Children's Bureau ExpressFebruary 2020 | Vol. 21, No. 1

Table of Contents
 

Spotlight on Developing a Full Prevention Continuum in Child Welfare
This issue of CBX highlights the importance of employing a full prevention continuum that includes communities, families, and agencies working together to make sure child maltreatment does not occur and families stay together. Read a message from Jerry Milner, Associate Commissioner of the Children's Bureau, and David Kelly, Special Assistant to the Commissioner, about the importance of addressing the conditions that leave families vulnerable and the need for a national commitment to a full continuum of prevention services that will prevent child fatalities and curb the need for foster care. The issue also includes a variety of resources and publications centered on prevention for professionals and families.

  • Continuum or Continuation? A Choice of Conscience
  • Why Multidisciplinary Advocacy Teams Are an Essential Tool to Keep Families Together
  • Hello Baby: Expanding Primary Prevention in Allegheny County
  • Parents Are NOT Broken
  • Primary Prevention Puts Families First in the District of Columbia
  • Building a Full Prevention Continuum for Families in New York City

News From the Children's Bureau
Read about how learning agendas can be used as a strategic approach for states to evaluate the implementation and impact of home visiting programs, a recent episode from the Child Welfare Podcast Series that discusses how evidence-based programs were tailored to meet the needs of specific constituency groups, a call for applications to join the Child Welfare Workforce Analytics Institute, and the latest additions to the CB website.

  • Developing a Learning Agenda to Help States Evaluate Home Visiting Programs
  • Prevention: Implementing Evidence-Based Programs
  • Call for Applications to Participate in the Child Welfare Workforce Analytics Institute
  • CB Website Updates

Child Welfare Research
We highlight a study that focuses on the effect early childhood home visiting programs have on maltreatment outcomes for mothers with at least one substantiated report of maltreatment and an article about how maltreatment prevention efforts can benefit from a public health approach.

  • Home Visitation as a Promising Intervention for Child Welfare-Involved Families
  • Adopting a Public Health Approach for Maltreatment Prevention

Strategies and Tools for Practice
This section of CBX offers publications, articles, reports, toolkits, and other resources that provide either evidence-based strategies or other concrete help to child welfare and related professionals.

  • Promising Interventions to Prevent Severe Child Abuse
  • Preventing Sexual Violence Against Children
  • Implementing the Family First Prevention Services Act

Resources
This section of CBX provides a quick list of interesting resources, such as websites, videos, journals, funding or scholarship opportunities, or other materials that can be used in the field or with families.

  • Kidpower
  • Play in Early Childhood: The Role of Play in Any Setting

Training and Conferences

  • Safe Environment for Every Kid Training
  • Conferences

Spotlight on Developing a Full Prevention Continuum in Child Welfare

Continuum or Continuation? A Choice of Conscience

Written by Jerry Milner and David Kelly

Most headlines and public discourse in child welfare orbit around two highly emotive topics: child fatalities and foster home scarcity. Both topics are incredibly important and warrant thoughtful attention. Unfortunately, thoughtfulness in media coverage and public discourse is rare. Seldom, if ever, do stories, discourse, and the policies they so often drive get to the underlying causes of family vulnerability and child maltreatment. Most stories highlight the most tragic and egregious occurrences and saddest stories. Sensationalism leads to blame and a deep desire to assign culpability. Political posturing ensues, data are disregarded, and knee-jerk reactions rule the day.  

This type of coverage and way of talking and thinking about child maltreatment, foster care, and fatalities have perpetuated the very problems they seek to improve. The most typical ways of speaking and thinking about these challenging issues is inertia feeding, leads far too often to doubling down on measures that have not proven effective, and leave us stuck in a highly reactionary way of being.

Groups have organized around these topics, industries have been built, lobbyists have been deployed, and stakes have been intractably driven into the ground. A panoply of panels, blue-ribbon reports, and studies have been conducted on child fatalities over decades, most commissioned after a high-profile fatality or several fatalities. The recommendations from such efforts are predictable; consistent; and, typically, call for better data sharing between family-serving agencies, lower caseloads, more frequent caseworker contact, enhanced fatality review efforts, and better interagency collaboration and coordination. Calls for more accountability, transparency, and greater resources also abound. 

With foster homes, the issue is always one of supply not meeting demand. Recruiting and maintaining high-quality foster homes is a perennial problem.

Both issues arouse emotions and activate well-intended caring people that want to help. This is commendable, appreciated, and necessary. However, as a field and society, we must guard against allowing tragedy and emotion to cause us to slip into a "child rescue" mentality.  We must not make judgements about worthy and unworthy parents, apply subjective standards from our own life experiences to families of different means and diverse cultures, and believe that taking more children into foster care where clear safety concerns have not been articulated will be beneficial to those children.

With both issues, the song largely remains the same. Yet, we stay the course with only minor adjustments. All the while, fatalities continue; cries for more beds resound; and the child welfare system remains funded primarily as a trauma-response unit as opposed to a well-being, trauma prevention, and, when needed, healing system. As discourse continues to spin, the next generation of trauma is occurring and disparities harden.

In recent years, much of the field's discourse and policy has centered on how science can help address some of the issues that leave families vulnerable to child maltreatment. This is useful. There is a clear need to understand what types of clinical interventions work best with which populations and to make them available. The Family First Prevention Services Act (FFPSA) will be helpful in these ways and serve as a vehicle for preventing foster care placement in certain circumstances. For some families, such services will help them stabilize a mental health issue, enter recovery, and/or gain new parenting skills.  That there is a new way to pay for some of these services is a big deal. It fills a needed band of the prevention continuum, but we have to recognize that families need more, and sooner.

We have to believe that families deserve more. We have to recognize that a glaring and dangerous gap in our system persists—a gap that makes fatalities more likely and leaves us in perpetual need for more foster homes. Our current funding structure, even with the helpful additions of the FFPSA prevention services funding stream, leaves a gulf unattended; It does not provide for primary prevention.

If we are truly serious as a field and a society about preventing child fatalities and having enough foster homes, we must go to the root causes of both. We must directly address the conditions that leave families vulnerable. This requires a national commitment to a full continuum of prevention services.

We believe incredibly strongly that robust primary prevention networks that operate at the community level can finally allow us to make progress on preventing child fatalities and curbing the foster home demand-and-supply conundrum.

To do so, we must think beyond clinical walls and interventions and hone in on efforts to strengthen communities. To do so, we will need to invest in community resources, community programming, and community-based services that provide basic supports and build protective factors. We have to see the value and importance in ensuring that families have a place to go where they are not afraid to ask for help. We have to ensure that there are places that parents look forward to going to connect with peers and to access opportunities for their children and for themselves. We have to organize community supports around what we know about the social determinants of health, and we have to act on what we know about the importance of supporting parents of infants, babies, and very young children—the population that is most at risk of fatality and most likely to require placement.

Until we do these things with clear intention, there is cause to question just how serious we are as a nation about preventing child fatalities. If we do not do these things, we will always have a foster care demand-and-supply problem. "Getting tough" on vulnerable parents and getting tough on child protection agencies is not going to solve the problem if they do not have what they need to provide or benefit from primary prevention services.

As a nation, we appear unable or unwilling to invest in and create a full prevention continuum.

We appear to be content at limiting the ways that child welfare agencies can help. We remain limited to waiting to help families until children are at imminent risk of entering foster care, which means something bad has likely already happened. It means addiction is already present, or that certain protective factors have eroded. It means that neglect has likely already occurred. It means we are waiting for trauma to occur before making help available in nonthreatening ways. It prevents us from addressing root causes and working to address normal challenges that most families experience in unobtrusive ways. When families do not have such support, normal challenges can escalate into crisis, and crisis can cascade into catastrophe.

Historically and now, precious little effort has been made or possible to address such questions from a federal child welfare funding perspective. As a nation, we remain committed to allowing trauma to occur, often compounding it through late-in-the-game intrusive intervention and then paying great sums to attempt to fix it.

For nearly 3 years, we have been attempting to knock the system out of its orbit so that we can move together with a broad range of partners in a more proactive, equitable, and humane path. For as long as it has existed, the system has revolved around crisis instead of trying to prevent it. To create that path, we must commit to robust primary prevention efforts as part of a full prevention continuum. Doing so will build on FFPSA and fill our largest and most dangerous gap.

No one is happy with our progress in preventing fatalities or reducing the need for foster homes, despite the best efforts of a committed workforce. The questions for everyone who cares about children and families are clear:

We have heard clearly from dedicated, caring, and deeply committed child welfare professionals across the country that the answer is a resounding "no" to each. We have heard from parents and youth with lived experience around the country that the answer is a resounding "no" to each. The field and those served by it clearly recognize the need for a full prevention continuum; they want to be a part of cocreating it. There are caring professionals and parents all over the country who love their children and know this is what it will take to reduce the risk of maltreatment, prevent child fatalities, and lessen the need for foster homes. It is time for statute and funding to catch up with what so many caring individuals, dedicated professionals, and communities know we need.

We can continue to admire the problems and mourn the consequent results. We can continue to cast blame, dig in, and perpetuate the circular conversation of the past several decades in child welfare. Or, we can demand and create a full prevention continuum that will strengthen families, strengthen communities, and prevent trauma and tragedy long before risk of either exists.

The work is not done. We need a full prevention continuum.
 

Issue Date: February 2020
Section: Spotlight on Developing a Full Prevention Continuum in Child Welfare
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=213&articleid=5499


Why Multidisciplinary Advocacy Teams Are an Essential Tool to Keep Families Together

Written by Vivek S. Sankaran, clinical professor of law, University of Michigan Law School

A parent in Detroit lost her five children to foster care because she was a victim of domestic violence. She was summoned to a family team meeting, at which she was informed her children would be placed in foster care. All alone at the meeting, she felt "confused, lost, and hopeless." That night, her children were placed in four different foster homes. For the next month, she didn't see them. Overnight, in her words, "she lost her children, job, home, and dignity." It took her 15 months to get them back.

We must do better. Can we dream of a different world, one in which parents can work with multidisciplinary advocacy teams to prevent the separation of their families? In the example above, a lawyer could have helped the mother obtain a custody and protection order to protect her and her children from her abusive partner. A social worker could have helped her maintain housing and employment while also connecting her with domestic violence counseling. A parent partner could have kept her engaged with the process and accompanied her to meetings. And all three could have helped her maintain her dignity and her family.

Isn't this the world we want to create for families? 

Research tells us that taking a child from parents is perhaps the most invasive intervention we can impose. It also tells us that most child welfare cases don't involve the serious physical and sexual abuse that necessitates immediate removal but instead require more nuanced decisions about what might be best for children. We also know that in these less urgent cases, children are far better off staying with their families than entering foster care. 

Only one conclusion can be drawn from this information: To get the best outcomes for children, we need high-quality attorneys, social workers, and parent partners to work with families—at the earliest time possible—to create alternatives to family separation, present agencies and courts with all the information about a family, and keep parents engaged in the process. Justice for children demands this. 



 

Issue Date: February 2020
Section: Spotlight on Developing a Full Prevention Continuum in Child Welfare
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=213&articleid=5480


Hello Baby: Expanding Primary Prevention in Allegheny County

Written by Marc Cherna, director, Allegheny County Department of Human Services

For more than 20 years, the Allegheny County (PA) Department of Human Services (DHS) has spent hundreds of millions of dollars on preventing child maltreatment through strategies such as family support centers; conferencing and teaming; the Allegheny Family Screening Tool; child care and early intervention; Head Start; home visiting; out-of-school programs; community and natural supports; and community collaboratives and joint endeavors, such as the behavioral health/child welfare community of practice. In Allegheny County (which includes Pittsburgh, PA) and other jurisdictions, however, infants and young children continue to be at the greatest risk of harm caused by serious abuse and neglect. Indeed, from 2009 through 2019, almost 80 percent of children in Allegheny County who suffered fatalities associated with child abuse and neglect were under the age of 3. Furthermore, in half of all events in which a child was seriously injured or died as a result of abuse and/or neglect, the child had not been identified as vulnerable and/or in need of protection by community members or professionals. Therefore, no allegation of maltreatment had ever been made to child protective services. Unfortunately, this means that there had been no opportunity to reach out to the family to intervene before the tragedy occurred.

In an effort to prevent serious abuse and neglect, DHS is set to launch Hello Baby, a tiered primary prevention strategy that combines universal, geographic, and intensive targeted strategies with the best of what we know about analytics to strengthen families; improve children's outcomes; and maximize child and family well-being, safety, and security. DHS will reach out to every Allegheny County family with a newborn to offer a variety of supports tailored to their varied needs and interests. In the first year, Hello Baby will be piloted in a limited geographic area.

Hello Baby's strategy is supported by the use of integrated data and a predictive risk model used to stratify families into the three tiers. Universal supports, the first tier, are available to all families, regardless of need, and include the Hello Baby warmline, available 24 hours a day, 7 days a week; the Hello Baby website (for information and to connect families directly to other services available in Allegheny County); and other available community resources for parents, such as NurturePA, a texting service staffed by trained volunteers who can answer questions related to parenting a baby.

The second tier, which connects families to family support centers (FSCs) and other services in their neighborhood, builds upon the findings of an evaluation conducted by the Center for State Child Welfare Data at Chapin Hall that indicate the presence of an FSC in a neighborhood is associated with lower maltreatment investigation rates. The key to this promising finding is getting the right families connected to the rich variety of services available at their nearest FSC. To that end, outreach workers will make home visits to families with new babies living near one of Allegheny County's 28 FSCs in an effort to engage them and encourage their continued involvement with the nearest FSC.

The third tier, intensive and targeted strategies, is available to families with higher and/or more complex needs, who will be offered the support of a team consisting of a family engagement specialist and a social worker. That team will work to engage families, learn about their needs, and work with them to develop an individual plan of wraparound services that they may utilize for up to 3 years. Examples of the types of assistance available include concrete goods (e.g., diapers, formula, food), transportation, eviction prevention, and connections to community resources (e.g., evidence-based parenting programs, behavioral health treatment, child care, emergency housing). To provide these services, DHS has partnered with Healthy Start Pittsburgh.

Hello Baby is a program of DHS's Office of Community Services and is not connected with child protective services. It is a voluntary program intended to build upon the robust set of services and supports that already exist for Allegheny County families. Hello Baby was developed through an extensive process that included research, community and stakeholder engagement, and two ethical analyses by experts in the field of child welfare and the use of data for decision-making. It builds upon DHS's earlier work in predictive analytics, developed in partnership with researchers at the Centre for Social Data Analytics at the Auckland University of Technology in New Zealand. Among the stakeholders involved in the development and review of the model were social workers; local, national, and international child development experts (including pediatricians, developmental psychologists, and academics); local service providers and peer-support agencies; families, including fathers, who are often underrepresented in family-strengthening efforts; judges and children's advocacy agencies; the Allegheny County Health Department; the United Way; local funders; and civil liberty, civil rights, and social justice advocacy organizations.

Hello Baby was developed—and will be implemented and evaluated—with support from the Children's Bureau (through a Community Collaborations to Strengthen and Preserve Families grant) as well as state and foundation funding. Through Hello Baby, DHS will reach more families who can benefit from support, better match families and babies to the right services, and ensure that the most vulnerable families and babies have access to the best supports Allegheny County can offer.

 

Issue Date: February 2020
Section: Spotlight on Developing a Full Prevention Continuum in Child Welfare
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=213&articleid=5482


Parents Are NOT Broken

Written by Corey B. Best, consultant and professional guide, Birth Parent National Network

When I began my career more than 10 years ago as an eager community organizer and professional, I soon realized that I needed to learn, unlearn, and relearn new ways of thinking about how I viewed the world and communities and, most importantly, how I viewed myself and my peers. 

The reality was and remains that I view myself as worthy, resilient, and filled with hope. However, I never quite understood why systems that were designed to support, nurture, and live by such a high standard viewed me as broken and in fact treated me and others around me as such. This daunting and harsh lesson about systems, specifically our child welfare/protection system, required a deeper look at our collective, institutional history to gain insight into our perpetual cycle of why we feel we must "save and rescue" parents and children. Eventually, I began to seek truer answers to a few baffling questions:

In my quest for greater self-discovery, I quickly realized that the reality I inherited and was indoctrinated into was a paternalistic system of ideologies that often are allowed to subjugate, dehumanize, judge, and deem parents unworthy of the basic dignities of life—to be seen, heard, and valued as being equals, good enough, hopeful, and resilient. These age-old legacies shape the way we practice, provide services, assess safety, and establish relationships with parents.

Along the journey, I've witnessed and experienced many oppressive and suffocating experiences. But none of those have broken me. In fact, some parents experience far worse when they need help that is not available, face criteria that are too stringent, or have been given the bandaids of several programs rather than one that is focused on root cause, community conditions, or invited Maslow's hierarchy of  social needs into their lives. Even when some families feel that our systems are there to provide support and engage them, countless others often find the face behind the glass saying, "we don't offer that here." And even so, those families' resilience grows!

My core values of justice, social contribution, and family are enriched by the conversations I have with parents across the country about what works to keep families strong, healthy, and thriving. While hosting Community Cafés, focus groups, and healing circles with parents, the common denominator is one brave soul. Parents have indicated that even during the mess, chaos, homelessness, substance use, domestic violence, and loss of employment, it only takes one human being to show up and acknowledge their assets.

We know that child neglect and abuse is preventable, and our child welfare system plays a critical role in developing and cocreating conditions where families are seen for who they are—human beings. However, along the way we must remain focused on the following adaptive challenges (i.e., challenges without a clearly defined solution and that require input from the collective community):

The beauty of adaptive strategies is, once identified, they'll help us embrace how interdependent we are and that the work of reimagining a child welfare system that's focused on primary prevention doesn't have a clearly defined path. Yet, in order to support families differently, unnatural partnerships with parents are mandatory. Systems are more inclined to partner with formal professionals, experts, and leaders.  Partnering with those most impacted by the delivery systems (i.e., parents, caregivers, families) are unnatural, challenging, and seen as less important.

In closing, prevention begins with authentic relationships in the community and with parents. Our current child welfare system has defined prevention as averting a child from coming into foster care. The Birth Parent National Network seeks to push our country forward by elevating the voices of parents and organizations that are bold enough to scream "parents aren't broken!" We know that for us to strengthen our communities, we must partner with parents. We see parents as treasured leaders—wise and filled with hope. I encourage all to continue mining for gold, not digging for dirt. There's a nugget inside of all of us. If you can't find it, you're not looking hard enough.

The way we see the world is how the world becomes!

To join the Birth Parent National Network, visit https://ctfalliance.org/partnering-with-parents/bpnn/.


 

Issue Date: February 2020
Section: Spotlight on Developing a Full Prevention Continuum in Child Welfare
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=213&articleid=5484


Primary Prevention Puts Families First in the District of Columbia

Written by Natalie Craver, program manager, Community Partnerships Administration, DC Child and Family Services Agency, Washington, DC

For over a decade, the District of Columbia's Child and Family Services Agency (CFSA), under the leadership of Director Brenda Donald, has implemented strategic initiatives to reform the city's child welfare system, moving purposefully away from a system focused primarily on foster care placement to a system designed to strengthen families, support children in their homes whenever possible, and prevent the occurrence of child abuse and neglect in the first place. In 2012, CFSA developed the Four Pillars strategic framework, which has guided all activities across the child welfare agency and in building partnerships with our system partners, to improve outcomes for children, youth, and families. Each of the four pillars sits on a values-based foundation, evidence-based strategies, and specific outcome targets. The results of this decade of work and strategic framing include a 60 percent reduction in the District's total foster care population, from over 2,000 children in 2010 to under 800 children today. Important to this success is the often less overt, but crucial, work to support families with "upstream," or primary prevention, services and supports.

CFSA recognizes that—as noted in Associate Commissioner Jerry Milner and special assistant David Kelly's recent article—to truly move the needle we must address the root causes of why families become involved with child protective services and not just tackle presenting issues once families' struggles have become apparent to agency staff. Primary prevention has become a cornerstone of the District's prevention services continuum and continues to guide our actions as new legislation, such as the Family First Prevention Services Act of 2018 (Family First) and the Family First Transition Act and Support Act of 2019 (Transition Act), provide states with key opportunities to invest in evidence-based prevention services and supports to meet families' needs.

Family First provided the District with a valuable opportunity to bridge the end of our title IV-E waiver demonstration project with an on-ramp to developing a holistic District-wide prevention strategy. This was a powerful moment. The current created by Family First has carried us forward over the past year and a half, and we, like many other jurisdictions across the country, eagerly focused our attention and efforts toward developing and implementing a title IV-E prevention services plan (prevention plan). From the start, CFSA knew our prevention plan would only be truly transformative and achieve the support and engagement of citywide partners if coupled with a broader primary prevention plan. Thus, when CFSA launched its Family First Prevention Work Group—a cross-sector group of government and community members—in June 2018, the charge was clear: develop a citywide strategy to strengthen and stabilize families. Our work was not driven by Family First; rather, it leveraged new opportunities provided by Family First as part of a comprehensive approach to family and child well-being.

While we received approval of our prevention plan this past October, the constraints of the legislation required the District to take a critical look at how far upstream we could focus title IV-E funds. We needed to identify additional funding opportunities to support primary prevention. Family First services must be targeted to specific populations, known as "candidates" for foster care. CFSA's approved candidate definition (outlined in section 1 of our approved plan) extends to children and their families known to CFSA's "front door" and "front porch," allowing for secondary and tertiary services to meet the needs of families who have been involved with CFSA. Due to these limitations, the District decided we would need to invest locally to support families who are not already known to CFSA (families in CFSA's front yard) and bridge potential funding gaps (now met by the Transition Act) to maintain valuable programs not currently approved by the Title IV-E Prevention Services Clearinghouse.

District Mayor Muriel Bowser reinforced the commitment to primary prevention as a cornerstone of our child welfare practice with a companion initiative: Families First DC. In fiscal year 2020, Mayor Bowser dedicated nearly $4 million to fund 10 family success centers, also known as family resource centers, in targeted neighborhoods east of the Anacostia River, where approximately three-quarters of the children and families served by CFSA live. At present, CFSA has selected 10 local community-based organizations as grantees to build family-strengthening supports upstream by cocreating a network of primary prevention services and resources with the families and community members living in these neighborhoods.

Families First DC has three goals:


The remainder of this fiscal year will serve as a planning period for grantees to work jointly with each neighborhood's community advisory committee, CFSA staff, and our prevention work group leadership. Sites will launch in the communities in October of 2020, and program outcomes will be evaluated at the family, neighborhood, and community levels as part of our comprehensive prevention-services analysis.

While we have made great strides in improving our child welfare system and have enlisted the partnership of government and community stakeholders, youth, and families, we, alongside the Children's Bureau, recognize that we are charting new waters as we shift from the waiver project to Family First and deepen our local investments in primary prevention. As we move further upstream, we will continue in our commitment to implementing truly transformative initiatives to strengthen families in their communities and addressing root causes—rather than just the imminent issues families face once engaged with CFSA—to reduce the need for child welfare agency involvement.

 

Issue Date: February 2020
Section: Spotlight on Developing a Full Prevention Continuum in Child Welfare
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=213&articleid=5498


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.
 

Issue Date: February 2020
Section: Current Theme or Topic
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=213&articleid=5500


News From the Children's Bureau

Developing a Learning Agenda to Help States Evaluate Home Visiting Programs

The Office of Planning, Research and Evaluation (OPRE) within the Administration for Children and Families (ACF) of the U.S. Department of Health and Human Services has issued a new evaluation brief to help states design options for assessing the impact of their home visiting programs in multiple settings. The Maternal, Infant, and Early Childhood Home Visiting (MIECVH) learning agenda provides activities for state-led evaluations of MIECHV programs, including performance measurement, continuous quality improvement, systematic reviews, descriptive research, and implementation and impact assessments.

The federal MIECHV program, administered by ACF's Health Resources and Services Administration, supports voluntary, evidence-based home visiting services for at-risk pregnant women and parents with young children. It also encourages states to develop their own learning agendas to ensure they are using the best available evidence to improve state-run program performance.

The OPRE brief describes the learning agenda as a strategic approach for states to develop a portfolio of evidence about the implementation and impacts of MIECHV to help guide decision-making in multiple contexts and settings. Such an approach provides an opportunity for "a continual and evolving" learning process, OPRE explains. According to the brief, a learning agenda typically features questions that identify existing knowledge gaps, research and evaluation activities designed to answer those questions, and materials that are developed and disseminated to increase the usefulness of the related findings. The goal is to improve state MIECHV program efficiency and effectiveness and build a broader home visiting knowledge base.

In addition to identifying knowledge gaps and using evidence to guide decisions, OPRE identifies the following benefits of developing a learning agenda: building a continuum of evidence, encouraging efficient use of resources, reinforcing strategy and policy, supporting organizational change through data-informed decision-making, and encouraging adaptive management. OPRE recommends states take the following actions to develop a learning agenda:

Developing a State Learning Agenda: The Maternal, Infant, and Early Childhood Visiting Program is available at https://www.acf.hhs.gov/opre/resource/developing-state-learning-agenda-maternal-infant-early-childhood-home-visiting-program.







 

Issue Date: February 2020
Section: News From the Children's Bureau
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=213&articleid=5485


Prevention: Implementing Evidence-Based Programs

A recent episode from the Child Welfare Podcast Series focuses on Community-Based Child Abuse Prevention grantees as they share their local and statewide perspectives on how evidence-based programs (EBPs) were selected and tailored to meet the needs of their specific constituency groups. The podcast discusses how EBPs fare when compared with other programs that also deliver positive outcomes; tailoring EBPs for targeted communities, such as immigrants; applying EBPs across diverse regions to support each region's unique needs; and guidance for other grantees in selecting and implementing EBPs.

The episode features the following presenters:

To listen to the podcast, "Prevention: Implementing Evidence-Based Programs," visit https://www.childwelfare.gov/more-tools-resources/podcast/episode-44/.

To find related podcasts on prevention and other topics in the Child Welfare Podcast Series, visit https://www.childwelfare.gov/more-tools-resources/podcast/.

 

Issue Date: February 2020
Section: News From the Children's Bureau
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=213&articleid=5487


Call for Applications to Participate in the Child Welfare Workforce Analytics Institute

The Quality Improvement Center for Workforce Development (QIC-WD) is seeking five to eight public child welfare agencies to join the Child Welfare Workforce Analytics Institute (the Institute), a short-term project that supports collaboration between human resources and child welfare staff. Institute participants will engage in discussions on how to leverage data to examine and address child welfare workforce challenges. These data can help agencies answer the following questions:

Selected agencies are expected to attend multiple webinars and an all-expenses-paid 2-day workshop in Washington, DC, on August 25–26, 2020. A QIC-WD representative will be assigned to each participating agency to provide coaching and individualized support as the agency prepares for participation in the Institute.

Applications must be submitted no later than February 14, 2020.

To learn more about the Institute and to apply, visit https://www.qic-wd.org/child-welfare-workforce-analytics-institute.




 

Issue Date: February 2020
Section: News From the Children's Bureau
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=213&articleid=5486


CB Website Updates

The Children's Bureau website hosts information on child welfare programs, funding, monitoring, training and technical assistance, laws, statistics, research, federal reporting, and much more.

Recent additions to the site include the following:

Visit the Children's Bureau website often to see what's new.
 

Issue Date: February 2020
Section: News From the Children's Bureau
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=213&articleid=5488


Child Welfare Research

Home Visitation as a Promising Intervention for Child Welfare-Involved Families

Early childhood home visiting programs have been shown to be effective in preventing child maltreatment and improving birth outcomes, child health and development, maternal health and life course development, and parenting practices. Most evaluations of these programs, however, have focused on young, first-time mothers and have mostly underrepresented families with prior or current substantiated reports of child maltreatment.

A recent study in Child Abuse & Neglect discusses the long-term maltreatment outcomes of Healthy Families New York (HFNY), an evidence-based home visiting program targeting high-risk families from communities with high rates of teen pregnancy, babies with low birth weights, infant mortality, Medicaid births, and mothers with late or no prenatal care. The prospective study, which is conducted through a randomized controlled trial, focuses on a subgroup of mothers with at least one substantiated report of maltreatment and the program's impact on preventing the recurrence of child maltreatment in this population.

Participants in the study were interviewed in their homes by trained interviewers not affiliated with the HFNY program. Study measures included sociodemographic variables such as the mother's race/ethnicity, age, and educational attainment; whether a partner was present; risk factors such as mental health issues; use of public assistance; and child maltreatment outcomes such as information regarding investigations and initiation of family support services.

The study found that the recurrence of maltreatment over time was consistently reduced for mothers who participated in home visiting programs compared with mothers who did not. Mothers in the HFNY program, for example, were involved in fewer subsequent indicated child protective services reports than mothers in the control group at the 7-year follow-up. The study also found that participation in the HFNY program resulted in a significantly lower rate of needing family support services to prevent foster care placement for the children of mothers involved with child protective services. 

Researchers recommend that mothers who are involved with child protective services participate in home visiting and that child welfare agencies should collaborate with home visiting programs as not only a prevention strategy but also as a support to families already involved with child welfare.

"Reducing maltreatment recurrence through home visitation: A promising intervention for child welfare involved families," by Eunju Leea, Kristen Kirkland, Claudia Miranda-Julian, and Rose Greene (Child Abuse & Neglect, 86), is available at https://www.sciencedirect.com/science/article/pii/S0145213418303673.


 

Issue Date: February 2020
Section: Child Welfare Research
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=213&articleid=5489


Adopting a Public Health Approach for Maltreatment Prevention

A recent article in Child Abuse & Neglect discusses how maltreatment prevention efforts can benefit from a public health approach, which may be unfamiliar to those who have been trained in social work, psychology, or other disciplines that often focus on interventions for one family at a time or small groups. Given that many families affected by maltreatment are not currently involved with the child welfare system, communities using a public health approach can better reach those uninvolved families, as well as those at risk for maltreatment.

A public health approach can also help normalize the receipt of parenting support interventions. The author cites the popularity of childbirth classes as an example. Parents from all types of backgrounds attend these classes and do not appear to believe that class attendance is stigmatizing or indicates ignorance of pregnancy or childbirth. A public health approach could also help communities integrate other types of interventions into their initiatives, such as those related to housing, medical care, and substance use.

"Parenting and Family Support Within a Broad Child Abuse Prevention Strategy," by R. J. Prinz (Child Abuse & Neglect, 51), is available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4871147/.  

 

Issue Date: February 2020
Section: Child Welfare Research
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=213&articleid=5490


Strategies and Tools for Practice

Promising Interventions to Prevent Severe Child Abuse

Current child welfare services may fall short of protecting children from severe maltreatment due to a variety of constraints, according to a report that finds there are few evidence-based practices for preventing fatalities and serious injuries. The report does acknowledge, however, that there are interventions and strategies that hold promise for reducing such tragedies, as well as opportunities for cross-system collaboration to prioritize prevention activities targeted to at-risk families.

The report lists strategies for preventing child fatalities and serious injuries, as well as interventions that should be considered for preventing such tragedies. It also looks at the following ways community and system design strategies can aid in child protection:

The report points to the following strategies to protect children:

The report Evidence-Based and Promising Interventions for Preventing Child Fatalities and Severe Child Injuries Related to Child Maltreatment is available at https://www.upbring.org/wp-content/uploads/2017/04/Evidence_based_and_Promising_042617.pdf (1,620 KB).
 

Issue Date: February 2020
Section: Strategies and Tools for Practice
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=213&articleid=5491


Preventing Sexual Violence Against Children

Together for Girls released a report that highlights existing evidence pertaining to which strategies are effective in preventing sexual violence against children. The report is intended for advocates, decision-makers, those who implement programs, and anyone involved in guiding efforts and policies. It highlights ongoing challenges as well as what is working from various case studies from around the world—with special attention to low- and middle-income countries.

This resource defines sexual violence against children, outlines the risks, and provides additional information, including victim ages by country, incident locations, perpetrator relationship, what supports children have, and the impact of the internet.

The review also covers the following prevention and response strategies and rates them as effective, promising, prudent, conflicting, no effect, or harmful:

For each strategy, the report highlights a case study and includes experts' perspectives and additional resources.

What Works to Prevent Sexual Violence Against Children: Executive Summary is available at https://www.togetherforgirls.org/wp-content/uploads/2019-11-15-What-Works-to-Prevent-Sexual-Violence-Against-Children-Executive-Summary.pdf (14,928 KB).

 

Issue Date: February 2020
Section: Strategies and Tools for Practice
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=213&articleid=5492


Implementing the Family First Prevention Services Act

The Children's Defense fund released a technical guide that aims to help child welfare agencies, policymakers, and other stakeholders with a range of strategies for implementing the Family First Prevention Services Act of 2018 (FFPSA). The act centers on three principles: helping families whose children are at risk of removal stay together safely, ensuring children in foster care live in the most family-like situation possible, and improving access to high-quality residential treatment opportunities.

The guide is a question-and-answer-style resource that provides information about the provisions of the law and the congressional intent behind it. It is based on a careful review of statutory language, agency guidance, and additional analysis by multiple organizations and partners involved in the support and passage of the legislation. The guide is organized into the following nine sections:

FFPSA is considered the starting point for child welfare reform, and implementation of the provisions of the act can be a long process that requires coordination and collaboration among federal, state, tribal, and local governments and other stakeholders as well as consideration of the ultimate impact on the children and families involved.

To read the guide, Implementing the Family First Prevention Services Act: A Technical Guide for Agencies, Policymakers and Other Stakeholders, visit https://www.childrensdefense.org/policy/policy-priorities/child-welfare/family-first/implementing-the-family-first-prevention-services-act/www.childrensdefense.org/policy/policy-priorities/child-welfare/family-first/implementing-the-family-first-prevention-services-act/.
 

Issue Date: February 2020
Section: Strategies and Tools for Practice
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=213&articleid=5493


Resources

Kidpower

Kidpower is an organization dedicated to providing education resources, tools, and training opportunities for schools and communities to teach safety skills and prevent and stop bullying and harassment in all its forms. Teachers, families, and adults who work with children and youth can use the materials on this website to learn how to use and teach skills for safety and confidence. It includes a well-developed curriculum and teaching methods that were created to stop child abuse and child sexual abuse, create safer schools, prevent violence and kidnapping, and stop domestic violence.

They offer several programs, workshops, and trainings that cover the following:

With books, workshops, and handouts on the topics, Kidpower aims to educate children and youth in age-appropriate ways that show how to talk about scary topics in a not scary way. The website also includes hundreds of free resources through their library. Many of these resources are also available in Spanish.

Explore the website and resources at https://www.kidpower.org/.

 

Issue Date: February 2020
Section: Resources
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=213&articleid=5494


Play in Early Childhood: The Role of Play in Any Setting

Harvard University's Center on the Developing Child has a multimedia guide, How-to: 5 Steps for Brain-Building Serve and Return, focusing on "serve and return," which is the give-and-take interaction between children and caregivers. One video in the series, "The Role of Play in Any Setting," describes the important role play and relationship building have on child development and positive outcomes. The video is based on three principles from the science of child development—supporting responsive relationships, strengthening core life skills, and reducing sources of stress—and how play is an effective way to support them. Children and youth involved with child welfare often have a history of trauma and must deal with uncertainty, which can lead to attachment disorders. 

Play in early childhood is a way to build a child's brain and helps them develop relationships through social interactions. Different types of play contribute to the three principles in different ways. Some types of play, such as building, can help strengthen their ability to plan, which is a life skill. Other types of play encourage flexible thinking or relationship building. For example, a musical installation in Boston, MA, encouraged families waiting at bus stops to play and interact.

Play also reduces stress levels in children and families and allows the practice of coping skills. Learning how to process experiences and express them in developmentally appropriate ways is an important, resilience-building skill for children who have experienced trauma.

Additional videos and materials in the guide provide additional details about serve and return, including the importance to responding appropriately to infants and how to engage in serve and return interactions.

Watch "The Role of Play in Any Setting" and the explore the rest of the guide at https://developingchild.harvard.edu/resources/play-in-early-childhood-the-role-of-play-in-any-setting/.

Issue Date: February 2020
Section: Resources
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=213&articleid=5495


Training and Conferences

Safe Environment for Every Kid Training

Safe Environment of Every Kid (SEEK) is a child abuse prevention model intended to be used by professionals in pediatric primary care settings involved with families who may have risk factors for child maltreatment. This includes pediatricians, family medicine physicians, nurse practitioners, and physician assistants.

SEEK has the following goals:

Through the use of online videos and other materials, professionals are trained in the principles of motivational interviewing; the use of the SEEK Parent Questionnaire-R, which is a brief screening tool parents complete before seeing the health professional; the availability of resources for families, such as user-friendly, one-page handouts; and working collaboratively with a behavioral health colleague. 

Continuing medical education credits as well as maintenance of certification categories 2 and 4 credits are also available to training participants through the American Board of Pediatrics and the American Board of Family Medicine.

For more information on SEEK, visit https://seekwellbeing.org/.

Issue Date: February 2020
Section: Training and Conferences
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=213&articleid=5496


Conferences

Upcoming conferences and events on child welfare and adoption include the following:

February

March

April

 

Issue Date: February 2020
Section: Training and Conferences
URL: https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=213&articleid=5497



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Children's Bureau Express does not disclose, give, sell, or transfer any personal information, including email addresses, unless required for law enforcement by statute.


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