Evaluating multisystemic efforts to impact disproportionality through key decision points

Working in four communities, Casey Foundation/Center for the Study of Social Policy (CSSP) Alliance on Racial Equity (the Alliance) have developed a Racial Equity Scorecard for measuring disproportionality at key decision points for use in impacting disproportionality in the child welfare system. The four communities include King County, Washington; Guilford County, North Carolina; Ramsey County, Minnesota; and Woodbury County, Iowa. Data from one site--Woodbury County, Iowa--are used as an example. This article provides the background and method for identification and measurement of key decision points in the child welfare system to track change effected by multisystemic approaches to reduce disproportionality. Interpretation of the results in the scorecard is provided and recommendations for future interventions based on the data are discussed.     

Emerging strategies for reducing racial disproportionality and disparate outcomes in child welfare: the results of a national breakthrough series collaborative

Racial disproportionality in child welfare has been discussed as a seemingly intractable challenge with complex contributing factors. Some argue that these dynamics are far too difficult to be significantly impacted by public child welfare systems alone. The Breakthrough Series Collaborative (BSC) methodology, incorporating an analysis of structural racism and potential system bias, was proffered as a tool for engaging public child welfare agencies in a rapid, action-oriented process for identifying innovative strategies and practices to reduce racial disproportionality and disparate outcomes. This article describes the Disproportionality BSC process, as well as the work of participating jurisdictions with respect to transforming organizational culture and testing/implementing child welfare practice improvements. A theory of change is presented and critical lessons learned are shared in the form of collaborative reflections.     

A Three-Pronged Approach to Addressing Racial Disproportionality and Disparities in Child Welfare: The Santa Clara County Example of Leadership, Collaboration and Data-Driven Decisions

Disproportionality and disparities in the treatment of children of color has been a growing concern in the child welfare system. System stakeholders have begun to recognize the problem through data, which help identify discrepancies within their jurisdictions. Nationally, the primary concern is the overrepresentation of African American children within the child welfare system, where African Americans represent proportions of the foster population at a level more than twice as high as they are represented in the community at large. In some jurisdictions, however, this is only one piece of the disproportionality concern. San Jose, for example, has both an overrepresentation of African American and an overrepresentation of Hispanic children in the child welfare system. Because San Jose’s child welfare population is unique, they have had to take a unique approach to addressing these concerns. This article outlines strategies and tools used to begin reducing disproportionality within the child welfare and juvenile dependency court system, using San Jose’s experience as an example. Some of the key approaches to addressing disproportionality include ensuring a systems approach (creating a Cross Agency Systems Team that prioritizes services for parents and children in various systems, e.g., mental health, substance abuse, etc.); addressing disproportionality from multiple perspectives and examining the roles’ of caseworkers, supervisors, service providers, judges, and attorneys; gaining community and system stakeholder buy-in by maintaining momentum and providing opportunities for dialogue about the complex issues facing families of color; using a data-driven approach to inform ongoing initiatives and changes in policy and practice (e.g., closely examining policies and practices such as the frequency of recommendations to by-pass reunification services); and implementing changes in practice at multiple levels including child welfare and on the bench. The examination of San Jose’s approach reveals challenges, successes, and lessons learned.     

Delineating disproportionality and disparity of Asian-Canadian versus White-Canadian families in the child welfare system

ObjectiveThis paper builds upon the analyses presented in three companion papers using data from the 2003 and 2008 cycles of the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS-2003 and CIS-2008) and the Ontario Child Abuse and Neglect Data System (OCANDS) to examine disproportionality and disparity of child welfare involvement for Asian-Canadian children involved in the child welfare system.MethodsThis study used CIS-2008 data adjusted by Census child population data to examine rates per 1000 and three disparity indexes (population-based disparity index [PDI], decision-based disparity index [DDI], and maltreatment-based disparity index [MDI]) to determine the representation of child maltreatment investigations for Asian-Canadian versus White-Canadian children involved in the child welfare system. Logistic regression analyses were conducted to determine the odds of case closure for substantiated child maltreatment investigations, and whether Asian ethnicity remained significant while controlling for child demographics and household composition, case characteristics, and clinical concerns.ResultsThis study found that Asian-Canadian children were underrepresented in the child welfare system compared to White-Canadian children (13.9 per 1000 Asian children in the Canadian population vs. 36.1 per 1000 White children in the Canadian population). Child welfare involvement for Asian-Canadian children are almost 2 times more likely to close after an investigation than White-Canadian children. The three disparity indexes (PDI, DDI, MDI) showed substantially different results with respect to the representation of child maltreatment investigations involving Asian-Canadian versus White-Canadian children for physical abuse, sexual abuse, neglect, emotional maltreatment, and exposure to domestic violence.ConclusionsDisproportionality and disparity are complex phenomena. The variation in results derived from different methods of calculating representation suggests the need for greater clarity and consistency in the definitions and methodology in examining racial disparity in child welfare research. Some methodological considerations for future child welfare research with Asian-Canadian populations were discussed.     

Moving toward cultural competence in the child welfare system

This paper uses a culturally competent (Cross, Bazron, Dennis & Isaacs, 1989) perspective to examine the child welfare system's, namely protective services, response to children of color. The purpose of the paper is to indicate how the absence of cross-cultural considerations in both child welfare policy and practice, limits the effectiveness of service delivery to children of color and their families. Specifically, three key aspects of the child welfare system are addressed: past responses to children of color, worker-client interactions, and child protective service agencies. The paper ends with several recommendations.     

Strategies for improving child welfare services for families of color: First findings of a community-based initiative in Los Angeles

A disproportionate number of families served in child welfare are families of color. But relatively few strategies for helping families of color have been monitored for their impact. This article reports early findings from a Los Angeles County based public child welfare office that has continuously developed, tracked, and has now begun to assess strategies supporting preservation and reunification of families of color. Some promising trends revealed by a four year data period include the reduction of number of African-American children within the caseload, reductions in substantiated referrals and removals. The most recently developed strategy, which uses specialized four person case management teams, was evaluated through the use of a comparison group. Public agency data revealed that families served by the team, compared with families served through customary agency services, had improved outcomes, including a higher percentage of cases closed with the child remaining in the home, and greater permanency exits from foster care. Additionally the data revealed that the case management team developed to mitigate disproportionality among African-American families also improved outcomes for Hispanic/Latino families.     

Broadening Our View

Summary

The growth in child welfare caseloads and the increasing use of kinship foster care has raised new questions about effective permanency planning. The majority of children in kinship foster care are children of color and have been less likely to exit the custody of the child welfare system than children placed in traditional foster care. Permanency planning which ensures the long-term protection and well-being of children from diverse cultural backgrounds requires a broad view of family, ongoing striving for cultural competence, collaboration between the formal child welfare system and the kinship systems of children in state custody, and a long-term view of permanency planning and child-rearing that builds on the case-management capacities of kinship networks to support permanent plans, looks beyond the child's exit from state custody, and helps families and larger kinship systems make long-term plans for the protection, permanence, and well-being of children.     

Comparative analysis of two community-based efforts designed to impact disproportionality

Children of color are overrepresented in child welfare in Iowa at a rate double their percentage of the population. In 2005 the Iowa Department of Human Services implemented two pilot demonstration projects to address overrepresentation of Native American and African American children in the child welfare system. The projects, called the Minority Youth and Families Initiative (MYFI), included ongoing evaluation. Results obtained over two years indicate improved worker and participant alliance, family functioning, and outcomes for children. Findings are discussed and recommendations are provided for further improvements in practice, research, and evaluation to reduce racial disparities the child welfare system.     

Caregivers' Endorsement of Barriers to Mental Health Services for Children and Youth in Child Welfare

The purpose of this study was to examine the three most common types of caregivers in the child welfare system (birth parents, relative caregivers, and foster parents), an active child welfare case, caregivers' endorsement of barriers to mental health services and mental health service use by caregivers for the children under their care. The sample consisted of 430 dyads (caregivers and their children). Results indicate that an active child welfare case, provider characteristics, and accessibility of services predicted mental health service use for children. Implications for the child welfare and mental health systems are discussed.     

Do children in foster care receive appropriate treatment for asthma?

Asthma is the most common childhood chronic disease, and children in foster care have the highest rates of chronic conditions of any studied child population. The purpose of this study is to determine whether there are disparities in asthma management and health care utilization between children in foster care and other children covered by Medicaid in the state of Illinois. We use performance measures developed by the state child welfare system as well as those developed by the National Committee on Quality Assurance and used throughout the country. The study sample was drawn from linked administrative data on children in foster care and paid Medicaid claims. In order to determine the influence of living arrangement setting within the child welfare system, children in foster care were further grouped according to whether they lived in a stable home setting, a stable congregate care setting, or other living arrangement. We found that children living in home settings performed better on most performance measures than income-eligible Medicaid children. In contrast, children with asthma living in congregate care were particularly vulnerable as reflected in poor asthma care measurements and high utilization of hospitalizations despite positive performance on indicators of medication use. This population presents a significant challenge to the child welfare and health care delivery systems.     

Neighborhood racial & ethnic diversity as a predictor of child welfare system involvement

Using U.S. Census and child maltreatment report data for 2052 Census tracts in Los Angeles County, California, this study uses spatial regression techniques to explore the relationship between neighborhood social disorganization and maltreatment referral rates for Black, Hispanic and White children. Particular attention is paid to the racial–ethnic diversity (or ‘heterogeneity’) of neighborhood residents as a risk factor for child welfare system involvement, as social disorganization theory suggests that cultural differences and racism may decrease neighbors' social cohesion and capacity to enforce norms regarding acceptable parenting and this may, in turn, increase neighborhood rates of child maltreatment. Results from this study indicate that racial–ethnic diversity is a risk factor for child welfare involvement for all three groups of children studied, even after controlling for other indicators of social disorganization. Black, Hispanic and White children living in diverse neighborhoods are significantly more likely to be reported to Child Protective Services than children of the same race/ethnicity living in more homogeneous neighborhoods. However, the relationships between child welfare system involvement and the other indicators of social disorganization measured, specifically impoverishment, immigrant concentration child care burden, residential instability, and housing stress, varied considerably between Black, Hispanic and White children. For Black children, only housing stress predicted child maltreatment referral rates; whereas, neighborhood impoverishment, residential instability, and child care burden also predicted higher child maltreatment referral rates for Hispanic and White children. Immigrant concentration was unrelated to maltreatment referral rates for Black and Hispanic children, and predicted lower maltreatment referral rates for White children. Taken together, these findings suggest that racial–ethnic diversity may be one of the more reliable neighborhood-level demographic indicators of child welfare risk across different racial/ethnic groups of children. However, many of the other neighborhood characteristics that influence child maltreatment referrals differ for Black, Hispanic and White children. Consequently, neighborhood-based family support initiatives should avoid a one-size-fits-all approach to child abuse prevention and strategically consider the racial/ethnic make-up of targeted communities.     

Child welfare services and delinquency: the need to know more

This article describes the need for a better understanding of the moderating effects of child welfare services on delinquency. Although juvenile delinquency is a commonly studied issue, researchers have paid little attention to the degree to which child welfare services may be associated with changes in subsequent delinquency rates. Emerging evidence suggests that for certain groups of maltreated children, such as children of color and females, certain child welfare services are associated with variations in risk of delinquent outcomes. The article discusses key methodological, theoretical, and policy implications that help guide further research in this area.     

Using sibling data to understand the impact of family group decision-making on child welfare outcomes

Few studies have examined the impact of family group decision-making (FGDM) on child welfare outcomes. Studies in this area have often suffered from small sample sizes and lack of adequate comparison groups. Since FGDM is administered at the family level, sibling data provides an ideal way to compensate for small sample sizes and low enrollment rates in research evaluating FGDM. This study utilized sibling data from California's Title IV-E Waiver Demonstration Project Evaluation in Fresno and Riverside Counties to compare child welfare outcomes for children of families randomly assigned to receive FGDM (Fresno County, n = 110; Riverside County, n = 87) to children of families assigned to receive traditional child welfare services (Fresno County, n = 74; Riverside County, n = 52). After controlling for clustering effects using general estimating equations (GEE), group differences in child maltreatment, placement stability, and permanence were modeled using linear and logistic regression. Outcomes from both counties suggested no group differences. Though neutral outcomes on child welfare indicators may bring into question FGDM's efficacy for changing child welfare outcomes, this study confirms previous findings with smaller sample sizes on the impact of FGDM and demonstrates a methodological improvement over individual or family-case analyses.     

Improving Relationships in Child Welfare Practice: Perspectives of Foster Care Providers

Foster parents care for our nation’s most vulnerable children and adolescents. Their ability to provide care is impacted directly and indirectly by their interactions with public child welfare agencies and workers. This study examines the perspectives of 1095 foster parents in a southwestern state in the U.S. regarding what they believe child welfare workers are doing well and their suggestions for ways to improve relationships between foster care providers and child welfare workers. Foster parents commended caseworkers who were responsive to their needs and provided ongoing concrete and emotional support, and believed there was a need for improved communication and enhanced teamwork. Foster parents consistently acknowledged an overwhelmed child welfare system and the impact on child welfare workers and child welfare-involved families. Understanding the perspectives of foster parents can improve relationships between child welfare workers and foster parents, improve recruitment and retention efforts of foster parents, prevent disruption of children from foster homes due to license closure, and improve the overall well-being of child welfare-involved children and families.     

Individual and systemic/structural bias in child welfare decision making: Implications for children and families of color

The factors contributing to observed racial disproportionality and disparity in the child welfare system have been the subject of national discourse for decades. This qualitative study used focus groups to engage child welfare and collaborating system decision makers, community partners, and families in a subjective interpretive analysis of racial disproportionality and disparity that had been demonstrated by a previous quantitative analysis of Oregon's child welfare system. Thematic analysis yielded eleven themes from the participant focus groups, four of which clustered around individual and structural/systemic bias and are examined in this paper: visibility bias; cultural bias and insensitivity; personal influences on determination of minimally adequate care; and foster and adoptive parent recruitment and licensing practices. Participants offered recommendations to improve outcomes for children and families of color in light of these observations: increase awareness of bias, create checks and balances in decision-making, contract with and hire culturally and racially diverse professionals, and increase funding for training.     

Race Matters: Child Protection and the Communication Process

It is well-known that, in the United States, African-American children are disproportionately represented in the child welfare system and that disparities in the provision of services exist. The debate over contributing factors to this overrepresentation and these disparities is ongoing as researchers seek explanations and practitioners pursue solutions. This qualitative inquiry finds that within the context of the child protection system and the juvenile court process, racial dynamics emerge between respondent parents and system representatives that may affect the process and, in turn, the outcomes for the thousands of children of color in the foster care system.     

An Appraisal of Fathers' Perspectives on Fatherhood and Barriers to Their Child Welfare Involvement

The present study provides insight into the extent and rationale of fathers' involvement with their children and the child welfare system. This qualitative study explored 12 child welfare–involved fathers' perceptions of fatherhood and factors that facilitate and inhibit case planning involvement. The findings indicate that most fathers strongly desired to stay involved with their children but felt they needed to overcome social workers' negativity, unfair agency policies and practices, and economic difficulties in order to complete their case plan goals and remain in their children's lives. Recommendations are provided for child welfare policy, practice, and research.     

Translating evidence-based treatments into child welfare services through community-university partnerships: A case example of parent-child interaction therapy

Children served by the child welfare system count among society's most vulnerable members given their history of abuse, neglect, and other potentially traumatic experiences. Once they enter the system, however, these children seldom receive empirically validated interventions to mitigate the effects of trauma. This article highlights the promise of parent-child interaction therapy (PCIT), an evidence-based treatment (EBT) for trauma-exposed children in the child welfare system. Barriers to implementing PCIT and other EBTs in child welfare are discussed along with ways that community-university partnerships can help to navigate these barriers. Preliminary supporting evidence from a community-university partnership in Wisconsin is presented, followed by a set of recommendations for future work aimed at translating science into practice.     

Developing collaborations between child welfare agencies and Latino communities

Collaborative efforts to achieve permanency planning and family stability for all children in the child welfare system are increasing. As Latino children and families constitute the fastest growing ethnic group in the child welfare system, it is important to understand how to develop culturally sensitive collaborations with their communities. The purpose of this article is to suggest helpful guidelines for developing collaborations between child welfare agencies and Latino communities.