State Child Welfare Agencies Research Articles

State Implementation of Congregate Care Reforms for Children in Foster Care.

The Family First Prevention Services Act (FFPSA) allows states to use federal Title IV-E funds to provide time-limited, clinically appropriate use of congregate care, including Qualified Residential Treatment Programs (QRTPs), for youth in foster care. October 1, 2021 marked the deadline for states to begin implementing these FFPSA congregate care reforms. From June to September 2022, we conducted a mixed-methods study to obtain a baseline understanding of implementation barriers, successes, and recommendations to inform congregate care policy and practice. We fielded a national survey with state child welfare agency directors and conducted focus groups with youth with QRTP experiences, child welfare agency administrators, and QRTP executive leaders. We integrated a descriptive analysis of survey data with focus group themes to summarize state implementation progress. A total of 47 states (90%) responded to the survey. Most states reported ongoing congregate care reforms aligned with FFPSA, reducing the use of congregate care and increasing kinship foster care. QRTPs have become the primary congregate care setting. Top implementation barriers concerned workforce resource and capacity constraints, funding, and access to therapeutic foster care models and foster families. Focus group themes converged on the lack of tailored treatment, quality staff, coordinated aftercare, and a need for QRTP outcome evidence. Early implementation lessons of FFPSA congregate care reforms call for additional funding and technical assistance, oversight of congregate care, professionalization and investment in QRTP staff, youth advisory boards to promote youth-driven treatment, and performance- and outcome-based monitoring of QRTPs.

Predictors of Identity Crime Victimization of Adolescent Youth in Foster Care

ABSTRACT Identity crimes pose serious risks and challenges for youth in foster care. As young people move through various out-of-home placements and schools, their personal data are often widely disseminated, difficult to secure, and thus vulnerable to theft and misuse. When they transition from foster care to adulthood, identity crime victims with compromised credit histories may be denied loans, employment, and/or housing during the already-precarious period of emerging adulthood. Even though federal law requires state child welfare agencies to conduct annual credit checks for adolescent youth in foster care, little is known about the factors contributing to risk of identity crime victimization among foster care-involved youth, either before or after their initial entry into care. To address this knowledge gap, we analyze linked child welfare and consumer credit records for a population cohort of 4,670 youth (age 14 to 17) in foster care in a southeastern state who received credit checks from November 2015 through December 2021. Using gradient boosted machine learning, we find that prior identity crime victimization before the youth first entered care is the strongest predictor of victimization while in foster care. Implications of these findings for policy and practice are discussed.

Engaging Victims of Child Sex Trafficking: Training for Child Welfare Workers

Abstract Child sex trafficking (CST) is the exploitation through commercial sex of a minor under 18. Federal law requires state child welfare agencies to respond and provide services to victims of CST. Social workers report lacking an understanding of state and federal law related to human trafficking, as well as resources for victims, and are often inadequately trained for identifying and serving survivors. As part of a CST awareness training including lecture, discussion, and game-based learning, child welfare workers were surveyed on their knowledge about CST and their self-efficacy in serving and engaging with survivors. Regression analyses showed that the training was associated with a positive change from pre- to posttest, on both knowledge (R2 = .472) and self-efficacy (R2 =.381), even when controlling for gender, race, experience, pretest knowledge, and position. Interactive trainings for child welfare workers on child trafficking survivor engagement that use a victim-centered, strengths-based lens are a promising practice.

Every state for itself: A comparison of states’ visitation guidelines with research studies

Contact between children in care and their families and affiliates is an important component of child welfare practice. Depending on how visitation is handled and the readiness of the parties to interact, contact can result in positive or negative effects. However, scholars find that workers who supervise and arrange visitation often lack the requisite skills and knowledge to conduct visits in the most beneficial ways. As agency policies, particularly when they are research-informed, influence practice, this study analyzes the guidelines on visitation collected from the state child welfare agencies in the United States of America (USA) and compares them with research findings and researchers’ recommendations for best practices. The materials analyzed were collected from 43 states and included pages from policy manuals or administrative standards, tip sheets for case workers, brochures developed for families, stand-alone guidelines, and documentation forms. The guidelines vary widely in terms of the amount and specificity of information they contain, but their overall coverage of topics is sparse and not always in line with research findings. A need exists to update and expand the guidelines, which could then function as one tool to improve practice.

Family, mental health, and placement outcomes of a low-cost preventive intervention for youth in foster care

This study assessed secondary outcomes of Connecting, a low-cost, self-directed, family-based prevention program for families with youth placed in their care by state child welfare agencies. Families caring for youth aged 11 to 15 years within Washington State were recruited and randomly assigned into either the Connecting program (n = 110) or a treatment-as-usual control condition (n = 110). The program included a 10-week sequence of self-directed family activities and DVDs with video clips. Survey data were collected from caregivers and youth at baseline, immediately post-intervention, and at 12 and 24 months post-intervention; placement data was collected from the child welfare department as well. Intention-to-treat analyses focused on 5 classes of secondary outcomes at 24 months post-intervention: caregiver-youth bonding, family climate, youth risk behavior attitudes, youth mental health, and placement stability. There were no intervention effects in the full sample. In subgroup analyses, among older youth (ages 16–17) but not younger youth (ages 13–15), the Connecting condition (vs. controls) yielded more frequent caregiver-reported bonding communication, bonding activities, warmth, and positive interactions, as well as less favorable youth attitudes towards early initiation of sexual behavior and substance use, and fewer youth self-injurious thoughts. Consistent with the social development model, the divergent outcomes between younger and older youth suggests Connecting’s driving mechanisms involve social processes that undergo critical shifts between early and mid-adolescence. Overall, the Connecting program showed promise in older youth for long-term promotion of caregiver-youth bonding, healthy behaviors, and mental health, but did not demonstrate long-term efficacy in facilitating stable or permanent placement of youth in care.

American Indian and Alaska Native overexposure to foster care and family surveillance in the US: A quantitative overview of contemporary system contact

Following a long history of forced assimilation through family separation, American Indian and Alaska Native (AIAN) children continue to be separated from their families by state child welfare agencies at exceptionally high rates. This study identifies those states with high levels of contemporary AIAN family separation through non-tribal state and local foster care systems. We describe how these risks vary over childhood and vary in magnitude relative to white children. We then examine three states with exceptionally high rates of AIAN foster care placement, Minnesota, Alaska, and Montana, in detail. We evaluate how child maltreatment reporting contributes to upstream inequalities in family separation through an examination of sources of maltreatment reports and types of alleged maltreatment across childhood. We conclude by arguing that child welfare scholars should understand contemporary AIAN child welfare system contact in the context of historical and ongoing settler colonialism. In order to reduce AIAN inequalities, child protective services should observe tribal sovereignty by deferring to the authority of tribes in caring for Native children and families and increasing the capacity tribes have to help their communities.

The influence of Decision-making ecology on placement into foster care

In recent years, the U.S. Administration for Children and Families has shifted policy and practice guidance to encourage state child welfare agencies toward efforts that strengthen family connections, increase primary prevention, and decrease unnecessary removal of children from their parents. However, the field lacks an understanding of the factors influencing removal decisions. Framed by the Decision-making Ecology, the purpose of this study is to explore the individual, organizational, and external variables associated with worker orientation toward family preservation versus child safety. Two hundred and sixty-six child welfare professionals participated in a survey. Findings showed significant differences between the family preservation and child safety/removal groups within individual decision-maker factors (age and STS) and organizational factors (collaboration with family support providers). No differences were found in measured external/community factors. Findings from multivariate logistic regression analysis indicated that regardless of the years of job experience of the worker, being a child welfare worker without clinically significant STS increased the odds of being in the family preservation group by 2.7 times as compared to the child safety/removal group. In addition, participants who reported collaboration with other child-serving community professionals had 4.4 greater odds of being in the family preservation group. Implications for workforce recruitment and development are discussed.

Examining the effects of the Eckerd rapid safety feedback process on the occurrence of repeat maltreatment among children involved in the child welfare system

BackgroundThe Eckerd Rapid Safety Feedback Process (ERSF) is an approach to child welfare practice that combines predictive risk modeling (PRM) with real-time quality assurance and staff coaching during a child protective services investigation. During the case investigation, quality assurance (QA) reviewers provide guidance to staff by assessing key dimensions of their investigative practices and providing coaching sessions as needed. ObjectiveTo determine to what degree ERSF reduced the incidence of children who experienced high severity physical, sexual, or neglect maltreatment (HS-CAN) among children known to a state child welfare agency, within 12 months of the agency's involvement in a previous investigation. MethodsThis multi-year quasi-experimental study evaluated the impact of the ERSF Process on risk of repeat high severity maltreatment among children and youth identified by a PRM algorithm as high risk for experiencing repeat maltreatment and receiving the additional QA intervention, compared to those receiving the usual standard of care. ResultsThe ERSF Process did not lower the rate of HS-CAN among children identified as high risk. The joint odds ratio for receiving ERSF given being high risk was 1.05, i.e. a point estimate indicating higher probability of future HS-CAN. ConclusionsIn this statewide implementation of ERSF, we did not find a positive effect of this particular PRM-based intervention. Future maltreatment, even within 12 months of a prior investigation, may be too distal an outcome for a PRM and QA process designed to produce a high-quality CPS investigation and safety plan.

The Role of Formal Policy to Promote Informed Consent of Psychotropic Medications for Youth in Child Welfare Custody: A National Examination

Active participation of youth and surrogate decision-makers in providing informed consent and assent for mental health treatment is critical. However, the procedural elements of an informed consent process, particularly for youth in child welfare custody, are not well defined. Given calls for psychotropic medication oversight for youth in child welfare custody, this study proposes a taxonomy for the procedural elements of informed consent policies based upon formal and informal child welfare policies and then examines whether enacted state formal policies across the United States endorsed these elements. A sequential multi-method study design included: (1) semi-structured interviews with key informants (n = 58) primarily from state child welfare agencies to identify a taxonomy of procedural elements for informed consent of psychotropic medications and then (2) a legislative review of the 50 states and D.C. to characterize whether formal policies endorsed each procedural element through February 2022. Key informants reported five procedural elements in policy, including how to: (1) gather social and medical history, (2) prescribe the medication, (3) authorize its use through consent and youth assent, (4) notify relevant stakeholders, and (5) routinely review the consenting decision. Twenty-three states endorsed relevant legislation; however, only two states specified all five procedural elements. Additionally, the content of a procedural element, when included, varied substantively across policies. Further research and expert consensus are needed to set best practices and guide policymakers in setting policies to advance transparency and accountability for informed consent of mental health treatment among youth in child welfare custody.

A Quiet Revolution

This Article argues that juvenile court judges can safely reduce the number of children entering foster care by faithfully and rigorously applying the law. Judges often fail to perform this core functon when a state child welfare agency separates a child from their family. Judges must perform their role as impartial gatekeeper despite the temptation to be "omnipotent moral busybodies".

Annual Credit Checks for Adolescent Youth in Foster Care: Factors Associated with Identity Fraud Victimization.

Child identity fraud, or the criminal exploitation of a child's personal data, poses serious risks and challenges for youth in foster care. Despite the 10-year history of a federal mandate requiring state child welfare agencies to conduct annual credit checks for adolescent foster youth (42 U.S.C. § 675), identity fraud has received scant attention in child welfare research. Analyzing a state-level administrative dataset with linked child welfare and consumer credit records, we employed hierarchical binary logistic regression modeling to analyze demographic and foster care placement factors associated with identity fraud victimization among a statewide population cohort of 1176 youth (age 14-17) in foster care in a mid-Atlantic state. In the model of best fit, covariates significantly associated with differing odds of identity fraud victimization included African American race (OR = 2.67, p < .001); two or more races (OR = 2.95, p = .003); and older age at credit check (OR = 3.49, p < .001). Youth with history of prior home removals (OR = 1.59, p = .059) were marginally more likely than youth with no prior home removals to experience identity fraud, controlling for all other variables.

‘Almost everything else goes to the wayside’: Experiences of caseworkers, middle managers and leaders responding to child fatality and near fatality cases

While child welfare scholars and caseworkers have acquired a better understanding of risk factors associated with occurrences of child fatalities due to maltreatment over the past 20 years, little is known about the organisational and system-level characteristics that impact efforts to prevent or intervene in these cases. As part of a collaborative agreement between a university-affiliated centre and a state child welfare agency, we conducted interviews by phone with 19 case managers, middle managers and regional leaders who were assigned to manage or oversee a near fatality or fatality case. They illuminated five major themes: 1) their perceived stressors and sources of support; 2) client and perpetrator risk factors; 3) system-level risk and protective factors; 4) case descriptions; and 5) lessons learned. Relying upon their lived experiences, we offer practice and policy recommendations to Child Abuse Review to support their efforts to prevent and respond to child fatality cases. Efforts should be devoted to evaluating strategies to reduce risk for all families before the child welfare system is involved, supporting workers when they are assigned to fatality cases by reducing caseloads and preparing them for the fatality review process, and embracing a culture of collaboration across and within child-serving systems. Key Practitioner Messages To respond effectively to child fatality and near fatality cases, child welfare caseworkers and leaders should be assigned fewer cases in the interim, and receive guidance, consultation, and time to prepare for the fatality review process. Embracing a culture of collaboration across and within child-serving systems may also prevent fatalities and facilitate an efficient investigative process if/when they do occur.

APA Files Another Amicus Brief in Ongoing Texas Case on Banning Trans Care for Youth

APA Files Another Amicus Brief in Ongoing Texas Case on Banning Trans Care for Youth

Child Welfare Services Response to COVID-19: Addressing Face-to-Face Contacts.

During the onset of the COVID-19 pandemic, child welfare case managers faced contradictions in their responsibility to make regular in-person contact with children and families to promote safety, permanency, and well-being while following public health directives to avoid social contact in order to curb COVID-19 infections. In response, federal guidance was issued regarding the use of technology to maintain mandated contacts with children in foster care. States had to make decisions about how to handle other contact types. This study reviewed documentation of state child welfare agency practices regarding face-to-face contact between case managers and child-welfare involved families between March 2020 and May 2020. Using a point-in-time search to obtain publicly accessible documents related to caseworker face-to-face contact and COVID-19, data was located for 49 states and the District of Columbia (n = 50). Documents were analyzed in NVIVO 12 using document analysis. Within the context of face-to-face interactions by child welfare case managers, documents were analyzed in six themes based on the types of services provided to children and families: (1) investigations, (2) family preservation, (3) family team meetings, (4) foster care, (5) adoption, and (6) general child welfare. State decisions about how to manage these contacts varied. In several states case managers were directed to document both virtual and in-person contacts during this time as face-to-face; which may impact future evaluations of child welfare systems during COVID-19. Findings highlight a range of strategies used by state child welfare systems. By reviewing previous practice and hearing what other states are doing, child welfare service agencies have the potential to evaluate appropriately, strengthen their plans and address disparate impacts.

Who Is an Indian Child? Institutional Context, Tribal Sovereignty, and Race-Making in Fragmented States

Despite growing interest in state race-making, we know little about how race-making plays out in the everyday practice of policy governance. To address this gap, I examine the implementation of the Indian Child Welfare Act (1978), which sought to end generations of state policies that denied tribal sovereignty and forcibly removed Native children from their tribes. ICWA’s protections extend to children based on tribal citizenship, not racial status. Marshalling 40 years of archival data from the government agencies charged with ICWA enforcement, I analyze how ICWA implementers determine a child’s Indian status. I find that authorities routinely eschew the requirement to treat Indian as a citizenship category, re-defining it as a race. Yet whether and how state actors racialize Indianness varies by the institutional contexts in which they work. Comparing state child welfare agencies, state courts, and federal courts, I identify three institutional characteristics that organize race-making practices: evidentiary standards, record-keeping requirements, and incentive structures. These characteristics influence whether state decision-makers operationalize “Indian” as a racial category and the cognitive and ideological processes that undergird their classifications. I also demonstrate that changes in these institutional characteristics yield concomitant shifts in whether and how state agents engage in racialization.

Kinship navigator program development: Listening to family, youth, and advocate voice

ABSTRACT Kinship caregivers are relatives or close friends who assume caregiving responsibilities due to a variety of unexpected (and sometimes traumatic) circumstances. While many kinship care arrangements happen outside the child welfare system, kinship care also forms an increasing percentage of all child welfare placements and is distinct from traditional non-relative foster parenting. Kinship placements can promote family and cultural continuity and better outcomes for children. However, they also present unique dynamics and stressors, and could significantly benefit from a specific array of social supports and economic resources. This study describes how a partnership-based research project by the state child welfare agency and university partners informed the development of a model for Oregon's Kinship Navigator Program. Researchers gathered statewide input from a diverse array of caregivers, youth in care, and kinship caregiver advocates. Focus groups and key informant interviews were conducted to identify the gaps and needs of Oregon's kinship caregivers. Eleven emergent themes were identified. Recommendations are provided for integrating themes into kinship navigator programs.

Vulnerable Youth and the COVID-19 Pandemic.

* Abbreviations: COVID-19 — : coronavirus disease of 2019 LGBTQ — : lesbian, gay, bisexual, transgender, queer, and/or questioning Vulnerable pediatric populations (including youth who are lesbian, gay, bisexual, transgender, queer, and/or questioning [LGBTQ]; homeless; maltreated; in foster care; and struggling with substance use disorders) warrant particular consideration during the coronavirus disease of 2019 (COVID-19) pandemic. It is likely that stay-at-home orders, combined with increased economic instability and family pressures, will increase their risks for harm and, in some cases, may make it untenable (and potentially dangerous) for them to shelter in place. Simultaneously, safety nets that protect youth (child protective services, medical and mental health providers, and educators) have fewer staff available or are inaccessible because of the COVID-19 crisis. These conditions highlight how morbidity and mortality in vulnerable pediatric populations will likely extend beyond the pandemic itself. For some children and youth, home can be isolating and, in some cases, dangerous. Adverse childhood experiences, including physical abuse, sexual abuse, and neglect, are common, with an estimated 678 000 children and adolescents experiencing maltreatment in 2018, and young children are at highest risk for serious harm.1 These risks increase for specific populations. Indeed, LGBTQ and gender nonconforming youth (up to 16% of all youth) are at far higher risk of experiencing physical and sexual abuse, with the level of gender nonconformity predictive of … Address correspondence to Rachel I. Silliman Cohen, MD, Child Abuse Research Education and Service Institute, School of Osteopathic Medicine, Rowan University, 42 E Laurel Rd, Stratford, NJ 08084. E-mail: sillimancohen{at}rowan.edu

Returning to foster care: Age and other risk factors

This study uses longitudinal administrative data from twenty U.S. states to examine the risk of returning to foster care after children are either reunified with their parents or placed with guardians outside the foster care system. Our sample for this analysis includes all children who, before age 18, exited their first spell to either reunification or placement with guardians between 2003 and 2010 with follow-up through December 31, 2017 (N = 607,289). Focusing on demographics of the children, placement history and elapsed time since their exit from care as risk factors, a discrete time hazard model was specified to integrate children’s development as a factor predictive of reentry. Subgroup analyses identified which children are most at risk of returning to care. Of all children who exited their first spell to reunification, 27% reentered care by 2018 and of all children who exited their first spell of foster care to live with a guardian, 17% reentered care by 2018.The study found older teens, children who experienced changes in care type before reunification, children who were discharged to reunification within six months of entering care, and children whose last placement was congregate care all show significant risks of reentry into care. Additionally, while the number of infants who enter, leave and return to care before their first birthday is relatively small, the children in this group have a substantial risk of re-entering care. State and local child welfare agencies can use the results of this study to target their service investments such as those they might support with federal Family First Prevention funds.

Nine Key Factors in Extended Litigation-Based Reform of State Child Welfare Agencies

Youth entering foster care encounter a multi-system state child welfare agency (CWA) that provides foster care and other child welfare related functions. CWAs face complex and ongoing governmental and organizational challenges contributing to a history of serious systemic deficiencies due to chronic under-funding, under-staffing, and under-resourcing. Child welfare advocates employ class-action litigation to engage leaders in sustained focus and action to remedy systemic failures and hold them accountable for poor care and outcomes for youth in foster care. A qualitative design using multiple case study and document analysis methods was used to explore extended litigation-based reform of thirteen state CWAs to identify key factors that contributed to substantive improvements in the state foster care system. Nine dominant factors were identified that included: (a) well-defined consent decrees and settlement agreements; (b) court-appointed monitors, special masters, and receiverships; (c) moving from an adversarial to collaborative environment; (d) case practice model/principles-based reform plan and family/team-based case management; (e) executive leadership support, resistance, and turnover (f) state governmental and legislature support; (g) building institutional capacity; (h) CWA structured as an independent agency; and (i) incremental reform plan implementation.

63.4 THE SILOED PSYCHIATRIST: OBSTACLES TO JUDICIOUS PRESCRIBING FOR YOUTH IN CHILD WELFARE AND OUTPATIENT SERVICES

This presentation will explore how injudicious psychotropic prescribing may be a result of various factors within 2, often intersecting, systems of care: 1) state child welfare agencies; and 2) outpatient psychiatric clinics.