Child abuse and neglect (CAN) cases in Pennsylvania generally enter the child welfare system through statewide or county hotlines. There are two types of CAN cases -- child protective service (CPS) cases and general protective service (GPS) cases. CPS cases are those with alleged harm, or with threat or risk of harm to the child. These cases include allegations of physical abuse that result in severe pain or dysfunction, sexual abuse, medical neglect, or lack of supervision resulting in a specific physical condition or impairment, psychological abuse attested to by a physician, or repeated injuries with no explanation. (65) GPS cases include most instances of child neglect, including environmental conditions such as inadequate housing, inadequate clothing, and medical neglect not leading to a specific physical condition (e.g., failure to keep appointments or get prescriptions). (66) Both CPS and GPS cases are relayed to the appropriate county DHS office via central intake for that county.
Philadelphia has a central intake for all CPS and GPS cases. The Children and Youth Division (CYD) of the Department of Human Services (DHS) is responsible for child welfare investigations and services. CPS/GPS investigations on new cases are handled by CYD Intake Units. (67) The "unit of the day" receives intake cases. CPS cases are given priority and GPS cases fill out the unit's remaining intake allocation for the day. Other cases, known as voluntary requests for services, include other court referrals, hospital referrals, referrals from other resources, requests for emergency placement, walk-ins, and runaways (68) are referred through a "general intake," separate from CPS and GPS intake.
CPS/GPS Abuse and Neglect Case Intake
Central intake has a 24-hour-a-day response capability. Investigation of CPS cases must begin within 24 hours after a report; investigation of GPS cases must begin within 5 days after a report. During these investigations, intake workers make a determination of the level of risk of harm to children and service needs of the family based on a standardized risk assessment. In general, children in low risk cases are provided with necessary services and their case is closed; intermediate risk cases are opened and families are referred to private agencies for services; and children in high risk cases may be referred to FPS or other services, or placed in foster care or another type of substitute care (judicial involvement is always required in high-risk cases). Intake investigators decide whether to open or close cases (changing from a "pending open" status assigned at the original call). CPS cases can be either: founded (by conviction of abuse in criminal court); indicated (based on evidence from a medical report, admission of the perpetrator, or CPS investigation); or unfounded. GPS cases are either substantiated or unfounded. GPS cases may also become CPS cases during investigation.
Services can be provided to children and families by an intake worker during investigation, although cases with more risk are more likely to be provided services at intake. For high-risk cases, services are usually required immediately to ensure the safety of the child. Counties must report results of CPS investigations to the state within 30 days after the original hotline call. If there is no report within 60 days, the record is automatically expunged from both the state and county systems.
After an intake worker has determined the level of risk for a child, the case is opened for services and sent to a DHS CYD Family Service Region (FSR) unit for case planning and further referral for services. There are four FSR units in Philadelphia County.
In 1996-97, a Centralized Referral Unit (CRU) was created to handle case referrals to residential treatment and SCOH service programs. The CRU is supervised by the Special Services Administrator, and serves as a conduit between and support to staff in Intake and the FSRs. The intent was to have one unit keep track of current openings in the private SCOH and residential treatment programs. However, this goal has not been realized and some SCOH referrals continue to come directly from intake staff who have established relationships with private agency staff. Intake workers should have a service (e.g., family preservation or SCOH) in place or refer the case to the CRU before the case is transferred to a FSR.
Philadelphia has always had a strong privatized system of service delivery. Large charity organizations in the city provided services to children and families beginning in the early 1900s. Private agencies did their own intake and services to children, and were paid through request for payment to the county up to the mid-1970s. In 1975, the Philadelphia County began CPS services. The late 1970s and 1980s saw exponential growth in service delivery and placement of children. As a result, DHS provided direct intake and protective SCOH services during the 1980s. As the need for services expanded, the number of private, publicly monitored, contracts expanded as well.
A DHS reorganization took place in the late 1980s to separate intake (evaluation, investigation and emergency services) from backend services such as foster care and adoption. At this time, FSRs were developed. Since the 1980s, almost all in-home services in Philadelphia have been purchased from private agencies.
DHS in Philadelphia County went through attempts at system reorganization in the 1990s. In the late 1990s, as part of a permanency planning initiative, DHS experimented with a FSR unit set aside specifically for permanency planning, to more closely coordinate permanency planning for children. However, with the implementation of ASFA, expediting permanency became the job of all FSR workers in the system. In 1997, DHS devised mechanisms for geographic-based assignment of workers and delivery of services to promote a more community-based service delivery system. Plans called for intake to remain centralized while families were assigned to workers based on geographic location. Implementation is moving forward, although not as quickly as was hoped.
In addition, the State of Pennsylvania and County of Philadelphia were parties in a class action suit brought by the ACLU concerning the quality of care provided to children who have been removed from their homes. With the implementation of ASFA, many charges contained in the lawsuit were addressed through new state and county policy. The state was released from the lawsuit, and Philadelphia and the ACLU entered into a consent decree to resolve remaining grievances, whereby the ACLU would participate in a number of case readings every 6 months, over an 18 month period.