Tuesday, February 5, 2013

Arizona CPS early investigations critical Reformers: First response to abuse cases crucial

http://www.azcentral.com/news/articles/20120316arizona-cps-early-investigations-critical.html

 

by Mary K. Reinhart - Mar. 24, 2012 11:12 PM
The Republic | azcentral.com

The preliminary investigation into allegations of child abuse and neglect is considered the most critical piece of the child-protection system.

Those very first steps in the process, experts say, are potentially life-or-death decisions that can set the course for the case and determine the future of the child and family. Caseworkers and supervisors with Child Protective Services must decide whether to pursue an investigation, whether to notify police or whether to remove a child from a home.

Arizona policy makers have zeroed in on the front end of CPS -- when the first report of abuse or neglect is made -- after a rash of high-profile child deaths last summer put a spotlight on the agency.

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Maricopa County Attorney Bill Montgomery, who chaired the governor's Child Safety Task Force, placed much of the blame on investigations, saying CPS workers "don't remove children that they should, and those children wind up dead."

But child deaths can happen no matter what the level of response. Adults have killed or seriously injured dozens of children after joint investigations between police and CPS. Children have died after CPS and community agencies offered services to families in what were considered low-priority cases. They've died after authorities have removed the children from parents and later returned them. And they've died in foster care.

CPS not only investigates suspected abuse and neglect, but also coordinates services for families and monitors children in the system. But policy makers and law-enforcement and child-welfare officials have paid significant attention to improving the initial investigative phase and better identify chronic cases that may fly under the radar.

Montgomery wants a specially trained investigative unit within the state Department of Economic Security, which oversees CPS, to bring a keener law-enforcement eye to the most serious cases and prevent others from falling through the cracks. Gov. Jan Brewer and state lawmakers support the proposal.

CPS is streamlining its investigative process with help from an independent consultant and is attempting to increase training and supervision to work through cases more quickly without missing key warning signs.

And a recycled proposal to divert thousands of low-level cases to contracted service providers is getting a new look as federal officials encourage states to develop these two-tiered responses to child abuse and neglect.

But during the task-force hearings late last year it became clear there is no single investigative solution to ensure that Arizona's children aren't victimized by their parents or caregivers. Brewer set up the task force to recommend improvements to the child-welfare system.

"Part of the issue with the investigation of child maltreatment is it's complicated," said Doug Kline, a retired Mesa police commander who ran the Mesa Center Against Family Violence. "But if you don't do it right, you've crippled the case. Any step toward improving that initial look is going to be a good thing."

Challenges

CPS investigators, administrators and police say the easiest decisions tend to involve the most severe cases, such as a hospitalized shaken baby. The tricky investigations, they say, are less obvious cases they may deem low risk but can and do become child fatalities.

"Usually the cases that are missed are the ones that aren't glaring. If they're at the hospital with broken bones, you pretty much know what the deal is," said Anna Arnold, who retired from DES in 2002 as assistant director for the Division of Children, Youth and Families.

In Arizona and nationally, at least two-thirds of CPS investigations stem from neglect allegations, not abuse, and an equal percentage are classified as low or potential risk situations. In this vast gray area, any danger to children may not appear imminent, and the family's problems, as well as the potential for criminal charges, are harder to respond to.

CPS units receive nearly 100 new abuse and neglect reports every day, pushing backlogs and caseloads to unprecedented levels. That can compromise the timeliness and thoroughness of initial investigations, which can lead to mistakes or delays that doom criminal prosecution and endanger children. Dozens of workers who recently left CPS say they worried that they could no longer ensure the children's safety.

Caseworkers also face other challenges that eat up time. They must investigate reports that some argue don't belong with CPS at all. Almost every night, they are ferrying teens from juvenile detention to group homes because their parents won't pick them up. CPS also is used as a pawn in custody battles, with hotline workers taking calls from angry spouses complaining about the other parent when there's no real threat.

"Someone has to go out and determine if the allegations are true," CPS investigator Rebecca Wright said.

At the same time, workers and their supervisors say, families have faced more challenges since the recession took hold, from poverty to substance abuse and untreated mental illness. Sweeping program reductions to close budget deficits, beginning in 2008, have reduced or eliminated services that helped families remain stable.

But the investigative challenges are only part of the problem. Most children who died from mistreatment in Arizona never came to the attention of CPS. Seventy children died from abuse or neglect in 2010, including 13 with prior CPS reports and five with open CPS cases, according to the state's Child Fatality Review Program.

The investigation

The initial investigation phase is fairly straightforward, but it requires workers and supervisors to make critical decisions, often in a matter of minutes when the call first comes in and sometimes without key pieces of information, such as interviews with the family.

First, CPS workers on the 24-hour Child Abuse Hotline take a call alleging mistreatment. Sometimes those calls come from the public, such as a worried family member or neighbor, but often from police on the scene or hospital workers who have admitted a child.

Anyone can make a report, but certain people -- including doctors, teachers and others responsible for children -- are required by law to call the hotline if they suspect child abuse or neglect.

Workers answer about half of all calls to the hotline immediately, but some callers can wait from five to up to 45 minutes on hold. Last year, 17 percent of the 144,000 calls were lost before workers could answer them.

Hotline staff, who are trained caseworkers, interview callers. They must decide whether to move the case forward and involve police, and they must determine how urgently a response is needed.

Questions are aimed at determining how well the caller knows the child and family and how recent, chronic and severe the abuse or neglect may be. Workers must meet daily call quotas, so they want to get the information as quickly as possible to move on to the next call.

Based on the interview and background research on the family, including prior CPS reports, the hotline worker decides whether to assign the case to a field unit for investigation or document it as a "communication only" report. About one-third of the calls to the hotline don't become investigations.

If the hotline worker assigns the case, he or she gives it one of four priority levels that determine how quickly an investigator should respond.

The hotline worker also decides whether the allegations rise to the level of criminal conduct, such as assault or child molestation, which requires local law-enforcement agency notification.

About 6 percent of CPS investigations are handled jointly with police.

A field investigator must respond from within two hours to seven days depending on the priority level.

Investigators try to conduct in-person interviews with the children and family, as well as others who may know them. They check court records, medical history and state databases for food stamps, welfare and other services that can show where the family has lived and who has lived with them. The investigation includes an assessment of the home and the overall safety of the children there.

At this point, the CPS worker decides whether there is imminent risk that requires removal of the children. The decision is supposed to be made in consultation with a supervisor. But caseworkers have authority to take temporary custody of children on their own in cases, for example, where there are obvious signs of serious abuse or concerns that a parent may flee with the children.

When there are allegations of criminal abuse or neglect, joint investigations with police are guided by each county's protocols that outline procedures for interviews, medical exams, scene preservation and other aspects of the investigation. Experts consider family-advocacy centers a model for cooperation between agencies, including CPS, medical, police and social-work professionals who investigate and treat child-abuse victims.

Following the initial investigation and safety assessment, CPS investigators decide whether the children are safe.

If so, they can close the case or keep it open so the family can receive services, such as child care or counseling. Eighty percent of neglect and abuse investigations are closed without any further action -- no services provided, no proof that abuse or neglect occurred.

If the child is in danger, the case remains open and is transferred to another CPS caseworker. Particularly when children have been removed, which happens about 10 percent of the time, these cases can last for years.

Officials have targeted the hotline as a key link in the investigations process. Internal DES reviews are focused on reducing the length of time callers are on hold and improving the filtering of calls to weed out the frivolous and catch the most serious cases.

Montgomery argues that the number of joint investigations is too low and says potential criminal cases are missed at the hotline. He wants workers to assign older allegations a higher priority if they involve criminal conduct. Now, state policy requires workers to assign the lowest priority to suspected abuse that happened more than 30 days ago.

A new team

The most significant proposal to address investigative problems would create a 28-member unit staffed by former law-enforcement officials.

The new unit would provide an additional layer of oversight for CPS investigations, housed under DES but separate from CPS. The unit's proposed role has shifted somewhat over the past several months and its particulars remain murky. Differing descriptions have been offered from the Governor's Office, Montgomery and DES, and the House bill that would create the unit. So it's not clear where these new investigators would be deployed or what they would do, though it's doubtful they would take on caseloads and relieve CPS caseworkers of their current responsibilities.

Despite disagreement over details, law-enforcement officials, politicians and child-welfare advocates agree any extra attention to the most serious cases of child abuse and neglect is welcome.

"(The new unit) says that we, the community, take this seriously," said Karen McLaughlin, a former Yavapai County deputy who now runs the Arizona Child and Family Advocacy Network, which represents the state's 15 advocacy centers. "That this is a crime. You can't keep doing this to this little kid."

The challenge, some say, is teasing out which cases merit a closer look and ensuring that the new investigators have the right experience to handle the job.

"Who they pick is absolutely crucial," said Kline, the retired Mesa officer, who also supervised the Mesa police sex-crimes unit. "So many of these cases are so grim. There's only so much of that that regular folks can take."

A draft job description would allow the workers to do everything from screening hotline calls to responding to the highest-priority reports.

Brewer wants investigators to assist CPS units in multidisciplinary family-advocacy centers, like Childhelp in Phoenix and Mesa's Center Against Family Violence, which typically see the most serious abuse and neglect cases, as well as help in other busy offices and conduct training.

House Bill 2721, sponsored by Rep. Eddie Farnsworth, R-Gilbert, and written by Montgomery's office, would require this new unit to respond to all cases where criminal acts are alleged, notify law enforcement and take children into temporary custody if warranted.

Montgomery sees DES investigators taking on a variety of roles while ensuring that law enforcement and CPS work together to successfully prosecute more cases. That will free CPS workers to do more intensive social work, he said.

"(They) can do what (they) came on board to do, which is to help families," Montgomery said. "Someone else is going to be handling the ugly side of what human beings do to children."

Brewer and lawmakers have included $2.3 million in their respective budget proposals next fiscal year to fund the new unit.

Including salaries and benefits, 23 investigators in the new unit would be paid $70,000 a year and four supervisors would earn $80,000 a year, according to legislative-budget analysts.

While Montgomery and law-enforcement officials argue for tougher investigations, CPS caseworkers and child-welfare advocates say reducing caseloads, stemming turnover and beefing up training are equally important.

"We need to have reasonable caseloads so that trained, qualified CPS investigators can assess what's happening with the needs of those families and the safety of those children," said Beth Rosenberg of the Children's Action Alliance and a former CPS administrator. "Caseloads are the foundation for people to do a decent job."

Alternative response

One quick way to reduce caseloads is to divert low-level abuse and neglect reports to community social-service providers and allow investigators to focus on the most serious cases.

Arizona had such a system for about five years, but dropped it amid financial and political pressure.

More recently, DES administrators developed a preliminary proposal to refer more than half of CPS cases to outside agencies for follow-up and services, but it was shelved. The annual price tag was estimated at $26 million, according to internal DES e-mails.

Federal funding is available for states to develop two-tiered or "differential" response systems, which are intended to give caseworkers more time for the most severe cases and encourage other families to accept services absent the stigma of CPS or police involvement.

Twenty states and counties in the U.S. use the two-tiered response, with full-blown investigations reserved for the most severe cases.

"There are people who need to be separated from their children. But they are an extreme minority. So the problem is, what do you do with the rest?" said Gary Siegel, a St. Louis-based public-policy analyst who evaluates child-welfare programs throughout the country. "A police approach isn't effective in a lot of cases."

Arizona created a differential-response system, called Family Builders, in 1997 to address a backlog of uninvestigated abuse and neglect reports. State audits and independent reviews generally found it was at least as effective as CPS in preventing future reports, but the program struggled to monitor costs.

Then-DES Director David Berns disbanded Family Builders as CPS underwent reforms in 2003 following a string of child deaths, declaring the agency would resume investigating 100 percent of child-abuse and neglect allegations.

Part of the challenge was that the non-profit agencies made initial visits and then notified CPS if families rebuffed their efforts, they couldn't locate families or thought the problem was more serious than it first appeared. Two separate CPS units were intended to follow up on those Family Builders cases, but some still fell through the cracks.

Longtime CPS workers also were concerned that social-services agencies lacked the authority and families too easily rejected them. These families were, for the most part, already too troubled to benefit from the kinder, gentler Family Builders approach, they argued.

"People just walked away from the family," said Rosenberg, of the Children's Action Alliance. "We never felt comfortable with that. We thought people should've gone back and made sure children were OK."

Child-welfare experts consider Minnesota the gold standard among jurisdictions with a two-tiered response to child abuse and neglect.

Erin Sullivan Sutton, an assistant commissioner for the Minnesota Department of Human Services, helped implement the program in 20 counties in 2000 and saw it quickly spread to the rest of the state's 87 counties.

"It became pretty infectious," she said. "Social workers really liked their jobs. They were doing social work, helping families and not having to take on a police role. Families were very responsive."

Child-welfare workers conduct the initial investigations, but they send 70 percent of all child-abuse and neglect reports down the social-work track. Child safety has improved since Minnesota implemented the program, Sutton said, and the number of foster children plummeted by nearly 40 percent.

"For us it was a culture change," she said. "Not only did (workers) have to change what they did, but we had to change the image people had about families who were reported to Child Protective Services."

Inside CPS

DES Director Clarence Carter says he welcomes the proposed investigative unit and has begun administrative changes to bring the new workers on board. He says he also is moving forward on several other fronts to improve CPS investigations.

But a stubborn backlog of more than 8,300 cases and the steady stream of new reports are getting in the way.

Change and Innovation Agency, a Kansas City, Mo., consultant, has a $631,000 contract to improve CPS performance from the hotline to investigations to ongoing case management. The company began work in 2010 to streamline investigations as the backlog began building, and its services have since been extended to recommend systemwide improvements.

A new, shorter internal process, which is being tested in three CPS offices, is aimed at reducing the time it takes CPS workers to complete investigations to 40 days from the current average of six months or more. The information-gathering phase is unchanged under the new model, but a slimmed-down form for documenting the information should take 90 minutes to complete, compared with the eight hours of paperwork under the current system.

DES officials are reviewing the results of the new form to ensure that it doesn't compromise child safety and plan to decide in May whether to expand the practice statewide.

In the meantime, the factors that created the backlog still exist, including turnover and caseloads that average two-thirds above state and national standards, and CPS offices are struggling to keep up with piles of paperwork.

That led DES officials earlier this month to call on about 50 administrators, policy analysts, trainers and other central-office staff to take on investigations or assist investigators in the field. Those who haven't handled cases in decades are encouraged to take refresher training courses, and overtime has been approved so they can continue to perform their regular duties.

"We do what we have to do to support our staff and ensure that those kiddos are safe. It's the right thing to do," said Stacy Reinstein, senior policy manager for DES, who will be driving around a caseworker. "We are putting all hands on deck."

It's been a few years since administrators were turned into part-time investigators. While it's not unprecedented, it's a troubling development that highlights how much the agency is struggling, said Rosenberg, the former CPS administrator.

"We're putting Band-Aids on a very critical situation," she said. "If we really care about the protection and safety of children, this is not the way to run Child Protective Services."

Proposed fixes

The state Department of Economic Security and the governor's Child Safety Task Force have proposed several reforms to help Child Protective Services and law-enforcement agencies work more closely together when children are endangered, improve initial screenings so cases are appropriately prioritized and remove bureaucratic barriers that have buried workers under caseloads.

Among the proposals:

Create the Office of Child Welfare Investigations, within DES but separate from CPS, to investigate criminal allegations of abuse and neglect.

Add a third line to the Arizona Child Abuse Hotline for mandated reporters, including doctors, teachers and counselors, and those who are with the child when they're making the call. The hotline currently has a second line for law enforcement.

Improve training for CPS investigators and hotline workers, including forensic interviewing and better recognition of potential criminal abuse or neglect; and add social-work training for police to improve their response to child-welfare calls.

Reduce paperwork for CPS investigators to shorten investigation time or free up more time for interviews and other casework.

Increase front-line supervision for investigators, including documented collaboration on cases, and reduce case backlogs so supervisors aren't working cases themselves.

Use CPS administrators, supervisors and others to help reduce a backlog of more than 8,300 cases, including cases assigned months ago but not yet investigated.

After initial investigation by CPS caseworkers, divert the lowest-risk cases to contracted providers, who would offer case management and social services to children and families.

Expand and fully staff family-advocacy centers, where police, CPS, medical and social-work professionals investigate and treat child-abuse victims.

Who must report child abuse and neglect

State law requires certain people to immediately tell Child Protective Services or police if they believe a child has been abused or neglected, including abandonment, medical neglect and exploitation.

Those required to report include:

The parent, stepparent or guardian of the child.

Any physician, physician's assistant, nurse or other medical professional, or psychologist, social worker or counselor who has treated the child.

Police.

Clergy members, unless the information was gathered during a confidential communication or confession.

Teachers, school administrators and other school personnel.

Advocates for domestic-violence victims.

Anyone else who has "responsibility for the care or treatment" of the child, such as child-care workers.

Reach the reporter at maryk.reinhart@arizonarepublic.com.

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This system still does not have enough safety nets.

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People are so frustrated under Obama they are abusing their children. No hope and very little change left in our pockets.

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I blame Obama and his administration for many of the problems we now have, especially in terms of the economy and our diminishing status in the world, but can't see a connection with him and child abuse. There is NEVER a good excuse, or reason, to abuse a child!

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such a stupid comment.

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burgandy ::: Another TP/GOP Obama hater. How absurd and ignorant.

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The economy was headed downhill long before Obama took office in January 2009. Dysfunctional adults have been abusing their children for decades. It didn't just start 3 1/2 years ago.
I think you've been drinking a little too much burgundy, whiner.

Obama bologna! This is not and should not be a federal issue. Before the bureaucrats get involved or Obamacare is applied, let the States get their arms around to problems. Increase transparency of CPS and understand full well that there can be NO low priority cases as stated in the story. “joint investigations between police and CPS. Children have died after CPS and community agencies offered services to families in what were considered low-priority cases”
Get it right early, get it right often and get it right in full view of all interested parties.

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Some of our elected leaders dont believe that programs like this are a priority, so they cut funding, place negative stories in the press and sometimes even alter the law to make it harder for the people who work in the agency to do their job.

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So if they can't cut education, and they can't cut medicaid, and they can't cut prison money should the state just raise taxes? Phoenix's 2% food tax helped them, perhaps the state should do the same then there will be enough money to go around.

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This system does not have many common sense people. If you have evidence a child is being abuse then take the child out of danger! CPS is a liability to the state and not an asset.

Arizona legislators now want to mandate changes in CPS but provides no funding relief after legislative funding cut-backs that eviscerated CPS.

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Exactly. The politicians make loud noises, but if you notice, very little will change. Changing the entire system would be very expensive.

If you want to help kids then find a way to help their parents. These layers of oversight these bureaucrats talk about suck up the money before any real help ever makes it to the kids. It is just one more cop agency that sucks more money out of the pockets that need it to buy more bureaucracy.
The other problem with CPS is it is used for revenge and control by warring family members and people with ulterior motives for their involvements.

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some parents can't be helped. CPS needs to be able to recognize this and stop throwing thousands of dollars worth of "services" at parents who are beyond help.  Place the kids permanantly with relatives who want to assume responsibility, or allow adoptions, or find permanant foster homes and give them a chance to survive. Family reunification isn't always in the best interest of the child. How many time do we hear of a child who has been in and out of foster care, and ultimately given back to the idiot parents who end up killing the child.

Chupasomthing: Wow !! You actually submitted something without "outing" your KKK colors...excellent comments without resorting to racist statements. Question: I heard a rumor or fact that a child abuser (broke 10-12 bones on the child) ONLY got probation..and that CPS "dropped" the ball again...Hope this rumor is not true...Recent story...

Never did.

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There appears to be huge holes in the monitoring of these families. I have read several of the reports after the deaths the case workers could not get in, or were refused admittance. When a family who has a history of abuse refuses to allow a case worker in, they should be able to contact the police and they should be able to go in.

And how many of these dead children have had long histories of having their cases investigated, re-investigated, documented, etc., yet they're still dead?
CPS has got to do more than investigate. These kids that suffer abuse and die deserve more than "investigations." They deserve to grow up in a loving, nurturing and safe environment and with adults who will provide that, nothing less.

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How about holding the case workers responsible. I understand they are underpaid and overworked but I have heard that since the 80s. I have recently dealt with a few of these case workers(fostering kids) and it is scary how they have control on the placement of these children and the lack of concern they offer. They have no work ethic and lack the basic skill of honesty. The problems a far reaching and the director obviously doesn't care and should step down.

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You sure have some negative opinions but I see no evidence to suggest they are accurate.
Did you follow the Powell story? A caseworker's life was on the line for 2 little boys during a supervised visitation with a psychopath daddy who killed his kids and blew up the house and himself. Should she hold herself responsible for their deaths?

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ra3657, how about holding ourselves responsible? A long time ago, my cousin's husband started whaling on his stepdaughter for something that didn't even warrant a smack on the butt. First and last time he made that mistake. All of the men and boys stood up. My Graandad looked at my cousin, and said, "Pack that child a bag and put her in my car." My cousin's husband, wisely, decided that it would be a good idea to cool off at his Mama's house.

You're right. The problem I saw when I worked as an investigator was that any person can have a baby. It doesn't matter whether you're qualified or not. Every female has the right to bear children and it doesn't matter if she can provide for them or not. Some of the females I investigated were very young and some were mentally challenged. I remember this one time when a mentally challenged female had a "noodle" baby and it died. All of us were emotionally hurt, but it surprised me that the mother wasn't. She just went back to work at the Wal-Mart.

The case workers are limited to the rules of law and unfortunantly there isn't a public demand that CPS be given authority to remove a child on limited abuse. The way the state law is now removing a child is the last thing they can do because for some reason our law makers feel keeping the family together should be done at all costs, even if it costs a life.

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depressing...

The best way to protect children is to get the government as far away from them as possible.

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YEAH Sure ! ------Let's PRIVATIZE the system and let the SPECULATORS take over !
----------I'm sure the Bankers and Real Estate Moguls will want to spend every cent of the CPS funding on the Children and NOT on their PROFIT MARGINS-----------------And if you believe THAT, I got some Smokin' HOT Beach front property in Scottsdale I wanna SELL YOU.

Yes we need the government out of our lives and that would solve a lot of our social problems but on the same line we all, each and every one of us need to take a personal responsablity for our society. As an example I have lived in Germany and if you kid is acting out and misbehaving and you don't handle it then someone will say something. Yes they do have child abuse in the Germanic countries but not neart the level we have here.

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Who do think should be doing it if not the police or CPS? Who do the neighbors report to? Some parents believe it is their right to beat a child until it is nearly dead or dead. Some believe it is their right to withhold medical care for their child. So who do you want to deal with them? Their church, their local drug dealer? Or maybe the child pornographer who would be happy to help?

If people really want to help then start lobbying for new laws on abuse and false reporting. So much time is lost by responding to the 7th report from the same upset grandmother because she can't see her grandchild. Prosecute please.
Also, let's start making some harsher punishments for those convicted of child abuse. Getting off on probation seems to be the norm these days.
Can we pass a damn law that makes it a felony to give birth to a substance exposed child?!?!? As it stands, there ISN'T a penalty whatsoever for bringing a child into this world that is going through withdrawals from their parents disgusting habit(s).
This whole system is completely unproductive and thanks to the hard work of a select few case managers, it stays afloat.

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Excellent idea, but it will never happen. There isn't enough money in it for the lobbyists and politicians, so what's the point. Lobbyists only work for things that will make money, politicians only listen to lobbyists who control their campaign contributions.

There was a baby born addicted to crack back in 2001, 10 days later that baby died due to second hand smoke from mom and granny smoking crack next to the newborn. If that baby had been taken away at birth it would still be alive, but all they did was detox the kid then sent her home.

excellent ideas.

And how about changing the privicy laws that are meant to protect the children to keep CPS from hinding behind them?
Time and time again questions have been raised about what happened to a child and the CPS will say they cannot answer due to the laws that protect the privacy of the child, but are actually being used to protect inept CPS employees.

Good ideas but I also see how CPS treat foster families and will never again foster kids as long as CPS allows case workers to abuse foster families. Having dealt with this problem I see there is no oversight from supervisors and managers and no work ethic from the people I unfortunately felt with...

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And as I said, CPS uses the "privacy" laws to protect themselves from ANY public oversight.
Just think of the howl if MCSO was allowed the same priveleges

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Wendy Rosenberg Nick Oza/The Arizona Republic

Child Protective Services caseworker Wendy Rosenberg talks with Phoenix police officers.

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In a yearlong series of stories, The Republic, azcentral.com and 12 News will examine the welfare of Arizona's children, highlighting the state's many families in crisis.

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