• February 2020
  • Vol. 21, No. 1

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Building a Full Prevention Continuum for Families in New York City

Written by Commissioner David A. Hansell, New York City Administration for Children's Services

The United States is on the cusp of a major transformation in child welfare. One of the most significant changes ever in federal child welfare law, the Family First Prevention Services Act, now enables more states and localities to invest in services that keep children out of foster care. For the first time, core federal child welfare funding will be available for evidence-based prevention services—services proven to support families and prevent foster care placements.

As commissioner of the New York City Administration for Children's Services (ACS), I am proud that, on any given day, we already provide prevention services to tens of thousands of children and their families across New York City. We contract with community-based nonprofit providers to deliver home-based services that enable families to remain safely together.

One of the important hallmarks of New York City's prevention services system is that we offer a continuum of services that allows us to match a family to the services they need, both in terms of intensity and specialization. Our services address a spectrum of needs and, depending on the prevention model, may include case management, counseling, and clinical interventions. I'm proud of the fact that many of our service models are evidence-based, evidence-informed, and promising-practice prevention programs. For instance, our innovative group attachment-based intervention (GABI) aims to promote secure attachment and social emotional development for children while reducing stress and building support for parents and caregivers. Our continuum also includes models already rated as well-supported by the Family First Clearinghouse, including functional family therapy and multisystemic therapy.

We've seen that once families complete our prevention services, they rarely return to our system. In fact, families that successfully complete prevention services (and more than 80 percent do) are five times less likely to have another investigation in which ACS finds abuse or neglect in the following 6 months than families who do not complete these services.

Furthermore, thanks in large part to our prevention services, there has been a dramatic reduction in the number of children in foster care in New York City; Currently there are less than 8,000 children in foster care in New York City—a historic low. This is a momentous shift from 25 years ago, when there were nearly 50,000 children in foster care in New York City, and from even just 10 years ago, when there were almost 17,000 children in foster care.

But these intensive prevention services are not the only way we're putting "families first" in New York City. These prevention services are usually triggered after there's been a child maltreatment incident and ACS is already involved. In recent years, we realized that our goal should focus on preventing initial maltreatment not just repeated maltreatment. In New York City, we're now starting as far upstream as possible by also providing primary prevention services, which engage families and provide support before maltreatment might occur and without involvement in the child welfare system. In 2017, we created a new division—the Division of Child and Family Well-Being—dedicated to making our communities and families stronger. This new division focuses on primary prevention, community partnerships, and addressing equity and disproportionality in the child welfare system.

Through the work of this division, we support 11 community partnership programs, which are coalitions that serve as local hubs for providers, community leaders, and other committed stakeholders located in high-need neighborhoods across the city. We've also opened three new family enrichment centers, which are open-door, walk-in facilities, with no connection to the child welfare system (except that ACS provides the funding and the vision). These centers are designed to promote family strength and stability by building community connections and by helping families meet concrete needs. One of the key factors that makes family enrichment centers special is community members and parents determine which services will be offered, what the facilities look like, what hours they're open, and what type of staffing they have. ACS supports these centers, and families lead them.

We are also expanding our public and community education programs—getting vital information to parents about ways to keep children safe. Like most child welfare agencies, we teach parents about safe sleep techniques for newborns and infants. We recently expanded that program to provide safe sleep toolkits to parents of all babies born in public-hospital maternity facilities. We teach parents about safe storage of medications that can be dangerous to toddlers and distribute lockboxes and bags for medication storage. We work with the fire department and the American Red Cross to make sure families know how to install smoke and carbon monoxide detectors. 

In addition to working to prevent initial child maltreatment through our programmatic and public education work, we believe there are important systemic and policy vehicles as well. That's where our focus on equity and disproportionality comes in. We want to be sure that involvement in the child welfare system occurs only when necessary to protect children from harm—and not as a result of prejudices or bias based on irrelevant factors like race, ethnicity, or sexual orientation. So, for example, we've developed implicit bias training programs for all of our staff to make sure that our decision-making is based objectively on avoiding harm to children. We've developed and begun implementing an equity action plan—a plan that will allow us to measure our progress toward race-neutral programming. And we are supporting legislative reforms to reduce unnecessarily onerous impacts of the investigative system on low-income families and families of color. 

In New York City, we may have laid the groundwork for implementation of Family First, but it doesn't mean we can rest on our laurels. For the first time in a decade, we're putting in place an entirely new set of prevention services. The new system is the result of nearly 2 years of rigorous research about the needs of New York City's families and children and how to enhance their safety and stability. ACS engaged over 300 stakeholders—including parents, other family members, legal advocates, and service providers—in redesigning our services. Our restructured system will ensure that each of our 10 prevention program models is available to families in every neighborhood and community across the five boroughs. It will enhance our investment in therapeutic and treatment-focused services that address more complex needs as well as in evidence-based services. In addition, it will require prevention providers to incorporate family voice into service design to ensure that prevention services reflect what families want and need and to increase the number of parents who successful complete those services.

A strong foundation for preventing child abuse and neglect is supporting families who need a helping hand. This can be done by putting forth a full continuum of prevention services. Now—as states and localities across the country are developing their Family First Prevention plans—is the time to ensure all families are offered access to the full continuum of services and supports that keep children safe.
 

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