CHAPTER
7
Multi-Tracking:
A Differential Response System
Currently,
there is a national trend away from the "one-size-fits-all"[138]
system of dealing with cases, towards a differential, customized
response to reports of child abuse and neglect.
In 1988,
the National Association of Public Child Welfare Administrators
concluded that child protective services was in need of
reform and called for a three-tiered system of response.
Such a system would narrow the focus of child protective
services to the more serious cases, expand family support
systems, and introduce an adequately funded child well-being
system.[139]
The
goals of reform were to create a system that could quickly
protect child victims of abuse and neglect, while also providing
services to support at-risk families so that their children
could remain at home. By working to support families before
risk factors resulted in serious abuse or neglect, families
would be more cooperative, less defensive, and more open
to participating in services. In turn, children would be
better protected.
Child
protective services would retain primary responsibility
for the most serious cases of abuse and neglect, while other
community resources would play an active supporting role.
Likewise, in less serious cases, community resources would
have the primary responsibility, but would also draw on
other partners on a case-by-case basis.[140]
Since
1990 several states have led the way in reshaping their
child protection systems to reflect a differential response
to reports.[141] Over ten state legislatures have moved
in this direction, including Arizona, Florida, Hawaii, Iowa,
Kentucky, Missouri, Nevada, North Dakota, Texas, and Virginia.
These
states recognize the unique opportunity their systems have
to identify families at risk of abuse or neglect before
maltreatment happens.[142] They have come to realize the
limitations of making a single state agency solely responsible
for delivering services to families reported for abuse and
neglect. We describe below the experiences of two states.
Missouri's
Dual-Track Approach
In 1994,
Missouri developed a new strategy to deal with the overwhelming
number of reports entering its system. The underlying principle
behind reform was that families entering the Division of
Family Services (DFS) had differing needs and required flexible
responses from the state and the community. DFS implemented
a dual track system where reports would either be triaged
to "Investigations" or referred to "Family Assessments."
Missouri's
system distinguishes between criminal maltreatment and maltreatment
due to social malfunctioning within the family system.[143]
Cases involving serious physical and emotional abuse, and
all cases of sexual abuse, which require law enforcement
intervention, are sent to the Investigations track. Cases
of mild physical abuse and neglect are handled by Family
Assessments.
In the
latter track, the caseworker determines the degree of risk
to the child, assesses the family's need for assistance,
and collaborates with community partners to support the
family. There is minimal lag time between initial contact
with the family and intervention because of partnerships
with community resources, such as schools and churches.
The services provided by community agencies address underlying
problems in the family, and are not focused uniquely on
the incident of the report. Such an approach helps the family
face its problems in a non-threatening and productive manner.
This
collaboration has helped DFS quickly increase the number
of people and resources available to serve children and
families, without having to increase its own staffing levels.
The method has reduced the caseload burden for DFS workers
without compromising child safety.[144]
The
dual track pilot program was observed to be beneficial in
many other aspects, as well. A 1998 evaluation of the system
by the Institute of Applied Research revealed many positive
effects:[145]
- Hotline reports declined;
- Reported incidents in which action was taken increased;
- Children were made safer sooner;
- Recidivism decreased overall;
- Children spent less time in out-of-home care though
removal rates remained the same;
- Services were delivered more quickly;
- Utilization of community resources was greater;
- Cooperation of families improved;
- Families were more satisfied and felt more involved
in decision making;
- Caseworkers judged the system to be more effective;
and,
- Investigations were not adversely affected and may
have been enhanced.
Overall,
the Missouri dual track system, and others like it, demonstrate
that the safety of children and the well-being of families
are better safeguarded in a system where:
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The
response to families is immediate, i.e. there is no
lag time between the initial contact with the family
and intervention.
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The
worker approaches the family with sensitivity to the
underlying family problems and conditions, not just
the particular incident of abuse or neglect.
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The
worker's attitude is positive and supportive, rather
than accusatory or punitive.
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Local
agencies are actively involved in a collaborative
effort with the child welfare agency to support the
family and the children.[146]
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The
Federal Mandate: The Adoption and Safe Families Act (ASFA)
In
November 1997, the federal government built upon the experience
of professionals and the reform-oriented states with the
enactment of Public Law 105-89, entitled the Adoption and
Safe Families Act (ASFA). This act was the first federal
legislation to emphasize child safety as a top priority
over all other social policy issues.[147]
Impetus
for the law was generated by a number of highly publicized
child deaths, the increasing number of children in care
of child protective services (more children entering each
year than exiting), and the belief that many states were
emphasizing family preservation at the expense of child
safety. Central themes of the law include:
- Safety of the child is the paramount concern.
- Foster care should be temporary and short term.
- Permanency planning should begin as soon as the child
enters care.
- Services to promote reunification should be provided
more quickly and intensively.
- Focus should be on results and accountability, as opposed
to the process.
- There should be an increased emphasis on parental responsibility.[148]
Proposal
for a Multi-Track System for Massachusetts
The
following proposed multi-track system for Massachusetts
would assist the state to comply with the provisions of
ASFA described above. Both seek to ensure the well-being
of children in the timeliest manner. Both seek an approach
to cases that takes into consideration the overall environment
of the child, and not just the presenting problem.
After
reviewing response models in other states, Summit Work Groups
agreed that a differential response system could address
inadequacies in the current Massachusetts system. However,
the Groups determined that a multi-track, rather than a
dual-track, system in Massachusetts. would lead to more
appropriate investigations, assessments and services.
The
diagram of the Proposed
Multitrack Assessment Model outlines some key features
of the proposed multi-track system.
click
to see full-size model
Under
this model, all "51A" reports would be assessed by DSS at
intake to determine the most appropriate track. This initial
assessment would include: interviews with the reporter of
the 51A, the child, siblings, parents, and the suspected
abuser; an observation of the child's environment; an observation
of the interactions among family members; and an analysis
of the collected information to reach a determination about
the child's safety and the validity of the report. Once
the child and family have been triaged into the appropriate
track, they would participate in an assessment to determine
appropriate services or supports.
Screened
Out Cases
If
after investigation a report is found to be unsubstantiated
or not supported, it will likely be screened out. A child
would be deemed safe if "an analysis of all available
information leads to the conclusion that the child, in
the current living arrangement, is not in imminent danger
and that no safety interventions are needed."[149] Such
a case would include one where the perpetrator is no longer
a threat or the original claim is deemed invalid. Even
in such an unsubstantiated case, however, the child may
have experienced some degree of abuse or neglect or inadequate
parenting, and the family may be receptive to participating
voluntarily in services at the community level.
Cases that do not meet the legal criteria to be screened
in and investigated can also involve at-risk families.
Under the proposed model, these screened out families
would no longer be turned away without help, but would
be directed to other more appropriate resources in the
community. This would reduce the likelihood of future
reports to DSS that could be generated if, without intervention,
family problems worsened and children were more seriously
harmed.
Families described above would be referred to local family
support collaboratives, i.e. "Community Connections" sites,
where they would be assisted by site coordinators and,
if appropriate, Family Support Teams that would help them
identify and address problems. All such services would
be offered on a voluntary basis. (For a description of
"Community Connections," see Chapter 16.)
Effectively addressing screened out and unsubstantiated
cases within a multi-track model cannot be accomplished
without a strong network of family and community supports
across the state.
Low
Risk Cases
After
investigation, some cases are screened in as "low risk.
Under the proposed multi-track model, these least serious
DSS cases could also be referred to local family support
collaboratives and Family Support Teams for assessment
and services. Community workers trained in the principles
of strength-based family support would help families in
the selection and delivery of local services and, when
appropriate, coordinate family conferencing through the
help of Family Support Teams. DSS would have minimal involvement
and case management, if needed, could be provided by identified
local agencies. This would allow DSS to expend its caseworker
resources on more serious cases.
Moderate
risk cases
The
moderately serious cases that involve reasonable risk
of harm would be referred to the DSS Multidisciplinary
Assessment Teams (MDATs). These teams would be responsible
for determining whether the child should be removed from
the home, or what other measures might be taken to reduce
the level of risk.[150] MDAT reviews would be conducted
by workers trained in the principles of strength-based
family support, and involve other professional disciplines
to assist in the assessment process. A statewide system
of MDATs currently exists in nearly all of the DSS Area
Offices.
Serious
Risk Cases
The
most seriously at-risk children involved in sexual abuse
and serious physical abuse and neglect would be referred
to Children's Advocacy Centers (CACs). The CAC system
would most resemble the traditional investigation system,
and would in most cases involve law enforcement agencies,
and the courts. Medical evaluations would be conducted
by pediatric experts trained in child abuse and neglect
who would operate within hospital-based Child Protection
Teams (CPTs). CPTs could function independently, but would
be collaborating members of local CACs, essentially serving
as their medical arm.
A full
discussion of MDATs, CACs, and hospital-based CPTs can be
found in Chapter 8.
The
system would have flexibility so that a case initially screened
into one track could be shifted into another if new information
or developments warranted that move. In this new system,
services would be provided to a much greater number of families
and children and DSS could focus its resources more efficiently.
RECOMMENDATIONS
- Establish a Multi-Track System in Massachusetts
to deal differentially with more serious and less serious
cases of abuse and neglect.
Low risk DSS cases, screened-out reports and cases deemed
unsubstantiated after investigation would be addressed
more appropriately by referral to community-based family
support collaboratives. There family support coordinators
and Family Support Teams would be available to assist
families in identifying needed services from among a range
of local resources. This triaging would address for the
first time the high percentage of families and children
reported to DSS who are screened-out without services.
It would reduce DSS involvement in less serious cases,
allowing the Department to use its resources efficiently
on more serious child protection issues.
Moderately serious cases would be referred to the DSS
Multidisciplinary Assessment Teams (MDATs) where DSS workers
and community professionals would work together to assess
cases, address child placement issues, develop service
plans, and link families to specific services.
The most serious cases, including those involving the
courts, would be referred by DSS to local Children's Advocacy
Centers. There the child and family would benefit from
multidisciplinary assessments, including forensic interviewing
and psychosocial evaluations. Treatment and case management
services would also be provided. Referrals would be made
for specialized medical evaluations through hospital-based
Child Protection Teams working in collaboration with CACs.
- Properly assess all cases entering the system and
ensure families a central role in this process.
Assessment must be the first response of any quality child
protection system. Without a solid understanding of the
multiple and interacting issues confronting troubled families,
case practice is undermined and cannot result in appropriate
and effective service planning. All cases, irrespective
of their level of presenting seriousness, would benefit
from an assessment conducted by a CAC, a DSS-based MDAT,
or by a Family Support Team in the community. Involving
families directly in the process of assessing the issues
and needs they face must be honored at every level.
- Make services available to all families who seek
them, not only when a child is at risk of immediate harm.
Children and families must have access to services when
concerns are of a less serious nature so that future harm
can be prevented. A comprehensive and expanded family
support system operating at the community level must be
implemented in order for multi-tracking to succeed.
- Strongly encourage and adequately support collaboration
among agencies and disciplines.
Collaboration among child protective services, law enforcement,
medical providers and child welfare agencies should be
coordinated centrally, through a statewide mandate, with
sufficient resources, support, and quality assurance.
The needs of children and families should be the driving
force behind freer information sharing and collaboration
among agencies and individuals.
- Support population-based funding among state agencies
involved with meeting the multiple needs of abused/neglected
children.
Services need to reflect the needs of the populations
served. Linking parents and children to services that
are available but that are not appropriate is grossly
ineffective and wasteful. "Wrap-around services" typically
will serve children by using funds from various agencies
to better address identified needs.
- Incorporate within social worker training the skills
to conduct strength-based assessments.
Workers must be trained to identify and nurture family
strengths, rather than focusing primarily on family weaknesses.
Even for professionals experienced in working with families,
a reorientation about the appropriate roles for families
and professionals must be included. The role of the professional
in a community family support system can be transformed
from that of director and producer of change to a resource
and facilitator of change.[151]
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Section
III: Protecting Our Children
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