Sites in National Initiative Work Toward Building a Child and Family Well-Being System

4/15/2021

By Amy Templeman, director of the Within Our Reach Office

April is Child Abuse Prevention Month, a time for communities to come together to build caring connections, supportive environments, and positive experiences for all children. This year’s theme is “Every day, we help positive childhood experience take root!” 

Science shows us that positive childhood experiences in nurturing environments provide fertile ground for physical and mental health, learning, and social skills to flourish.  Enabling these positive childhood experiences requires that we reimagine child welfare and focus instead on child well-being with upstream resources that can prevent child abuse and neglect before it occurs.

The Family First Prevention Services Act, which was signed into law as part of the Bipartisan Budget Act on February 9, 2018, was an important step toward realizing this goal. By emphasizing prevention, early intervention and evidence-based practices for children and families, Family First is helping shape the future of child and family well-being systems based on a public health approach.

What do policies to build a child and family-well being system look like in practice? Answering that question is the impetus behind a new national demonstration initiative to address child fatalities and injuries from maltreatment launched by the Department of Justice’s Office for Victims of Crime. The initiative features five sites selected across the nation, including Cook County Health in Illinois; Indiana Department of Health; Michigan Department of Health and Human Services; St. Francis Hospital in Hartford, Connecticut; and Sacramento County, California’s Child Abuse Prevention Council.  

The project launched a year ago with each site conducting retrospective reviews of at least five years of fatality review data to identify families who could benefit most from supportive services. Based on that data and informed by a community needs assessment to identify areas of opportunity for improved services and response, each site has developed an implementation plan targeted to a specific focus.

The following summarizes the implementation focus for each site:

  • Cook County Health in Illinois – Based on a data review of Cook, Peoria and Vermillion counties, as well as data released in the annual Office of the Inspector General report, they will focus on community awareness programs targeting unsafe sleep practices and coping with infant crying. They will also work to improve They will also work to improve systems and training to support earlier detection of families in need of support. Their efforts will help to normalize and destigmatize parents seeking help and foster collaboration among community leaders by opening new opportunities to work together to strengthen multidisciplinary teams.  
  • Indiana Department of Health – Based on research conducted over the past year in four target counties, Clark, Delaware, Grant and Madison, unsafe sleep-related deaths were the leading cause of death due to external cause for children ages 0-18 years old, when excluding medically expected fatalities. Based on this data, they will focus on local safe sleep interventions. Child Fatality Review teams and community stakeholders will have the opportunity to engage with training in such areas as trauma-informed care, social determinants of health, inter-state record sharing, and death investigation training. They will also focus efforts on a one-year research plan to increase knowledge around unsafe sleep behaviors in the state of Indiana. 
  • Michigan Department of Health and Human Services – With input from an advisory panel, they will employ a collective impact approach to enhance the level of services for families in need of support and improve safety planning across Michigan’s child protection system. To improve the level of services for families, they will examine outcomes of current policies and practices related to families with low or moderate risk for child maltreatment to identify change recommendations. They will also partner with statewide or regional outreach efforts that focus on protective factors and work to promote these services to families. Finally, they will review current safety planning practices, assess the perceived needs, barriers, and facilitators to safety planning among child protective services (CPS) workers and other professionals, and assess the perceptions of safety plans among persons with lived experience. Collectively, this information will be used to identify areas for practice change and inform the development of educational resources and supports to reinforce safety plan best practices. 
  • St. Francis Hospital in Hartford, Connecticut – They have established a stakeholder group, composed mostly of community- based organizations and community leaders, who will work with leadership of State and municipal agencies, elected officials, medical and other service providers to improve systems and practices to support healthy families and children.  This model is unique among the demonstration sites because the lead agency is a community-based organization. They are working to integrate community leaders with decision-making agencies such as CPS, law enforcement, the courts, etc. As part of their sustainability plan, St. Francis Hospital has committed to support the project for ten years with a focus on establishing a more standardized data collection and analysis system; improving cooperation between community members and agencies responsible for child protection; and, ultimately, significantly decreasing repeated child maltreatment and injury.
  • Sacramento County, California’s Child Abuse Prevention Council – Based on a 10-year analysis of data, they identified several common risk factors across families, including poverty, parental crime and drug history, sibling child welfare history, and certain child and parental characteristics such as child age, age of mother at birth, child welfare history, and substantiated abuse/neglect history. Based on this data, the Sacramento County Prevention Cabinet has developed a model for a coordinated response using collaborative partnerships and data to inform and implement a strategic plan to eliminate child abuse and neglect deaths and critical injuries in Sacramento County by 2030. Strategies and corresponding actions will focus on building community partnerships through continued data collection and analysis of risk and protective factors; supporting trauma informed systems and practices through the expansion of collection, analysis, and review of data regarding risk and protective factors; promoting community, parent, and youth voice by engaging members of the community with lived experience; embedding equity into all aspects of the implementation plan; and advancing work on community resource education and cross-referrals to ensure strengthening of the referral process.

Each site is working with a collaborative body of stakeholders and partners, including those with lived experience, to guide the work. All sites are reviewing short and long term goals through an equity and diversity lens. The sites are supported in their efforts by a broad range of technical assistance providers led by the Within Our Reach office at the Alliance for Strong Families and Communities and Council on Accreditation.

“We know from the work of the federal Commission to Eliminate Child Abuse and Neglect Fatalities that child abuse is not inevitable,” noted Stacy Phillips, DSW, and a program specialist with the Office of Victims of Crime. “We also know that child protection agencies cannot do this work alone. Through this initiative we hope to examine what works and help build a knowledge base about the impact of a multidisciplinary approach to child and family well-being that engages a broad range of stakeholders working jointly to strengthen families and ensure the well-being of all children.”

As we celebrate National Child Abuse Prevention Month, let us not forget that addressing community needs by giving families support prevents traumatic events from happening, has much more impact, and costs much less, than attempting to address the consequences of adversity after a child has grown up. We all have a stake in our kids’ future. Let’s plant those seeds today.

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Amy Templeman is director of the Within Our Reach office at the Alliance for Strong Families and Communities. Within Our Reach is supported by Casey Family Programs.

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.  

 

For Child Welfare Advocates and Leaders, It’s Not Just What You Say, It’s How You Say It

3/31/2021

By Amy Templeman, director of the Within Our Reach Office at the Alliance/COA and Julie Sweetland, sociolinguist and senior advisor at the FrameWorks Institute

With the final deadline for implementation of the Family First Prevention Services Act coming in October, child welfare policymakers and practitioners are looking to how best to utilize title IV-E funding for a range of prevention services, including mental health, substance abuse, and in-home parent skill-based programs for children or youth who are candidates for foster care.

When communicating prevention policies to the public, to media and to stakeholders, challenges emerge. They are notoriously hard to communicate since the results are abstract. How do you quantify, for example, abuse or other problems that didn’t occur? 

Framing scientists are seeking to answer that challenge by changing the way we talk about child welfare. 

In 2004, Prevent Child Abuse America commissioned the first framing study on child abuse and neglect, in part because the strategy of using emotionally evocative stories of abuse and neglect had run its course. Today there is a need for a new framing around prevention as we look to remodel “child welfare” systems into “child and family well-being” systems. We are also reckoning with the evidence of systemic racism in child protective services – such as the harsh reality that children of color are more likely than white children to be removed from their families and placed in foster care – and we are working with communities to design approaches and systems that live up to the ideal of racial justice. 

To make the case for strategies that ensure that every child grows up in safe and nurturing environments, we must widen the lens to depict the factors that shape those environments.
This includes acknowledging that all families face adversity from time to time, as the current pandemic has so exemplified. It means being clear that financial stability is an essential part of weathering any of life’s storms – and that many in our country struggle to keep themselves afloat as income inequality only widens. 

It involves lifting up policy solutions like the proposed new expansion of the child tax credit, expanded childcare subsidies, and family-friendly workplace policies, such as consistent and flexible work schedules and paid family leave. It asks us to become more fluent and more forward in talking about how many child welfare interactions are symptoms of a flawed economy and a lack of conditions that support families, not evidence of a flawed family.  

Focusing on economic issues can’t be a substitute, however, for speaking directly to issues of racial justice. The two are related, but they shouldn’t be conflated. To do so would risk missing issues like implicit bias or the disparate racial impact of child welfare policies. In “centering race,” it’s not enough to merely point out disparities, as it leaves room for audiences to assume that the problem lies somehow with people of color. It means explaining the links between a history of injustice, contemporary systems and practices, and the effects on children and families. Framing science shows that when advocates make these connections clear, it increases and broadens support for policies aimed squarely at eliminating racial disparities.

In addition to widening the lens, we need to bring prevention into crisper focus, using that clarity to disrupt the assumption that child abuse and neglect – or its worst outcomes – are bound to happen. As Dr. David Sanders, chairman of the federal Commission to Eliminate Child Abuse and Neglect Fatalities noted in his forward to the Commission’s seminal 2016 report: “Child protection is perhaps the only field where some child deaths are assumed to be inevitable, no matter how hard we work to stop them. This is certainly not true in the airline industry, where safety is paramount and commercial airline crashes are never seen as inevitable.” 

We need ways to reframe child abuse and maltreatment fatalities as a preventable public issue, and, most importantly, a solvable one.

We can increase support for prevention by emphasizing the connection between now and later – and by giving concrete, realistic examples of what prevention looks like in action. It is equally important to emphasize that solutions exist and to champion programs that work. The body of evidence-based practices is still growing, however, there are resources that currently exist to help support families in times of need. These include community-based child abuse prevention programs, such as home visiting programs and Family Resource Centers .

Most of all, we need a common commitment to aspirational, solutions-oriented storytelling that moves mindsets beyond narrow conceptions of “problems children experience” to an expansive vision of how to do right by kids. To build a broader constituency for those approaches, the story we tell must spark a sense of collective responsibility and offer a sense of realistic hope.

One of the most challenging aspects of communicating a solutions-oriented, preventive message around child welfare is the way in which media outlets cover this topic. Many media outlets cover child welfare primarily through a crime lens that focuses on the consequences of harm after it occurs. Since the start of the COVID-19 pandemic, we have seen increasingly hyperbolic stories about the dangers to children who are out of the public eye, most of which speculate on what to make of the fact that calls to child abuse hotlines are down substantially

These stories fit neatly with the larger cultural narrative of vulnerable children, but they are misleading. Experts know that reduced referrals do not tell us the whole story, nor is it fair to say that children are necessarily at higher risk while they are home with their families. In fact, research by Mathematica shows that it is mostly the low-risk referrals that have decreased during the pandemic; the high-risk referrals are still coming through.

As child welfare advocates, we must work to educate and guide journalists on covering child welfare stories from a preventative, public health perspective that highlights resources and solutions that will benefit families in need of support. 

If our field can successfully embrace a common narrative – one that emphasizes that we all have a stake and a role in addressing this issue – we will continue to build critical public support for the momentous shift from child welfare systems to child and family well-being systems that can enable all families to thrive.

Access the Reframing Childhood Adversity: Promoting Upstream Approaches webinar. This webinar will delve into newly released guidance from the FrameWorks Institute for building the public understanding and political will needed to effectively prevent, identify, and address childhood adversity.

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Julie Sweetland, PhD is a sociolinguist and senior advisor at the FrameWorks Institute. Amy Templeman is director of the Within Our Reach office at the Alliance for Strong Families and Communities. Within Our Reach is supported by Casey Family Programs.

A version of this article previously appeared in The Imprint on March 16, 2021.

 

Former Foster Youth Informs DOJ Initiative to Address Child Abuse and Neglect

2/24/2021

by Amy Templeman, director of the Alliance’s Within Our Reach Office

An essential resource for professionals in the child welfare field are the voices of those with lived experience who are willing to share their stories. Matthew Peiffer in Indiana is one of those heroes. Matthew’s resilience in the face of tremendous adversity has given him the passion and drive to speak out for system reforms even after facing some of the most challenging life circumstances. 

Matthew Peiffer and his two sisters were adopted at a young age. Their adoptive parents abused them physically and sexually for almost thirteen years. When they were finally removed from their adoptive parents, they were placed into separate foster care homes and institutions. Matthew, who is now 23 years old, aged out of the foster care system. His younger sister Emily did not make it out. She died by suicide at age 18.

The experiences of Matthew and his sisters are horrific and tragic and are shared by too many children in the child welfare system. In its groundbreaking report released in 2016, the federal Commission to Eliminate Child Abuse and Neglect Fatalities noted that, on average, between 1,500 and 3,000 U.S. children die from maltreatment every year. These numbers have remained constant for years because for too long, our systems have been geared to addressing child abuse and neglect only after harm has occurred.

A new and innovative demonstration initiative is aiming to change that. Child Safety Forward, supported by the U.S. Department of Justice, includes five sites across the nation who are utilizing comprehensive and evidence-based strategies to identify those children most at risk and develop targeted steps to strengthen supports and address those risk factors.

A key element to the strategy is the integration of the voices and experiences of youth and families involved with child welfare. 

As Jerry Milner, associate commissioner of the Children’s Bureau recently noted: "Young adults with lived experience are the experts in the child welfare system. Any meaningful change in the child welfare system must happen with youth and young adults as our partners.”

Matthew is one of the young adults helping provide that important perspective. He serves as a member of the Advisory Council for the Indiana Department of Health (IDOH), one of the five sites for the Child Safety Forward initiative. His experiences and perspective have been a valuable tool in the development of IDOH’s implementation plan to reduce child abuse and maltreatment.

For example, Matthew shared details of attempts that he and his sisters made to reach authorities to let them know of the abuse they were experiencing. As young children they were often locked in their rooms for hours and deprived of food. They were home schooled and rarely encountered other adults. Matthew would sometimes call 911 and hang up. He also managed to get out and vandalize his adopted parents’ car with the hope that the police would notice their plight and take them away. In both cases, law enforcement would show up but wouldn’t enter the house and would only talk to the children with the parents present, so there was no chance for the children to seek help.

In response, Matthew is providing training seminars for law enforcement today on what to look for when visiting a home where abuse might be suspected.
 
Matthew has also spoken out about the need for better data to address children at risk, a strategy which is receiving emphasis in Indiana’s plans for Child Safety Forward. As IDOH notes in its draft implementation plan, “The lack of standardization in investigation practices, including incomplete investigations, limits our understanding of the causes and circumstances related to child maltreatment related fatalities, Sudden Unexpected Infant Deaths (SUIDs), and youth suicide. It also leads to incomplete and inconsistent data. Quality and accurate data allow us to better understand and address risk factors.”

IDOH’s efforts to collect and analyze data, bring in the voices of those like Matthew with lived experience, and work collaboratively across the community to develop new models for addressing child fatalities and serious injuries from maltreatment will provide what has been sorely lacking in previous attempts – the identification and evaluation of evidence-based practices. 

Coupled with the federal government’s focus on preventing foster care and requirement of statewide 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 tragedies like those experienced by Matthew and his sisters.
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Amy Templeman is director of the Within Our Reach  office at the Alliance for Strong Families and Communities. Within Our Reach is supported by Casey Family Programs. A version of this article appeared on February 3, 2021 in Youth Today.

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.

 

A Conversation on Race and the Child Welfare System in the United States

12/21/2020

By Regina Dyton

Since the nation witnessed the murder of George Floyd at the hands of members of law enforcement, it has been hard to contain the sorrow and  anger. As he called out for his deceased mother, he spoke to every mother across this nation who has struggled to keep her child safe. As a Black mother of an incarcerated son, I am tired and scared to stand witness to yet another generation of children and grandchildren who must learn to navigate the racial prejudices that infuse our systems. 

And, while it is clear that this issue extends far beyond law enforcement, any dialogue about how we move forward must acknowledge the fact that systemic racism across all of our systems is interconnected and interwoven.

What child of an African American mother hasn’t heard the phrase: “I’m beating you now so the cops don’t kill you later.” Too many Black and brown parents believe that teaching our children compliance without question can save our sons from being taken from us by police through imprisonment, permanent injury, disability or outright murder, like the knee to the neck that took George Floyd. “That boy better learn to listen!” 

It is with anguish and desperation that we seek to impart submission into our children early on. In doing so, we prepare our children for servitude while others prepare their children for leadership.   

A 2015 Pew Research survey found that Black parents are more than twice as likely as white and Latino parents to use corporal punishment on a regular basis. Many believe it is a tradition that has its roots in slavery, with enslaved Black mothers and fathers preferring to beat their child rather than allow the slave owner and his overseers to beat them. I find it appalling, but understandable on some level, that descendants of one of the cruelest examples of slavery in world history would pass the beatings on. 

This is clearly also one of the root causes for the disparities we see in the child welfare system. There is no question that racial bias exists in Child Protection Services. A parent of color is more likely to be reported for abuse or neglect, that report is more likely to be substantiated, and that child more likely to enter the foster care system.

In fact, according to The Imprint’s Foster Care Capacity website, while African Americans make up 9.8% of the population in Connecticut, they represent 22.5% of the population of youth in foster care. 

Once in that system, that child is more likely to be exposed to situations and environments leading him to trouble with the juvenile justice system. The juvenile justice system is too often a road to the adult criminal justice system. Every step on that road is life threatening. 

Challenging the negative definitions and images we have been given of ourselves and working to heal internalized racism is one critical step to reducing the number of children of color fed into child protective services.

That is one of the key goals of the St Francis Hospital and Medical Center/Trinity Health of New England’s participation in the Child Safety Forward initiative. Funded through a grant from the U.S. Department of Justice, Child Safety Forward is a demonstration initiative across five sites to develop multidisciplinary strategies and responses to address fatalities or near-death injuries as a result of child abuse and neglect. Our site is primarily focused across the Hartford, Connecticut, region.

The challenges we face include socioeconomic conditions across our region that include poverty, racially segregated communities, and inadequacies in data collection and reporting that have led to a reactionary rather than proactive approaches to child safety. Ultimately, we hope to utilize a population health approach to reduce the rate of repeated child injuries and fatalities in Hartford, which is currently two times the national average.

The effort will include a collaborative approach involving grassroots neighborhood organizations, caregivers, health professionals, researchers, foundations, state agencies and others to eliminate health disparities in communities served by St. Francis Hospital and Medical Center. And, it will include a conversation across communities about the systemic racism that impacts families of color and how we can engage all voices and all lived experiences to bridge the gaps and disparities that have resulted.

These issues may not be solved overnight. But I am encouraged that the dialogue is real, that the voices speaking out are loud are multi-cultural and united in the call for change.

For every Black mother of a newborn who, like me, whispered into my baby’s ear, “I will not lose you to the police, I will not lose you to prison, I will not lose you to the law enforcement system,” know you are heard.

Child abuse and neglect is not inevitable. It is our responsibility as a society to tackle these hard issues and ensure that all children have the opportunity to grow up in an America that represents equity, inclusion, diversity and most of all, hope.


Regina S. Dyton is director of community health and well-being for Trinity Health of New England and project director of the Child Safety Forward Initiative in Connecticut. This article originally appeared in The Imprint on Dec. 6, 2020.

New Report From Within Our Reach Tracks National Efforts to Transform Child Welfare Systems

11/4/2020

Within Our Reach released a new report today entitled “Transforming Child Welfare Systems to a 21st Century Model that Strengthens and Supports Families and Communities: Innovations from the Field,” authored by Teri Covington, former director of the Within Our Reach office and funded through support from Casey Family Programs (CFP).

Within Our Reach is an office of the Alliance for Strong Families and Communities that was established to further the recommendations of the federal Commission to Eliminate Child Abuse and Neglect Fatalities (CECANF). In a 2016 report, the commission called for fundamental reforms in the child welfare system including: “A comprehensive public health approach premised on the importance of strong, integrated, and collective responsibility and coordinated action and measurement across agencies and states and within our communities.”

Significant progress has been made in the four years since the commission’s report toward transforming child welfare into 21st century child and family well-being systems that focus on preventing child abuse and neglect and strengthening families. 

Over the past several years, a number of convenings have taken place featuring transformational leaders across the child welfare ecosystem. Organized by CFP, in partnership with the U.S. Administration on Children, Youth, and Families (ACYF), the Centers for Disease Control (CDC), the Association for State and Territorial Health Officials (ASTHO) and American Public Human Services Association (APHSA), these convenings have helped coalesce leaders around a common vision and an improved understanding of a public health approach to child welfare.

This recently released report provides a framework and description of a prevention-aligned, public health approach to child welfare and provides some examples of innovations states and communities are implementing in their efforts to become a 21st century model of child welfare. Many of these innovations are based on the recommendations of CECANF and the frameworks being developed through the CFP convenings.

Some of the examples of community and state efforts towards a more family-supportive, public health approach to child welfare include: 1) Establishment of a network of Family Resource Centers (FRCs) in San Francisco, CA that provide a community-based resource hub for families needing to access formal and informal supports that promote health and well-being; 2) A Maricopa County, AZ effort to establish the Safe Babies Court Team™ approach first developed by the national organization, Zero to Three, that transforms child welfare into the practice of child “well-being” by using the science of early childhood development; 3) The Housing Opportunities Made to Enhance Stability (HOMES) initiative in Milwaukee, WI, which promotes stable, healthy, and affordable homes that provide a foundation for well-being and prosperity for children, families and communities.

Click here for more information and to access the full report.

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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.

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