Should This Family Be Reunified Child Safety DecisionMaking Following OutOfHome Placement

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Should This Family Be Reunified?Child Safety
Decision-Making Following Out-Of-Home Placement

• A Presentation for the 2007 Dependency Summit for
  Floridas Protection Communities
  
• By
• Barry Salovitz, MSW
• Judge Kathleen A. Kearney (Ret.)

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• Think of the last case you had where
  reunification was in issue.
  
• Now, answer these questions. and
• BE HONEST!

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How comfortable are you with the recommendation
or decision you made?

• Have you ever had a child under your
  supervision/jurisdiction return to substitute
  care after reunification?

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No matter what your job is

• The Safety,
• Permanency, and
• Well-Being
• of those we serve is the responsibility of all of
  us
  

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Goals of Todays Presentation

• As a result of attending this presentation you
  will
  
• Learn what current literature tells us about
  reunification and repeat maltreatment
  
• Learn about an evolving safety construct which
  will help you make better decisions on behalf of
  children and families

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Look at the Numbers

• 1 out of 4 children who goes home, returns to
  foster care
  
• Slightly less than 70 of children who returned,
  did so within a year of reunification
  
• 57 returned within 3 months of reunification
• Chapin Hall, University of Chicago
• Multistate Foster Care Data Archive

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Predictive Factors of RepeatMaltreatment

• Prior history of CPS reports
• Type of maltreatment neglect, more likely
• Age of child younger, more likely
• Number of children in the home more children,
  more likely
  
• Family income lower, more likely
• Parental substance abuse
• Child vulnerability/disability
• T.L. Fuller, Child Safety at Reunification A
  Case Control Study of Maltreatment Recurrence
  Following Return Home from Substitute Care,
  Children and Youth Services Review, March 2005.

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Fuller Study

• Published in late 2005, this study looked
  specifically at families post-reunification
  
• Controlled study of 174 families in Illinois
• Examined factors predicting short-term (defined
  as within 60 days) maltreatment recurrence
  
• Looked at administrative data and reviewed case
  records
  
• T.L. Fuller, Child Safety at Reunification A
  Case Control Study of Maltreatment Recurrence
  Following Return Home from Substitute Care,
  Children and Youth Services Review, March 2005.

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Findings

• Younger children are more likely to experience
  maltreatment recurrence within 60 days of
  reunification than those 12 or older
  
• Children under the age of 1 were at highest risk
• Cases involving caretakers with documented mental
  illness were 9 times more likely to experience
  recurrence of maltreatment
  

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Findings

• Children with high placement instability (more
  than 5 placements) were 11 times more likely to
  experience recurrence
  
• Children who were in substitute care 3 years or
  more were approximately 8 times more likely to
  experience recurrence than those in care less
  than 3 years
• Fuller notes that other studies found that very
  short stays (less than 3 months) also elevate the
  risk
  

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Findings

• Children whose initial placement was in kinship
  care were approximately 10 times more likely to
  experience recurrence than those whose initial
  placement was a group home or institution
• Children who returned to homes in which 4 or more
  children were present were 3 times more likely to
  experience recurrence
  
• Children returned home to a single-parent
  household at the same time as one or more
  siblings were approximately 5 times more likely
  to experience recurrence

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Okay, so what does this mean for me?

• Closely scrutinize those cases where one or more
  of these factors is present especially where
  parental stress is increased
  
• Consider recommending/ordering post-reunification
  supports and services, including increased home
  visitation by case workers

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Suggestions

• If there is more than one child in care, consider
  reunifying them one at a time to gauge how the
  family is coping
  
• Hold a judicial review 60 days post reunification
  to assess family progress
  
• Consider the use of updated safety assessment
  tools that take into account issues unique to
  reunification
  

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Shaw Study

• Published in 2006, this study looked at 137,385
  children in the California child welfare system
  who entered care between 1998 and 2002
  
• 45,154 of these children were reunified in less
  than 1 year
  
• 6,021 of these children reentered foster care
  within a year
  
• Shaw looked at the odds of reentering care
• T. Shaw, Reentry Into the Foster Care System
  After Reunification,
  
• Children and Youth Services Review, April, 2006

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The Good News

• Five years post-ASFA implementation
• The percentage of children reunifying within 1
  year is increasing, while
  
• The percentage of children reentering foster care
  has been decreasing overall

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The Bad News

• The odds of reentering the foster care system
  within 1 year of reunification are 1.23 times
  higher for an African-American child than for a
  White child
• Shaw found this was strictly race based after
  screening out poverty indicators

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Findings

• Children in the system for longer periods of time
  have decreasing odds of reentry within 1 year of
  reunification
  
• Infants reunified within 1 year have higher odds
  of reentry than any other age group
  

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Findings

• Dramatic increases in the odds for reentry are
  seen when drug/alcohol services are included in
  the case plan
  
• Children placed in relative homes or in close
  proximity to their communities have the lowest
  odds of reentry

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Okay, so now what should I do?

• Ensure family interventions have enough time to
  work by engaging the family at the earliest
  opportunity
  
• Consider placing children close to their home of
  origin if their safety is not compromised
  
• Be vigilant about racial bias
• Parental support systems, both formal and
  informal, should be assessed
  
• Consider post-reunification services and
  supports, especially for parents of infants

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Suggestions

• Check out these websites
• Floridas Center for the Advancement of Child
  Welfare Practice
  
• www.cbcta.fmhl.usf.edu/PDFs/centerpresentation.pps
  
  
• California Evidence Based Clearinghouse for Child
  Welfare
  
• www.cachildwelfareclearinghouse.org
• National Center on Substance Abuse and Child
  Welfare
  
• www.ncsacw.samhsa.gov

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A Framework for Safety Decision-Making
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Signs of Present Danger

• Common beginning of a safety assessment and
  response
  
• Usually a consequence of a child abuse/neglect
  report
  
• Often represents the symptom or harm itself
• May not suggest the cause or what is maintaining
  the danger to the child or what needs to change
  to protect the child from future serious harm

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Protective Capacities

• Particular strengths of the family relevant to
  child safety
  
• When protective capacities increase, danger to
  children is usually reduced
  
• Not all strengths are protective capacities
  e.g. a mother may express love for her child, but
  this is alone is not a protective capacity

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Protective Capacities

• Protective Capacities may include
• Intellectual skills
• Physical care skills
• Motivation to protect
• Positive attachments
• Social connections
• Resources such as income, employment and housing

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• Environmental
• Cognitive
• Behavioral
• Emotional
• PROTECTIVE CAPACITIES

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Examples

• Mother asks step-father to leave after child
  discloses sexual abuse (Behavioral)
  
• Father takes 3 year old son to grandmothers home
  while father drinks to point of intoxication
  (Cognitive and Behavioral)
  
• Parents ask neighbor to care for their toddler
  while they work because their current babysitter
  left the child unsupervised (Cognitive and
  Behavioral)
• Caregiver demonstrates healthy attachment to the
  child (Behavioral and Emotional)
  

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Child VulnerabilityCharacteristics of the Child

• Age
• Ability to communicate
• Medical condition
• Physical, emotional or developmental disability
• Ability to physically remove oneself from
  dangerous situations
  
• Ability to ask for help and/or recognize danger

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Child Vulnerability Stimulus for Caregiver
Response

• Inconsolable crying
• Feeding problems
• Difficulties in toilet training
• Challenging and/or confrontational behavior with
  parents

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Child Vulnerability

• Consider the childs
• Visibility to others
• Access to others who can protect
• Role in the family
• Prior victimization
• Ability to recognize abuse and/or neglect

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Threats of Serious Harm

• The dynamic or condition that leads to the
  maltreatment and its related harm or potential
  for harm
  
• Because harm to a child is not happening right
  now does not mean that there are no safety
  threats and the child is safe
  
• Assessment of safety is an ongoing process and
  must be done during every interaction with the
  family and child
  

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Threats of Harm

• Assessments need to identify
• The specific nature of the safety threat
• Exactly what protective capacities are
  insufficient and need strengthening
  
• What verifiable change is necessary to resolve a
  safety threat
  

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Critical Issues for Reunification

• The safety assessment must focus on the extent to
  which
  
• The underlying conditions or contributing factors
  related to serious threats have been resolved or
  diminished,
  
• Protective capacities have been increased,
• Child vulnerability has been reduced, and
• A feasible plan for reunification support exists

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The key question now is not whether the threats
will never appear again, but whether they can be
controlled with the child in the family
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Reunification Checklist

• Have the original safety issues been reduced to a
  level where control within and by the family is
  probable?
  
• Were there other safety issues identified after
  the children were in care that necessitated or
  contributed to their continued stay?

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Reunification Checklist

• Are the parents in compliance with court orders?
• Do the children demonstrate an acceptance of the
  reunification plan?
  
• Do the parents demonstrate an acceptance of the
  reunification plan?

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Reunification Checklist

• Do the parents have the capacity to provide for
  the childrens basic needs (e.g. food, clothing,
  shelter, medical care)?
  
• Are the parents willing and able to use their
  protective capacities, resources and strengths to
  provide sufficient support to the children?

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Reunification Checklist

• During visits, have the parents demonstrated the
  ability to meet the childrens needs for safety
  in a manner that suggests safety threats are not
  expected to emerge by the childrens presence
  within the family?

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Reunification Checklist

• Are there any issues or concerns related to other
  children or adults in the family that may impact
  the childrens return?
  
• Is reunification recommended?
• Are interventions needed to support the
  childrens reunification? What are they?

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ANY QUESTIONS?
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• For more information or future consultation,
  contact
  
• Barry Salovitz, MSW
• [phone]
• www.gocwi.org