Creating Long-Term Health and Well-being for Communities During COVID-19 Pandemic

3/24/2020

By Susan N. Dreyfus, president and CEO of the Alliance for Strong Families and Communities.

All Americans want the same things – we want our children to be safe and healthy, our neighborhoods to be secure, our economy to be strong, and our friends and families to unite and lift each other up in this time of crisis. 

Congress and the White House are moving quickly to provide economic relief for families as well as for essential industries as the COVID-19 pandemic spreads. This must also include support for community-based human services organizations that are typically hit hardest by economic downturns, particularly when their services are needed more than ever. 

One area that deserves our attention is our nation’s child welfare system, which has the critical responsibility of keeping our families strong and intact so that parents can care for their children safely at home. On a normal day, child welfare caseworkers interact with thousands of families across the country that are experiencing stressors, adversity, and other issues that put their children at risk for maltreatment. Research shows that increased financial and emotional stress during a crisis, such as a natural disaster or today’s pandemic, increase the likelihood that children will experience physical abuse or neglect.  

Our systems must be nimble, flexible, and innovative. Caseworker visits, essential to the safety of children known to the child welfare system, need to continue despite facing a virus that is spread by people-to-people contact. Fortunately, the U.S. Department of Health and Human Services recently issued guidance allowing for caseworker visits via videoconference. 

Many of the families involved in the child welfare system are dealing with complex issues, such as substance use disorders, mental health issues, and domestic violence. As the number of coronavirus infections rise, reduced access to medical care will also be a significant concern for children and families who have come to rely upon the much-needed treatment and services they were receiving. We must ensure through telehealth and videoconferencing that families can continue to access mental health counseling and substance use disorder treatment. 

We currently face a shortage of foster homes in this country.  A large number of children in foster care are placed with relatives, typically with grandparents, who are at increased risk for the virus. We must identify back-up homes for these kinship caregivers, put more resources into our foster parent recruitment and retention efforts, encourage virtual foster parent training, and do everything we can do to ensure we have enough safe and qualified homes should we witness a spike in need.  

As a former child welfare director and current head of a national strategic network of community-based human services organizations, I think it is absolutely crucial that state and county child welfare agencies work alongside and in partnership with our community-based organizations. Because community-based organizations are closely connected to the communities we serve, we are indeed essential to emergency responses in crisis like what we are experiencing today. 

We applaud New York’s Mayor Bill de Blasio for his executive order naming all 40,000 community-based human services employees as essential city personnel. All governors, mayors and county executives should follow suit quickly or they will find that the organizations they are dependent upon will face disastrous financial challenges they are not equipped to meet alone.  

We are working in partnership with child welfare advocacy leaders calling on Congress to provide new funds to state and local communities, programs, and services that support vulnerable children and families through prevention and intervention of child abuse and neglect during this public health emergency. The requests include more support for kinship care providers, domestic violence programs, and critical supports for older foster youth, especially those who have to leave college with nowhere to go. 

This should be a loud wake-up call for all of us who work in or support our nation’s child welfare system. As we all scramble to ensure we are meeting our obligations and responsibilities to our families, communities, and staff, we should take a moment to take note of all that we are learning here, and all that we should put in place before the next crisis comes our way. We should also find opportunities to identify ways that the child welfare system can be more flexible, more efficient, and with fewer regulations that just do not make sense in this day and time.  

We can rise to this challenge. We have done hard things before. We need to remain united as a field and across sectors in ensuring every child, every family, and every community remains strong and healthy and can come through this pandemic able to move forward in their lives. 


This article appeared in The Hill Congress Daily blog on March 23, 2020.

Transforming the Vision of a 21st Century Child Welfare System into Practice

2/28/2020

By Amy Templeman, Alliance director of safety and resilience, Within Our Reach Office

Child abuse and neglect fatalities are preventable, not inevitable. This was the bold vision laid out by the federal Commission to Eliminate Child Abuse and Neglect Fatalities when it issued its report in March 2016, reimagining a 21st century child welfare system. 

Commissioners called for a public health approach to transforming child welfare systems guided by greater leadership and accountability, decisions grounded in better data and research and a multidisciplinary approach to ensuring child safety.

Based on the Commission’s findings, the U.S. Department of Justice’s Office for Victims of Crime announced earlier this year funding for a demonstration initiative to develop multidisciplinary strategies and responses to address serious or near-death injuries as a result of child abuse or neglect. Through a competitive grant process, they selected five sites that are receiving national technical assistance for a three-year period from a team of national experts. The sites were selected based on their ability to support a collaborative, community-based approach to reducing child maltreatment fatalities and serious injuries. 

This effort will provide what has been sorely lacking in previous attempts to reduce child fatalities – the identification and evaluation of evidence-based practices. Coupled with the federal government’s focus on prevention services and requirement of fatality prevention plans in the Family First Prevention Services Act, these actions will add up to a new knowledge base on best practices and what works to reduce and prevent these tragedies.

The five selected sites include St. Francis Hospital in Hartford, Connecticut; Cook County Health, Illinois; Indiana State Department of Health; Michigan Department of Health and Human Services; and Sacramento County’s Child Abuse Prevention Council.

Technical assistance will support sites in improved data collection and analysis using a safety science approach, development of strong community collaboratives, engagement of persons with lived experiences, better communications strategies, and developmental evaluation. This assistance is geared toward helping sites plan and implement an all-systems approach and coordinated strategic planning to respond to and reduce their child maltreatment fatalities and child crime victimization.

Each site will conduct their own data-driven needs assessment to identify children most at risk, as well as the strategies most likely to prevent future tragedies.

For example:

  • The Michigan Department of Health and Human Services will use data and input from partners to create a fatality/injury risk identification tool, which will be used by child protective services. They are also focused on expanding the efforts of the Michigan Child Death State Advisory Team and Citizen Review Panel on Child Fatalities. Serving as a state advisory committee for the project, the panel will create a forum for sharing information and innovations related to preventing child maltreatment deaths and injuries.
  • The Child Abuse Prevention Council of Sacramento will develop a model for a coordinated response to effectively identify and address recurring child injuries and fatalities using collaborative partnerships. Sacramento County will utilize a county-wide cross-disciplinary, public and private Prevention Cabinet to expand analysis of child fatality, near-fatality and injury data; gather social determinants of health data for neighborhoods most at-risk; review current screening and investigative policies; and use this information to inform and implement a strategic plan to eliminate child abuse and neglect fatalities in Sacramento County.
  • Cook County Health in Illinois, working in partnership with the Chicago Children’s Advocacy Center, will bring together other critical stakeholders to form the Collaboration of Helpers Lowering Deaths of Children (Project CHILD). Using a public health model, the Project CHILD collaborative will address the problem through parenting education, a home visiting nurse program, and family referrals. Additional strategies include use of a simulation laboratory, regional unit-based multidisciplinary teams and telehealth technology to improve the assessment of information gathered during investigations.
  • St. Francis Hospital in Hartford, Connecticut will utilize the funding to work with diverse stakeholders, including state agencies, policy makers, affected community members, first responders, educators, researchers and providers, in order to develop a standardized, data-driven systemic approach to documenting and tracking child maltreatment. They will focus on cities and towns under the judicial district GA-14, including Avon, Bloomfield, Canton, Farmington, Hartford, and West Hartford. 
  • The Indiana State Department of health will conduct a two-phase project in three target counties (Clark, Delaware and Grant counties) whose child fatality rate is higher than the state average. They will undergo a 5-year retrospective review to identify risk factors for child injuries and deaths and will work in partnership with the Community Partners for Child Safety program to develop prevention strategies for schools, social services agencies, health care providers, public health, hospitals, child care providers, community mental health agencies, local DCS office, child abuse prevention agencies, Youth Services bureaus, Child Advocacy Centers, the faith-based community and Twelve Step programs to create and implement a collaborative prevention network.

All sites will establish learning exchange teams and communications strategies to share findings both regionally and nationally.

In the words of the Commission’s final report: “In the Commission’s two years of hearings, deliberations, and meetings with stakeholder groups, we found little in the way of evidence-based programs to end child maltreatment deaths. We found no state that had developed a sufficiently comprehensive plan to address the problem. But we found hope and urgency for building the steps to a 21st century child welfare system that can prevent deaths of the 3,000 children who will die from abuse or neglect next year if the status quo remains in place.…We must build a more comprehensive child welfare system that goes beyond CPS agencies and uses a public health approach to develop community capacity to help families and prevent abuse and neglect before problems turn into tragedy.”

It is hoped that this innovative initiative will fulfill the mission of the Commission by taking the first step to inform an ongoing nationwide effort to reduce child abuse and neglect tragedies.

______________________

Amy Templeman is project coordinator for the cooperative agreement and director of the Within Our Reach office at the Alliance for Strong Families and Communities. Previously, she served as the Executive Director for the Commission to Eliminate Child Abuse and Neglect Fatalities. This article previously appeared in The Hill.

Disclaimer: This product was supported by cooperative agreement number 2019-V3-GX-K005, awarded by the Office for Victims of Crime, Office of Justice Programs, U.S. Department of Justice. The opinions, findings, and conclusions or recommendations expressed in this product are those of the contributors and do not necessarily represent the official position or policies of the U.S. Department of Justice.

Why Better Data and Data Sharing Are Critical to Preventing Child Abuse and Neglect Fatalities

12/5/2019

By Theresa Covington, director of the Within Our Reach Office at the Alliance

There has been an important shift in the conversation around child abuse and neglect fatalities in recent years. Previously, our systems were designed to respond only after a tragedy occurred. Today, however, with the support of new public policy and greater knowledge, we are beginning to think and act in terms of preventing child abuse tragedies before they occur. 

Effective prevention efforts, however, are reliant on improved data and data sharing between child support agencies. This includes current and comprehensive numbers on child abuse and fatalities and their causes in order to identify those most at risk.

In 2016, the Commission to Eliminate Child Abuse and Neglect Fatalities, charged by Congress and the President to develop a national strategy to eliminate child maltreatment deaths, released a groundbreaking report. In it, we highlighted the fact that, if our nation does nothing different to prevent these tragedies, somewhere between 1,500 and 3,000 U.S. children will die from maltreatment each year. Some experts, however, estimate the real number may be much higher.

Why the discrepancy?

There is currently no standard, mandated reporting system for child abuse or neglect deaths in this country. Definitions, investigative procedures, and reporting polices vary from state to state. Some states may classify a drowning death as a neglect fatality while others may classify it as an accident. 

That is why the Commission included in its recommendations the need to create uniform standards for fatality reporting, better sources of data on risk and protective factors, and policies to encourage real-time data sharing across agencies.   

For example, the Commission learned that the highest risk factor for an abuse or neglect fatality was the age of the child, with infants and toddlers most likely to suffer a maltreatment death. A call to a child protection hotline, regardless of the disposition, is also a strong predictor of a later child abuse or neglect fatality. And yet, all too often, child protection workers “screen out” certain calls even among these higher risk groups. Even if screened in, data sharing policies may prohibit public health and other human services from learning about these high-risk children and making sure supports are put in place to help the family better support their children.   

With passage of the Family First Prevention Services Act, states are mandated to accurately quantify child maltreatment deaths and develop prevention plans to mitigate them. And yet, the federal government has not yet developed a national, standardized counting framework to assist in this effort.  There has also been no federal effort to encourage and support states in the development of fatality prevention plans. 

Outdated data (many government agencies are currently reporting data that is two to three years old) and the inability to see data across systems also impedes the ability of staff on the ground to share real-time information and inhibits research that could lead to better policies and practices. 

More and more, non-governmental agencies, including media outlets and nonprofits, are working to fill these data gaps.

For example, The Chronicle of Social Change, a national news site focused on children, youth and families, launched an ambitious data and reporting project in 2017 to examine where at-risk children go when they are removed from home due to abuse.  Entitled “Who Cares: A National Count of Foster Homes and Families,” their research draws upon multiple sources, including information requests with each state and the District of Columbia, as well as federally collected data from the Adoption and Foster Care Analysis and Reporting System (AFCARS).

The Annie E. Casey Foundation annually publishes The KIDS COUNT Data Book, a ranking of states on 16 key measures of child wellbeing. They offer the best available data and statistics on the educational, social, economic and physical wellbeing of children at the local, state and national levels.

Predict-Align-Prevent is a new nonprofit that is helping communities identify and share fatality data and other socio-economic community data to better predict areas at highest risk and then develops prevention programs rooted in a health equity/public health framework.

Having current and comprehensive data is critical, however, data sharing among organizations is equally critical.

In a recent article, the American Academy of Pediatrics noted: “Sharing data between health care and child welfare systems is vital to help provide the highest-quality and most continuous care possible for children in protective custody.” They outlined the importance of ensuring appropriate agreements are in place between medical care providers and child protective services caseworkers to address data privacy and security, and comply with the Health Insurance Portability and Accountability Act.

A new report from the Data Quality Campaign and the Legal Center for Foster Care and Education also finds that states that share data among child welfare and education agencies have a better chance of lessening some of the barriers foster care students face. The report details which states (currently 24, plus the District of Columbia) securely link K-12 data systems with foster care data systems to provide foster care students with crucial supports like assisting with timely enrollment.

In our modern, data-driven society, we must utilize the tools, including a standardized, national data system to classify, quantify and analyze child abuse and neglect incidents and their outcomes in order to get a clearer picture of children at risk. And, we must bring innovation to the ways in which we share data across multiple systems to ensure that everyone has the information they need to help children succeed.

With the reauthorization of the Child Abuse and Prevention Treatment Act (CAPTA) on the horizon, the federal government has the opportunity to develop national standards for data and data-sharing that can help practitioners have access to the information they need to prevent child deaths before they occur.


Theresa Covington is director of the Within Our Reach office at the Alliance for Strong Families and Communities. She also is the director of the National Center for Fatality Review and Prevention and previously served as a commissioner on the Commission to Eliminate Child Abuse and Neglect Fatalities. This article originally appeared in the Chronicle of Social Change.


Latest Proposal Targeting Immigrants Impacts Families in Need

8/19/2019

By Theresa Covington, director of the Within Our Reach Office at the Alliance

A little known immigration policy called the “Inadmissibility on Public Charge Grounds,” enables immigration officers to determine whether an applicant for a green card or an individual seeking to enter the U.S. on a visa are likely to access welfare, TANF, or other government support. This determination can impact the decision-making in who is allowed to enter the country.

In the past, however, there have been exceptions to the public charge grounds. Because our country believes everyone should have access to basic needs, such as nutrition, health care and housing, use of publicly-funded programs that provide access to these have been excluded from the public charge determination.  Twenty-one states and the District of Columbia have even eliminated the federal five-year waiting period for lawfully residing children and pregnant women allowing them to access both Medicaid and the Children’s Health Insurance Program (CHIP).

That is about to change.

The Trump Administration has proposed an expansion to the list of publicly-funded programs that immigration officers may consider in determining if an immigrant is likely to become a public charge. The list now includes basic needs programs such as Medicaid, Supplemental Nutrition Assistance Program (SNAP), Section 8 housing assistance and federally subsidized housing. The new proposal would also consider any use of a cash assistance program (not just TANF and SSI).

The new rules are expected to take effect as soon as October 15, 2019. It is expected that 8.3 million children will be at risk of losing benefits from Medicaid and the Children’s Health Insurance Program. Five and a half million of these children have serious medical conditions, including asthma, epilepsy and cancer.  Losing benefits will put all of these children at greater risk for bad health outcomes. Is this what our nation wants? 

Imagine if these draconian rules had been in place after the Holocaust when many survivors emigrated to the United States with no family and no money.  People like Elie Wiesel who survived Auschwitz and came to the U.S. in 1956 as a penniless teenager. He went on to author 40 books about the Holocaust and was awarded the Nobel Peace Prize. 

Jan Koum was born in Ukraine and came to the U.S. when he was 16 years old. His family was so poor that they relied on food stamps to eat. Jan went on to found WhatsApp, which was recently acquired by Facebook for more than $19 billion. Koum has donated generously over the years. He donated 12.6 million shares of Facebook to the Silicon Valley Community Foundation between 2014 and 2016. He also gave $114 million of his fortune to the Goldman Sachs Philanthropy Fund in 2016.

We are a nation of immigrants. Our strength is based on our diversity and the uniquely American belief that anyone can succeed and achieve the American Dream. The majority of immigrants come to America with the goal of finding freedom – freedom to work, freedom to care for their families, freedom of religion, and the freedom to live in peace. 

Let’s not lose our compassion and care for all children, regardless of how they arrived in America. Let’s make sure all children living here have the chance to not just achieve the American Dream, but to give back to our nation when they reach adulthood.  And let’s not lose what truly makes America great – our people.

About the Author

Theresa Martha Covington is the director of the Within Our Reach Office funded by Casey Family Programs and housed within the Alliance for Strong Families and Communities. She is the director of the National Center for the Review and Prevention of Child Deaths, a position she has held at the Michigan Public Health Institute since 2003. Formerly, she served as a commissioner on the federal Commission to Eliminate Child Abuse and Neglect Fatalities.  

Celebrating the Reintroduction of the Every Child Deserves a Family Act

6/25/2019

By Theresa Covington, director of the Within Our Reach Office at the Alliance

Within Our Reach applauds the reintroduction of the Every Child Deserves a Family Act, which would prohibit federally-funded child welfare service providers from discriminating against children, families, and individuals based on religion, sex, sexual orientation, gender identity, and marital status. Specifically, the bill:

Prohibits adoption or foster care placement entities that receive federal assistance from using the sexual orientation, gender identity, or marital status of a prospective adoptive or foster parent, or from using the sexual orientation or gender identity of the child, to: (1) deny a person the opportunity to become an adoptive or foster parent; (2) delay or deny the placement of a child for adoption or into foster care; or (3) require different or additional screenings or procedures for adoptive or foster placement decisions, including whether to seek the termination of birth parent rights or to make a child legally available for adoptive placement.

Most importantly, this bill recognizes the historic importance of the federal/state partnership in ensuring all children are protected from abuse and neglect. For child welfare providers, the paramount goal should be to provide safe, stable, nurturing family-centered relationships and environments for all children and youth in the child welfare system. If a child must be removed from their extended family of origin, policies and practices should work quickly and effectively to reunify children with their family of origin, or ensure that strong and healthy family connections can be maintained through a non-relative home.

Child welfare policy must reflect the diversity of our children and our society. With the nation facing a current shortfall in foster care homes, as reported by The Chronicle of Social Change, we strongly support policy decisions that increase the number of opportunities to connect all children with permanent, loving families. This includes ensuring that prospective parents who meet licensing standards are fully considered for foster care placement and adoption.

Currently, there are more than 440,000 children in the foster care system, with over 120,000 of them waiting for a permanent family. More than 20,000 youth “age out” of care each year without any family and with limited support and resources. 

The Every Child Deserves a Family Act will ensure that state-licensed child welfare provider organizations and the public agencies that oversee them will be guided by the universal principle of acting in the best interest of children, regardless of personal and religious beliefs.

About the Author

Theresa Martha Covington is the director of the Within Our Reach Office funded by Casey Family Programs and housed within the Alliance for Strong Families and Communities. She is the director of the National Center for the Review and Prevention of Child Deaths, a position she has held at the Michigan Public Health Institute since 2003. Formerly, she served as a commissioner on the federal Commission to Eliminate Child Abuse and Neglect Fatalities.  

 

About this Blog

The goal of the Within Our Reach blog is to provide actionable advice for child welfare practitioners; a place to discuss policy trends and ideas for policy makers at all levels; and to provide leading commentary for any stakeholders involved in preventing child fatalities due to abuse and neglect.

As a space for conversation, the Within Our Reach Office at the Alliance for Strong Families and Communities welcomes guest submissions from service providers and policymakers.

For questions or more information about guest submissions for this blog, contact us