AdvOCAcy : your child welfare update, 2018 September

Office of the
Child Advocate
For Georgia's Children

AdvOCAcy
Your child welfare update

September 2018

Page 1

Editorial: I'll Rush FFPSA -- Prudently would be to implement it immediately because it makes these

By Tom Rawlings DFCS Interim Director

keep children out of foster care and help them stay with family and relatives. We'll have the

Title IV-E funds available to keep children safe without resort to foster care. In spite of

ability to provide additional in- my desires, it just can't be done

Preparing to im- home services for parents and instantly.

plement the most significant federally -required changes to child welfare funding and practice in the last three decades won't be simple or quick, but it will equip us to better care for Georgia's children. For the first time, we will be able to use federal matching

better address mental health and addiction issues while keeping families together.
President Trump signed into law the Family First Prevention Services Act in February, giving states the option to implement portions of the new law as early as this October and as late as

There are a lot of moving parts for the entire child welfare system to adjust to such sweeping legislation. Internally, it will require significant revision to our policy and procedures; to our training; to our state laws; and, perhaps most significantly, to

dollars for services designed to October of 2021. My preference

See FFPSA, page 4

OCA's monthly platform for the unedited voices of young people who have been in care....

Why is delinquency linked to dependency?
By M. M., age 12

Youth Voice

That is, why are youth involved in the juvenile justice system likely to be involved in the child welfare system, or dually- involved?
Certainly, not all children who have experienced neglect and abuse will engage in delinquent behavior, yet we know that 60% to 80% of youth arrested have had some involvement with DFCS. Why?
Child maltreatment itself increases the risk of delinquent behavior. And delinquency and dependency share other risk factors, such as domestic violence, lack of parenting skills, and substance abuse.
Yet another reason our efforts to improve child welfare are critical to youth outcomes!

At the time she colored this, 12 year old M.M. had been in foster care for over 55 months. The bright colors she uses suggests she maintains hope and optimism as the Cold Case Project focuses on permanency for her. Art is an interest that serves as a creative outlet for this talented and resilient young lady.

Office of the Child Advocate
For Georgia's Children
September 2018

AdvOCAcy
Your child welfare update
Page 2

Focus on Neglect Our Interim Director, Rachel Davidson, recently attended a presentation where she saw a startling statistic. And she asked, "Why?" This is a common occurrence, and

By Diana Summers OCA Administrator

at OCA it leads to some thoughtful discussions, deeper investigation, and more often than not a new project. The statistic in question is that 60% of children enter foster care due to neglect. The "why" in this case is "Why does neglect result in so many

entries to foster care, and what can be done to support families to prevent these removals?" An excellent

question, Rachel! And, fortunately, I like new projects.

In the realm of child maltreatment it is the abuse cases, particularly the heinous ones, that make headlines and gather attention. Yet neglect accounts for more than three-quarters of confirmed cases of child maltreatment in the United States, more than physical, sexual and emotional abuse combined. The definition of neglect varies from state to state, but referring to OCGA 15-11-2 (48), the state of Georgia defines "neglect" to mean:

The failure to provide proper parental care or control, subsistence, education as required by law, or other care or control necessary for a child's physical mental, or emotional health or morals;
The failure to provide a child with adequate supervision necessary for such child's well-being; or The abandonment of a child by his or her parent, guardian, or legal custodian.

Why is neglect, or the failure to act, so important as to necessitate removal of children from their homes? According to the latest Children's Bureau Child Maltreatment report, neglect is either the sole or contributing cause of more than 70% of deaths related to child maltreatment. Additionally, neglect is a form of trauma. Stress responses that occur in the brain from a lack of care are the same as those that occur when a physical threat occurs.1 Neglect may disrupt brain development resulting in lowered IQ, cognitive delays, and difficulty regulating behavior.2
The level of child well-being in a State is strongly associated with its rate of child poverty.3 According to KIDS COUNT, 23% of Georgia's children live in poverty that is nearly one in four. Children from low income families (annual incomes below $15,000) are about seven times more likely to be neglected than children in higher income households.4 And while most poor families do not neglect their children, poverty increases the risk of neglect by interacting with and worsening related risks.5 So impoverished families struggle not only to provide their children with the basic needs of food, shelter and clothing, their lack of resources and the stress associated with trying to care for their children exacerbates their struggles with other issues commonly associated with neglect, such as domestic violence, substance abuse and mental health concerns.

An examination of OCA's child death files from a recent 18-month period highlights these same risk factors and provides confirma-

tion that many children should indeed be removed from their homes for neglect. Parental substance abuse was an issue in more

than half of the cases and the single most common risk factor in this sample of child death cases. Neglect has strongest association

with substance abuse among all forms of maltreatment and substance-abusing parents are three to four times more likely to ne-

glect their children.6 Additionally, two in five of the victim children had physical or mental health issues, many born medically frag-

ile or drug-exposed, a particularly vulnerable population when caregivers may be under the influence of

See Neglect, page 6

Upcoming Events:

Big Voice for Children Awards, September 21, 2018, Atlanta, GA. More info here. The 2020 Census: Implications for Georgia's Children and Families, September 24,
2018, Atlanta, GA. More info here. Georgia Conference on Children and Families, October 17-19, 2018, Augusta, GA.
More info here. The Summit: Georgia's Child Welfare Conference, December 3-5, 2018, Atlanta,
GA. More info here.

Office of the
Child Advocate
For Georgia's Children

AdvOCAcy
Your child welfare update

September 2018

Page 3

Editorial: Where are the Dads? A recent "Cold Case" review underscored a persistent problem in dependency cases--not engaging fathers early

Engage Fathers Early On

on. In this particular case, three siblings have been in care

By Rachel Davidson OCA Interim Director

for 4 years with no involvement from a father. Must the father be a deadbeat dad? Must the father not care? In this case, the fathers were never informed of the dependency

proceedings. The case had been to court at least 12 times,

had been before a citizen panel review, and had been handled by at least 16 different case managers, 16

different supervisors, and 3 different child attorneys. No father was ever served with a dependency action,

given a case plan, or engaged in the case until a relatively newly hired case manager found the names of

the fathers on the children's birth certificates shortly before the scheduled TPR hearing.

This may seem like an extreme example, but it is not an isolated case. We need to do better with identifying and engaging fathers. And we need to do so as early on in a case as is possible. When we don't, we miss out not only on fathers, but paternal relatives as well.

Identifying fathers through a diligent search may be accomplished by asking the mother, child, relatives, and/or friends about the father; reviewing a birth certificate or other vital records; checking the putative father registry; determining if an administrative legitimation was ever completed; or following up on information contained in an Accurint or CLEAR report. Juvenile courts and lawyers can conduct their own diligent searches and help focus attention on fathers early and often.

When engaging with fathers, a recent study from the UK highlighted the following:

Effective engagement with fathers has to both hold men accountable and directly value their parenting on its own terms.

Father engagement requires thinking critically about parenting as gendered: fathers and mothers encounter different expectations, sanctions, rewards, opportunities and constraints as parents.

It's important to think about father engagement not just in terms of whether things happen (and whether a father is included), but also to look at when things happen.
Child protection services and processes produced gate-opening Dr. Georgia Philip from the University of East Anglia in the UK presenting and gate-closing moments for men--opportunities created, or at on father engagement at ISPCAN's 2018 International Congress in Prague other times missed, to include fathers, to be curious, to respond, or to review, what their involvement could be. Sometimes this gatekeeping was to do with formal or procedural factors, but at others it was to do with attitudes or assumptions about men and parenting.

Social workers can, and need, to apply curiosity, persistence and skill to hearing fathers' stories. Achieving some means of hearing a man's story should also be seen as routine and valuable, rather than as an additional or unmanageable task. Individual workers need to be supported, at an organizational level, to achieving direct contact, and build relationships--particularly with non-resident fathers.

A legal father for one of the children from the Cold Case review appears to be a viable resource for his child. In fact, she had already been in contact with him through social media for about a year. His home will be evaluated and he will begin more meaningful contact with his child moving forward. Although the mother in this case had been sneaky and not entirely forthcoming, this father could have and should have been identified and engaged much sooner in this process.

It is the responsibility of all involved, including child attorneys, guardians ad litem, SAAGs, court clerks, and Judges, to ensure diligent searches are meaningful. Let's start shifting our mindsets and making it a routine practice to ask about and engage with fathers at the beginning of and throughout the life of a case. Children deserve for our efforts to be truly diligent.

Office of the Child Advocate
For Georgia's Children
September 2018

AdvOCAcy
Your child welfare update
Page 4

FFPSA, continued...

our integrated child welfare data and accounting systems. We must put in place procedures to carefully identify the "evidence-based" services

that federal dollars will cover as well as the situations in which we can use those services. Under the

new law, the feds will pay in situations where services will directly prevent a child from coming into

care or re-entering care after going home from our foster system.

We are developing monitoring systems to reflect those higher standards. Beyond the Division, the law requires changes in court procedure and adds new requirements for court reviews of children in certain residential placements. Our providers of prevention services are gearing up to become certified in the delivery of evidence-based, trauma-informed programs and to change their own accounting systems so they can be reimbursed appropriately.

Another aspect of FFPSA is that it ends Title IV-E funding for many of our traditional group home placements. These providers will either need to create more traditional family foster home settings (with six or fewer children per home) or become certified to serve the populations still eligible for Title IV-E funding. Those include children with significant physical or behavioral health needs who are need residential therapy in a Qualified Residential Treatment Program (QRTP); child victims of human trafficking and those at risk; and youth who are in our "extended" foster care programs for young adults aged 18-21.

Currently, the state receives about $15 million annually to support children who are placed in these group settings. As we don't want to lose our valuable providers many of whom have been doing this work for decades we will need to help them through the transition. We will be able to continue using these providers. For example, we are expanding our extended foster care services and will need transitional living settings. We also are always in need of residential services for our children who have significant behavioral health issues stemming from the abuse and trauma they have experienced. Currently, we estimate that approximately one-quarter of children in See FFPSA, page 7

Office of the
Child Advocate
For Georgia's Children

AdvOCAcy
Your child welfare update

September 2018

Page 5

Sharing and Caring

"You are special." Three simple words Mr. Fred Rogers used to

say regularly on his show. During a commencement speech, he ex-

By Rachel Davidson plained that, to him, this phrase meant that you don't ever have to do OCA Interim Director anything sensational for people to love you.

The month of August brought a number of stressors for me personally nothing that was overwhelming in and of itself, but it all seemed to come at once. As the saying goes, "when it rains, it pours". Throughout this time, I felt special and loved by so many people who offered support in a variety of ways, for which I am extremely grateful.

Mr. Rogers was constantly striving for goodness and kindness. His work was about caring for people. This is what our work in child welfare involves too. Understanding that there is inherent good in everyone is no small feat. Neither is helping others understand that they are special.

Although this work and our personal lives can be very stressful, there are always caring people that are looking to help. Thank you to all of you for caring and helping. The families we encounter are special. And you are special too.

Comings and Goings

We're excited to welcome our newest intern, Lakisha Pitts to the team. Lakisha is a MSW student who will be spending this academic year with us.

Martha Guraro, a Mandela fellow from Ethiopia, spent 6 weeks in Georgia learning about our child welfare system. We were glad to have been a part of her journey and are thankful to the Administrative Office of the Courts for hosting her.

Office of the
Child Advocate
For Georgia's Children

AdvOCAcy
Your child welfare update

September 2018

Page 6

Neglect, continued...
drugs or alcohol. More than one-quarter of these child deaths occurred in homes with domestic violence and parental mental health was a factor in at least one in five cases. Parents coping with these stressors may not have the emotional capacity to care for their children, particularly when they are already struggling with economic hardships and providing for the physical needs of their family, elevating the likelihood of child neglect.
1 DeBellis, M.D. (2005). The psychobiology of neglect. Child Maltreatment, 10 (2), 150-172. 2 Wilkerson, D., Johnson, G. & Johnson, R. (2009). Children of neglect with attachment and time perception deficits: Strategies and interventions. Education, 129(2), 343. 3 Ozawa, M. N., Joo, M., & Kim J. (2004). Economic deprivation and child well -being: A state-by-state analysis. Children and Youth Services Review, 26(8), 785-801. 4 Sedlak, A. J., Mettenburg, J., Basena, M. Petta, I., McPherson, K., Greene, A., & Li, S. (2010). Fourth National Incidence Study of Child Abuse and Neglect (NIS-4): Report to Congress. 5 Eckenrode, J., Smith, E.G., McCarthy, M.E., & Dineen, M. (2014). Income inequality and child maltreatment in the United States. Pediatrics, 133(3), 454-461. 6 U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children's Bureau, Office on Child Abuse and Neglect. Child Neglect: A Guide for Prevention, Assessment, and Intervention, 37. 7 U.S. Department of Health and Human Services, 48. 8 U.S. Department of Health and Human Services, 46. 9 U.S. Department of Health and Human Services, 56. 10 NC Division of Social Services, the Family and Children's Resource Program. Children's Services Practice Notes, 18(1), January 2013.
September is Kinship Care Month
Thank you to all kinship families!

Research-based thoughts on how to ensure safety while preventing so many neglected children from entering foster care:
Conduct risk assessments. Risk assessments determine the degree to which a child is likely to be neglected in the future, as opposed to safety assessments which indicate imminent harm. While the current family situation may not rise to the level of neglect substantiation, use of a risk assessment tool will quantify where families fall on a continuum.7
Create a 3rd dispositional category. Allegations of child maltreatment are generally either substantiated or unsubstantiated. Adding an "at-risk" category allows families scoring high on the risk assessment to receive crucial support services to prevent the situation from escalating.8
Engage families. We know how important this is, yet family engagement is easier said than done. Families often see DFCS as the people who want to take away their children or the bureaucracy that makes it difficult to get food stamps. And caregivers with neglect problems often have difficulty forming relationships and lack communication skills.9 But it is crucial to engage the family in active partnership when developing the service plan for an effective intervention.
Acknowledge the correlation between substance abuse and neglect. Substance-abusing parents provide less supervision, spend less time with and express greater dissatisfaction with their children.10 Assessing and treating substance abuse, including creating relapse plans, must be implemented to reduce the risk of neglect and ensure the safety of children.
Utilize plans of safe care. There has been much work around this topic across the state. The Multi-Stakeholder Opioid & Substance Use Response Plan was released by the Georgia Department of Public Health in August. This statewide prevention strategy was developed in partnership with the Office of the Georgia Attorney General, the Georgia Department of Behavioral Health and Developmental Disabilities, the Georgia Department of Community Health and includes recommendations for maternal substance use. Also, Douglas County Juvenile Court is developing a collaborative approach to address mothers with substance use issues and their substance-affected children. Funded through the National Quality Improvement Center for Collaborative Community Court Teams, Douglas County will develop the protocols, policies and procedures that reflect the Comprehensive Addiction and Recovery Act's requirements and best practices and will implement them statewide.

Office of the
Child Advocate
For Georgia's Children

AdvOCAcy
Your child welfare update

September 2018

Page 7

FFPSA, continued...

congregate settings have behavioral health issues that may require a "qualified residential treatment" setting.

One of my personal goals as Interim Division director is to use this opportunity to reestablish a solid, standardized therapeutic foster care system. We need to create additional foster homes in which emotionally fragile children can receive intensive care and support from both well-trained foster parents and professionals in a more family-like setting.

As you can see, a lot has to happen to fully implement Family First. That's why, despite my inclinations to move faster, I've come to recognize the need to take a staged approach to implementation.

We have to give time to our information technology teams to modify our data systems to track children qualifying as "candidates for removal" who are thereby eligible for the prevention services. We have to give our providers time to get certified in the evidence-based programs that the federal government hasn't even identified yet, and I'm mindful that the organizations offering the certifications are going to be swamped.

The Division has had ongoing dialogue with its provider network to discuss service needs under the new law. These discussions have also focused on how DFCS can help its providers adjust their business models to align with the new law while allowing them to continue serving and supporting Georgia's families. I am very pleased that many of our providers, like me, are eager to jump into this work and provide services designed to keep children with their parents or extended family. Like most folks in child welfare, they realize that children fare much better when they can remain in the care of their family members and connected with their friends, school, church, and extracurricular activities.

We have under consideration a "staged implementation" in which we work with all our partners to quickly and successfully put the necessary systems, practices, policies, and laws in place. Once one part of the system is working, we will then be able to implement the aspects of the law that rely on that particular system. The whole time, I'll be urging everyone to move quicker for the sake of our children, with all deliberate speed.

Georgia Office of the Child Advocate for the Protection of Children
Rachel Davidson, Interim Director https://oca.georgia.gov 7 MLK Jr. Blvd, Ste 347 Atlanta, GA 30334
For general inquiries, assistance, or to file a complaint: Phone: (404) 656-4200 Internet: https://oca.georgia.gov/webform/request-oca-
assistance-or-investigation To submit an article for the newsletter: rdavidson@oca.ga.gov

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