionally assess interactional dynamics within the family, the family's patterns of functioning over time, and family strengths. An investigation would primarily focus on the situation that led to the abuse or neglect report, covering some of the same topics as assessments, but from a different perspective (APHSA,1999; Combs-Orme & Thomas, 1997; Day, Robinson, & Sheikh, 1998; The National Child Welfare Resource Center for Family-Centered Practice [NCWRCFCP], 2000a).
Assessments not only increase the types of information that social workers have available to use in making services plans, they can also be useful in identifying familial or community-support systems. Expanding the range of participants in service planing and provision is the second goal of a broadly responding CPS system.
According to Farrow, broadening the response of CPS does not necessarily mean that CPS provides more services. Rather he describes the shift in emphasis as involving new participants in child protection systems. He writes:
The CPS agency must shift from viewing itself as the provider of all child protective services, and instead begin to catalyze, organize, and, in a variety of ways, provide leadership to the development of community partnerships for child protection and neighborhood-based systems of service delivery that achieve the result of child safety (1997, p.6).
Some of ways new participants are being included in child protection are as follows:
In sum, various proposals for change were found in the literature. These proposals suggest that each of the responses of helping parents who maltreat their children find services to improve their parenting skills, mandating that parents participate in services, and prosecuting offenders of child maltreatment are appropriate. They are not, however, all appropriate for all families. In addition, different authors focused their proposals on different sets of family/response combinations.
While this section reviewed theoretical proposals for change, the next section reviews actual change initiatives described in the current literature.
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The reviewed literature reveals that there is at least some aspect of CPS practice or policy undergoing change in almost all of the States. These changes are being undertaken at different levels. In some States, changes are occurring Statewide; in others, changes are limited to a specific locality; in still others changes are occurring at a number of demonstration sites. The literature clearly shows that change in the CPS system is being implemented throughout the Nation.
Some types of initiatives are found in several localities. These include:
Exhibit 2 presents an overview of the current status of demonstrations and initiatives among the States. Notes explaining the criteria used to include a State in this Exhibit are found in appendix D. (This list may be incomplete due to lags in publication or other types of documentation. The Final Report of the national study of CPS systems and reform efforts will include an updated summary.)
|Community Centered Services||CPS and Police||CPS and AOD||CPS and Domestic Violence|
|District of Columbia||X|
|Notes: See Appendix D for notes.|
One of the most widely discussed reform initiatives in the literature is the introduction of family assessment procedures in place of, or in addition to, other investigation procedures (AHA, 1996; Christian, 1997; English, Wingard, Marshall, Orme, & Orme, 2000).
The descriptions of the models being implemented indicate that there are many different approaches under this rubric. For example, Minnesota, Missouri, Virginia, and Washington are piloting models in which the family receives either an investigation or a family assessment. In Florida, localities are conducting assessments of all families with reported incidents of maltreatment. Additional investigation activities are being performed on only those cases involving criminal proceedings. In Iowa, family assessments and investigations are being conducted on all cases. In contrast, North Dakota is conducting only family assessments.
States differ in the implications of a family receiving a family assessment. In Missouri and Virginia, children in families on the family assessment track cannot be found to be a victims of child maltreatment, and parents cannot be found to be a perpetrators. Furthermore, information on the parent is not placed in a central registry. North Dakota no longer establishes findings of substantiation, but maintains a registry. All cases are entered into the registry if there has been a determination that services are required.
In addition to describing their differential response initiatives, some States have published evaluations of their initiatives. Evaluations in Florida, Iowa, Missouri, and Virginia found the initiatives to be generally successful. The criteria for success have included a decrease in number of families receiving CPS investigations, an increase in the level of services for families, and no increase in the number of children kept safe (Center for the Study of Social Policy [CSSP], n.d., 1996a, 1996b, 1997; Hernandez & Barrett, 1996; Siegel & Loman, 1998; Virginia Department of Social Services, 1999; Wakeling, 1995, 1996). Some of the findings are highlighted below:
While generally reporting positive results from the reform initiatives, the evaluations also qualify the level of benefits accruing from the reform initiatives. Hernandez and Barrett (1996) report that, in Florida, the better outcomes occurred in sites with higher implementation levels. Burrell (1995) suggests that reform efforts in Missouri are hindered by a lack of service resources and staff training in new methods of service delivery.
English et al. (2000) add that good initial risk assessments are crucial in a differential response model where the family's participation in an assessment is voluntary. This voluntary aspect is especially significant because research shows that high-risk families often resist acknowledging problems and, hence, would be less likely to participate in a voluntary family assessment and services delivery system. The authors suggest that the level of cooperation parents show should be a criterion in deciding whether a family is assigned an investigation or family assessment response.
The review of the above initiatives highlights the important realization that States using similar reform vocabularies may have different practices and that differences in vocabulary might actually obscure the similarities in how families are actually served. A common typology for analyzing such efforts would be useful.
Thirteen States were identified in the literature as having innovative community-centered services initiatives (AHA, 1996; Christian, 1997; Shirk, 1998). Geen and Tumlin (1999) and McCroskey and Meezan (1998) attribute the increase in community collaboration to the Family Preservation and Family Support Act of 1993. This legislation mandated that agencies convene a wide array of partners to help identify community needs for family support and family preservation services.
The implementation of community-centered services initiatives does not take the same form in all sites (AHA, 1996; Christian, 1997; Wakeling, 1995). One approach is to turn services over to non-traditional providers. For example, one district in Florida has turned over the assessments of substance-exposed and drug-dependent newborns to public health nurses. Jacksonville, Florida, has written up community- support agreements in which a community volunteer commits to help a family. When the agreement is signed, the case is closed, but the local agency remains available to the community helper for consultation. In Los Angeles, families are served by community-based networks, which have as their focal point non-child welfare agencies.
A second approach is to co-locate traditional service providers in a community-based site, convenient to clients (AHA 1997; Shirk, 1998; Wakeling, 1996). Iowa's Patch project, Louisville's Neighborhood Places, and Jacksonville's Full Service Schools are three examples of this approach. These programs bring together public agencies, such as CPS, income support, public health, and employment, with private agencies providing recreation programs, parent support groups, preschools, and community-building activities.
Several evaluations of community-centered services initiatives report that building collaboration is difficult (Apple et al., 1997; Burrell,1995; Hernandez & Barrett, 1996). Hernandez and Barrett (1996) found that the problems of community-based collaborations were different for communities that had few resources than for those that had many. In resource-poor communities, the difficulties for creating partnerships involved a lack of resources and a fear of risk. Community partners such as churches were already financially limited in what they could do. Non-traditional partners were also concerned about liability issues, fearing that they would be held responsible if a child died or was hurt. In resource-rich communities, problems were related to the complexity of coordinating the activities of a wide array of partners and developing data systems for sharing information. Apple et al. (1997) and McCroskey and Meezan (1998) also suggest that social workers have difficulty approaching community agencies and community members from a strengths perspective, which leads to communication and collaboration problems.
Based on experiences in a number of communities, the literature presents suggestions for overcoming such barriers:
This review of the literature on community-centered services reveals a variety of initiatives States and localities are implementing in the name of community-centered services. Despite this variety, a unifying theme is found, which is that there is a need for a common vision and shared decision-making in order to achieve successful child protection community partnerships. What is not addressed clearly in the literature, however, is what changes, if any, these local community initiatives have made on the larger State child protection practices of which they are a part.
The literature identified two types of involvement of the police in child protection issues. The first has been the inclusion of police in multi-disciplinary teams (MDT) and/or Child Advocacy Centers (CAC). These teams and centers, some of which have been in place for more than 10 years, have been formed in order to reduce the trauma to the child due to multiple interviewing and to improve the prosecution of cases, particularly in sexual abuse cases. They are an important example of the reliance that CPS agencies have had on community expertise.
In 1981, 16 States had MDTs, and the States used the teams primarily in a consultative role. However, there has been a significant increase in the use of these teams in the investigation of maltreatment and in the treatment of children. From a survey of State officials, Kolbo and Strong (1997) found that 33 States were using MDTs statewide for investigations and/or treatment planning. Twenty-six of the States included law enforcement as members of the team. In addition, a review of the National Children's Alliance's website showed that forty-four States have a CAC in at least one city in the State.
The second type of involvement has been the development of formal contracts to clarify the roles and responsibilities of the police and CPS in child maltreatment investigations. The main location in which these formal agreements are being attempted is in Florida. Christian (1997, p.20) notes:
It [a recent Florida law] also authorizes DCF to enter into agreements giving law enforcement agencies partial or full responsibility for conducting child protective investigations in cases involving a criminal investigation. These agreements are required to include protocols covering a number of items, including responses to abuse reports, conduct of investigations and performance of risk assessments.
A greater participation of law enforcement in CPS decision-making would clearly have an important impact upon the nature of CPS investigation activities and outcomes for children and families. Bollenbacher (2000) argues that the sharing of responsibility between the police and CPS is best for children. She suggests that either sole police or sole CPS responsibility for specific types of child maltreatment investigations is problematic for children because neither approach can secure a full range of rights for children. She argues that giving CPS sole responsibility over investigations leaves some children unable to secure their legal rights. In particular, it makes it difficult to prosecute abusers, torturers, or child killers in criminal court because the evidence gathered during a CPS investigation may not meet judicial standards. On the other hand, giving police sole responsibility makes it hard for children to secure their social and economic rights. In particular, it may make it hard for them to access needed services.
Since 1997, five major reports have been issued on the alcohol and drug treatment needs of parents and children in the child welfare system (Gardner & Young, 1997; U.S. Government Accounting Office [GAO], 1998; National Center on Addiction and Substance Abuse at Columbia University [CASA], 1999; U.S. Department of Health and Human Services [DHHS], 1999; Young, Gardner, & Dennis, 1998). These reports describe innovative programs and explain some of the difficulties involved in creating closer collaboration between CPS and AOD. Several States have been identified as trying to build bridges between CPS and AOD providers.
Some of the variety in approaches is highlighted below (Young & Garner, 2000):
Research findings suggest that between one-third and two-thirds of substantiated child abuse and neglect reports involve substance abuse. Research also suggests that 30 percent of female problem-level drug users live with children, and 18 percent of male problem-level drug users live with children (DHHS, 1999). These overlaps in populations suggest the need for coordination and collaboration between CPS and AOD.
A general criticism in the literature is that the standard operating procedures of CPS and AOD agencies are not designed to facilitate collaborative relations between these two agencies. Examples of problems that are being examined include the following:
Gardner and Young (1997) suggest that progress in addressing AOD addiction and child maltreatment will not occur without better collaboration between CPS and AOD programs. In a forthcoming report, Young & Gardner (2000) suggest that while the development of pathways between these two agencies is critical to better supporting children and families with multiple challenges, the pathways must also be expanded to include the courts, mental health agencies, agencies that deal with family violence, the juvenile justice system, child development agencies, schools, and others.
In 30 to 60 percent of families in which women are abused, the children are abused as well (National Council of Juvenile & Family Court Judges [NCJFCJ] 1999). Eight States have piloted innovative programs to improve their ability to deal with families in which both domestic violence and child maltreatment is present (Aron & Olson, 1997; NCJFCJ, 1998). These programs involve increased collaboration between CPS and domestic violence workers.
Several authors suggest that these collaborations are not easy to build, due to differences in mandates/orientations of the two agencies (Aron & Olson,1997; Beeman, Hagemeister, & Edleson,1999; Findlater & Kelly, 1999; Schechter & Edleson, 2000; Whitney & Davis, 1999). Aron and Olson (1997) identify a difficulty in building bridges between CPS and domestic violence workers in that there is a mandate for CPS to preserve families and reunify children with their parents, while domestic violence workers encourage women to leave batterers. Beeman et al. (1999) describe the principle barrier as the difference between CPS workers viewing their work as child-centered and domestic violence workers viewing their work as women-centered.
This tension results in contradictory approaches to similar problems. For example, in putting the safety of the child as the primary concern, CPS protocols may consider a mother accountable in domestic violence situations, even though the spouse or boyfriend is abusing the child (and her). Domestic violence workers, in contrast, argue that in such situations, holding the mother responsible is ineffective and results in blaming the victim. They suggest that if efforts are made to keep the mother safe, the children will also have a safer environment (Beeman et al., 1999).
The recent special issue on the co-occurrence of child abuse and domestic violence in Child Maltreatment (Edleson, 1999) profiles three such initiatives:
Underlying these change efforts are suggestions on ways to improve collaboration between these two domains. Beeman et al. (1999) suggest that collaboration can be improved in the following ways:
In addition to the above resources, the National Council of Juvenile & Family Court Judges (1999) has published guidelines and recommendations for communities interested in improving their responses to families experiencing domestic violence and child abuse. The report offers community-level recommendations and describes specific recommendations for the three main partners in the process CPS agencies, domestic violence agencies, and the courts.
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The articles reviewed for this paper describe many proposals and initiatives for improving child protection practice. Interestingly, these proposals tend to take a structural approach to improvement. That is, the proposals suggest that CPS agencies may need to more precisely define, divide, and channel interventions into particular philosophical models, rather than leaving intervention decisions to workers.
For most of the past thirty years, agencies providing protective services to children have allied themselves based on law, policy, training, and organizational culture at some mid-range point along the legalistic to helping intervention continuum. Individual case-level intervention decisions by workers, supervisors, and other community collaborators have encompassed a range of responses depending on the case circumstances and the organization's context. Perhaps the increasing scrutiny to which agencies are exposed has generated this new interest, found in the literature, in structural solutions.
The review also suggest some of the general directions that change in CPS practice might take in the next few years, e.g. offering alternative responses to child maltreatment reports, increasing the involvement of police in child maltreatment cases, and expanding the network of service providers in a coordinated fashion. The literature does not, however, provide a clear or comprehensive picture of how CPS work is currently being done.
The national study of CPS systems and reform efforts, of which this literature review is a part, will address this need. The study will examine the complexities of current CPS work processes from the knowledge gained through interviews of State administrators, surveys of county CPS agency staff, and site visits to innovative localities. The final report will be completed in Fall 2002.
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Last updated: 05/09/01