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Implications for Child Protective Services
Nancy K. Young, Ph.D., and Sidney L. Gardner, M.P.A.
Many policy experts in the child welfare field have warned about the implications of welfare reform for child protective services. Child abuse and neglect are not caused by poverty,
just as child abuse and neglect are not caused by substance abuse. The
child welfare case load is, however, often a subset of the welfare case load,
with estimates of 50 to 90 percent of child protective service (CPS) clients
receiving income support through public assistance. The correlation
among child protection cases and substance abuse problems is also alarming,
with similarly high estimates of population overlap. These three intersecting
arenas call for dramatic policy and practice changes to protect children
as States move forward with welfare reform.
Both experience and research have documented the substantial need
for substance abuse treatment services among parents in the CPS system.
However, current policy and daily practice typically lack any sustained
connections between the two systems other than pilot projects or
smaller scale demonstrations. Despite service plans and court orders that include
a referral to substance abuse treatment, many clients in the CPS system
who need treatment do not receive it.
The systems have many barriers to working together, including
differences in attitudes toward clients, training
and education, and different funding streams. The response to the needs
of clients in the CPS system for substance abuse treatment services
is inadequate to ensure that the intended outcomes of either the welfare or
the CPS system will be achieved. These barriers become explicit when we
view the four "clocks" of the systems.
1. The New Timetable for Temporary Assistance for Needy
Families (TANF) RecipientsIncome assistance for 24 consecutive
months and a 60-month lifetime cap.
2. A Shorter Time to Ensure a Child Has a Safe and
Permanent HomeChildren removed from the home and placed in protective
custody must have a permanency plan at 12 months, according to the
1997 Adoption and Safe Families Act (P.L. 105-89). Parental rights
may be terminated if the child has remained in foster care for 15 of
the most recent 22 months, or if the child was abandoned, or if the
parent has killed a sibling or committed a felony assault against the child
or sibling.
3. The Indefinite Time for Recovery From
AddictionThe substance abuse treatment system
operates on its own timetable, viewing recovery as a lifelong process requiring
a long-term commitment to sobriety to achieve family stability.
However, substance abuse treatment funding under health care reform (e.g.,
managed care) has moved to shorter lengths of covered treatment
benefits.
4. The Developmental Clock for
ChildrenUnderlying each of
these policy-generated timetables is the most important of the
clocks: the developmental clock for the children in the family. This is
the clock that cannot be externally driven. Experts in the field of
neuroscience increasingly warn us of the critical importance of a child's
early years. Yet, it is this clock that is most frequently neglected at
the intersection of these service systems.
Need for Linkages
The adequacy of the connections among the systems can be
measured by reviewing five features of their linkages: daily practice, information
systems, budgeting, staff development, and alternative service delivery
systems. A major problem is the fragmentation of the funding systems for
child welfare, welfare, and substance abuse treatment services. Although each
of these systems carefully tracks the number of individuals that
receive treatment and other services, they have generally not been held
accountable for their results. But just as the substance abuse treatment field
is moving toward results-based accountability, so too are the child welfare
and welfare systems. Unfortunately, these system-specific efforts have
formulated no policies to sustain linkages that can be measured in terms of
their effect on all three systems. It seems clear, however, that the separate
goals of these systems cannot be achieved unless they are working together
to achieve and measure their common goals for the families they share.
To summarize, many children's lives are diminished by the inability of
their parents to care for them adequately, and many of these parents suffer
from substance abuse problems. These children's lives are also affected by
the lack of clear policy to assist and/or compel the parents to address
their substance abuse problems. If treatment services are fully available
for the parent, removal and reunification should be contingent on the
parent staying in compliance with a treatment program or an aftercare program.
Thinking more clearly about and act-ing on creating a family support
system could help far more children and families than continuing to deny
the realities of substance abuse in these families and their potential for
recovery.
Creating a Family Support System
The following are necessary to create a family support system for
substance abuse treatment clients under welfare reform:
Tools to assess the substance abuse-related problems of families
Training for workers in welfare and CPS on how to use these
tools effectively
Better understanding by CPS and welfare workers of substance
abuse and its effects on families
Improved information systems that can track specific clients
Systems that can identify substance-abusing clients with
children and determine the outcomes of substance abuse treatment,
including the effects of treatment on the child welfare system
Upgraded client screening and
risk assessment to address substance abuse, family functioning, and
the developmental stage of the child
Appropriate substance abuse treatment and programs for parents
who are willing to make an effort to stay in treatment and follow-up
services; a high priority must be given to ensuring that adequate numbers
of treatment slots are available
Better measures of early signs of treatment success
Treatment services that are appropriate for women with children,
and instrumentation to track the progression of the mothers'
substance abuse recovery
Inventories of funding sources that provide a full continuum of care
and wraparound services for abusing parents
Assessment of the effectiveness of substance abuse treatment
programs using outcome measures that include family functioning
so that resources can be shifted to the most effective programs.
The 1997 General Accounting Office (GAO) Report estimated that 78 percent of young
children entering foster care are from families in which substance abuse is
a significant factor for removing the child from the home.
General Accounting Office, Health, Education and Human Services
Division (GAO/HEHS). Parental Substance Abuse. Implications for Children,
the Child Welfare System, and Foster Care
Outcomes. Washington, DC: GAO/HEHS; 1997.
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