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The Field Center for Children’s, Policy, Practice & Rese

Postby Dazeemay » Fri Feb 03, 2006 5:42 pm

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Fall 2005 Newsletter

THE FIELD CENTER KICKS OFF BREAKFAST MEETING SERIES
The Field Center for Children’s, Policy, Practice & Research has kicked off the fourth year of its highly successful Breakfast Meeting series with a presentation by School of Social Policy & Practice Dean Richard J. Gelles on September 20, 2005 on Risk Assessment and Stages of Change.

Dean Gelles’ seminar drew a pre-registration of 190 professionals from the tri-state area, representing multiple disciplines and work settings. Providers of direct service and administrators alike found this presentation to be both enriching and thought-provoking. Attendees described the seminar as “very informative and worthwhile.” Participants found it “great for putting individual practice issues in perspective.”

The next presentation scheduled for the Breakfast Meeting series will take place on November 17, 2005 at the Levy Conference Center at Penn’s Law School. Law School Practice Professor and Child Advocacy Clinic Director Alan Lerner will moderate a discussion on Kids in Care: Where We Are, Where We Need to Go. Distinguished panelists include Anne Marie Ambrose, Director of the Bureau of Juvenile Justice Services of the Pennsylvania Department of Public Welfare, Gillian Blair, Ph.D., LLM, Angel Flores, Esq., Chief of the Juvenile Unit of the Office of the District Attorney of Philadelphia, Marsha Levick, Esq., Legal Director of the Juvenile Law Center, and Sandra Simkins, Esq., Assistant Chief of the Juvenile Unit of the Defender Association of Philadelphia. Social Work continuing education units are offered for a nominal fee. Preregistration is available at [email protected] or by calling the Field Center at 215.573.5442.

A public service for the professional community, the Field Center is pleased to offer its free Breakfast Meetings throughout the academic year to enhance knowledge and enrich communication among those varied disciplines involved in the child welfare arena.

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Fall 2005 Newsletter

ABUSE PREVENTION, FAMILY PRIVACY, AND THE FOURTH AMENDMENT
by Alan J. Lerner, J.D.
Practice Professor of Law, University of Pennsylvania Law School
On August 9, 2005 The Department of Human Services (DHS) received a General Protective Services (GPS) Report that a young child, living alone with a single parent who was alcoholic, and violent, had been heard screaming inside her home. The caller also reported that when she went and knocked at the door to ask what was going on, a male voice from inside the house cursed her and told her to go away. On August 10, 2005, a DHS worker made an unannounced visit to the home. Finding no one present, the worker left a letter requesting that parents contact her/him. On August 11, 2005, the worker made another unannounced visit. Once again, finding no one home the worker left another letter requesting contact. However this time, the letter said that if the Department had not heard from the father by the next day, a Petition to Compel Cooperation would be filed in court. Another unsuccessful visit was made on August 18.

On Monday, August 22, the worker requested that the City file a Petition to Compel Cooperation in Dependency Court. As of August 25, 2005, the date of the filing of the Petition, the Department had had no further contact with the family, and had no further information about the safety, health and welfare of the child. The hearing was scheduled for September 8.

This scenario, with minor variations, occurs frequently. Common to these cases is the parents’ disinclination to cooperate with DHS, and the inability of the investigator to gain access to the child and the child’s home to assess the situation. One reason for this is the right of parents under the Fourth Amendment of The US Constitution “to be secure in their persons, [and] houses…against unreasonable searches and seizures….” In the criminal law the Fourth Amendment usually requires a search warrant based upon “probable cause” to believe that the search will yield evidence of a crime, or contraband, or “exigent circumstances” that are likely to make the search unavailable in the time it takes to obtain a warrant, for a non-consensual search. However, the US Supreme Court has held that there are “special circumstances” in which searches do not require a warrant or “exigent circumstances,” usually because they are unrelated to “law enforcement” purposes. (e.g., the search of high school students’ lockers for drugs to prevent drug use among the students, or border searches to prevent the entry of illegal immigrants.) The remedy for searching without a warrant or “exigent circumstances” is the exclusion of any evidence obtained thereby from introduction at a trial of the person whose privacy has been invaded. In the area of child welfare investigations, however, the law concerning what evidence, and what legal procedures are necessary to permit a non-consensual entry into a home, or other “invasion” of the parent’s privacy, in order to investigate a report of possible child abuse or neglect, is decidedly unclear.

In May, 2005, The Superior Court of Pennsylvania held that the search warrant and “probable cause” requirements of the Fourth Amendment to the United States Constitution had to be satisfied before a child protective services worker could enter a home against the will of the parent in order to investigate a report of child abuse or neglect. One week later, the Supreme Court of Nebraska held that those provisions of the Fourth Amendment do not apply to a warrantless, non-consensual, search of a home for evidence of child abuse and neglect – at least insofar as the obligation to exclude from admission at a trial evidence obtained in violation of the Fourth Amendment is concerned. Neither case was appealed further.

Given the state of the law, the understandable concern on the part of DHS workers who are not legally trained, both to respect the legal rights of parents, and to avoid risking personal liability, and the fact that DHS workers have plenty of other cases demanding their attention, it is not surprising that they do not take it upon themselves to force their way into a home to complete an investigation where the parents are not cooperative. At the same time, the relative passivity of leaving a letter requesting that the caregiver contact the Department’s investigator, and then waiting anywhere from a week to more than a month, or perhaps until news of a serious injury or fatality is received, is certainly not all that can, or should be done to protect vulnerable children.

What is needed are: (1) a clear set of policies, procedures and guidelines concerning (a) the evidence that is needed, (b) where and how it might legally be obtained, and (c) what resources are available to assist in its gathering; (2) clearly enunciated procedures for going from receipt of a report of possible child maltreatment to the prompt completion of an appropriately thorough investigation; and (3) training for child protective services workers, law enforcement agencies, and attorneys so that everyone is fully versed in, and comfortable implementing, lawful policies and procedures, designed to protect our children.

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THE STATE OF CHILD WELFARE
by Carol Wilson Spigner, DSW
Kenneth L. M. Pray Professor, University of Pennsylvania School of Social Policy & Practice
What does the new federal child and family service review (CFSR) system tell us about the current state of child welfare?

Between 2001 and 2004, each of the 50 states, the District of Columbia and Puerto Rico, participated in a CFSR to determine how well the states were meeting the goals of safety, permanency and well being for children in need of protection. Conducted by the federal government in partnership with the states, this three phase review included an agency self assessment based on current data, a site visit which included interview with stakeholders and a qualitative review of a small number of cases. Although the new review protocol was controversial on a number dimensions, it does constitute the first nation-wide picture of child welfare systems using common measures.

The review focused on a series of outcome measures as well as a set of systemic measures. The outcome measures were organized around safety permanency and well being:

Children are first and foremost protected from abuse and neglect
Children are safely maintained in their homes
Children have stability and permanency in their living situations
The continuity of family relationships and connections is preserved
Families have enhanced capacity to provide for children’s needs
Children receive services to meet their educational needs
Children receive services to meet their physical and mental health needs
The systemic factors were viewed as essential components needed by a child welfare system to achieve its intended goals. The factors upon which agencies were evaluated included:

Statewide information systems
Case review system
Quality assurance system
Training
Service array
Agency responsiveness to community
Foster and adoptive parent licensing, recruitment and training.
Each state was assessed to determine whether it was in substantial compliance with both the outcomes and the systems factors. Each factor had a number of indicators which were measured to make that determination.

The states were more likely to be found in compliance with the systemic factors than with the outcome measures.

States in substantial compliance with CFRS standards N= 53 Number (%) of states in compliance
Systemic factors
State wide info systems 45 (87)
Case review 13 (25)
Quality assurance 35 (67)
Training 34 (65)
Service array 23 (44)
Agency responsiveness 49 (94)
Licensing, recruitment and retention of foster parents & adoptive parents 43 (83)
Children are protected from abuse and neglect 6 (11.5)
Children are safely maintained in their homes 6 (11.5)
Children have permanency and stability 0 (0)
Continuity of family relationships 7 (13.5)
Families have enhanced capacity to provide for their children’s needs 0 (0)
Children receive services re: education 16 (30.8)
Children receive services re: physical and mental health 1 ( 1.9)

The first major impression I drew from the data is that we have spent the last two decades improving the infra-structure of child welfare. Build the system has been necessary but not sufficient. We have not paid enough attention to the direct work with families and children. In fact, when you examine the systemic factors, the one most closely related to direct work with families and children did least well: case reviews systems.

In examining the indicators that are the basis for the assessment of the outcomes one finds that the number of states with a strong performance is limited. Most notably few states did well in the areas of family involvement in case planning (5 states), worker visits with the child (13 states), visits with the parents (7 states), meeting the needs of child, parent, foster parent (1 state) and meeting the child’s mental health needs (4 states). In contrast, the majority of the states did well on placing children close to home (49 states) and placing siblings together (36 states). Agencies seemed to have focused more on the system and tangible tasks than on the quality of service. There is a tremendous need to focus on the treatment needs of children and their families and to create agency environments that will support this kind of work.

Among the challenges identified among the states were the needs to improve the consistency in services to parents and consistency in completion of adoption home studies. There is also a need to address the inadequacy of placement resources and the process by which placements are selected for children. In terms of permanency, limited efforts were being made to conduct concurrent planning; agencies were using long term foster care as the plan without consideration of adoption or guardianship, and agencies are not filing for termination of parental rights as required by law. As it relates to well-being, children were not receiving mental health assessments and responding to the physical and dental health of children has been compromised by the lack or providers who will accept Medicaid. Finally and perhaps most importantly, the assessments of the needs of children, parents and/or foster parents remains a challenge.

The results of the CFSRs are deeply troubling. Every child welfare agency in this county has much work to do. States are actively engaged in implementing program improvement strategies. There are some simple things that can be done to turn systems around like conducting good assessments, engaging parents actively in goal setting and service planning, assuring that the services available are responsive to the needs of children & families, and making sure that both families and workers have what they need to protect children. In all of this work, it is important to keep the results for children and their families central.

Source: General Findings From The Federal Child and Family Service Review, U. S. Department of Health and Human Services,
Administration for Children and Youth, Children’s Bureau.
http://www.acf.hhs.gov/programs/cb/cwrp ... ings04.pdf

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MEDICAL CHALLENGES IN THE FIELD OF CHILD PROTECTION: MAKING ACCURATE DIAGNOSES
by Cindy W. Christian, MD
Children's Hospital of Philadelphia Chair in the Prevention of Child Abuse and Neglect
Associate Professor of Pediatrics at the University of Pennsylvania School of Medicine
The accurate identification of child abuse is an important, but difficult, task for physicians. Doctors who care for children are mandated by law to report children who they suspect are victims of abuse or neglect to governmental child welfare agencies (and sometimes police) for further investigation. In an ideal world, physicians would have the tools needed to identify all children who are victims of maltreatment without having to report those who are not. This is hardly what happens in real practice. There is clear evidence that reporting of suspected abuse by physicians lacks accuracy. In general, medical diagnoses are made by completing a careful and thorough history and physical examination. In cases of child abuse, the history is almost always inaccurate- either because the adult providing the history is unaware of the abuse, or is in fact the perpetrator of the abuse and is purposefully misleading the physician. Without an accurate history, it is often difficult to reach the proper diagnosis. Research has shown us that abused children are often misdiagnosed by unsuspecting physicians. For example, Jenny et al, reviewed the medical records of 173 infants and young children with inflicted head trauma to determine how often the children had been seen by their physicians with symptoms of their abuse, and were misdiagnosed.1 They found that approximately one third of children were not recognized as victims of abuse and were given incorrect diagnoses. Of those, 25% were re-abused before the correct diagnosis was made. The authors also found that Caucasian infants living in two parent households were more likely to be missed, suggesting some racial and social biases in diagnosing inflicted head trauma. In 2002, we expanded on that finding and studied racial biases in the evaluation of young children with fractures for suspected abuse.2 We found that while there was no racial difference in how infants with fractures were evaluated for abuse and reported to child welfare, minority toddlers with accidental injuries were five times more likely than their Caucasian counterparts to be medically evaluated for abuse, and three times more likely to be reported to child welfare for further investigation. National data support these findings. The federally funded national incidence studies on child abuse and neglect indicate that while no significant racial differences exist in the incidence of maltreatment, minority children are more likely than white children to be found in the child protective service system.3

Communities around the country turn to local physicians to assist in the recognition, medical evaluation and care of maltreated children. For many physicians, it is an emotionally difficult and unpleasant task. Most physicians have received inadequate training in the identification and care of abused children, have limited clinical experience in evaluating abused children, and do not look forward to working with social services, law enforcement and the courts. And while the laws in all states mandate physicians to report suspected abuse, recent work from Pennsylvania suggests that there is so much variability in how pediatricians interpret the phrase “reasonable suspicion” as to make the phrase uninterpretable.4 This leaves doctors with the duty to recognize and report suspected abuse, but with little medical training or specific legal guidance in how to accurately accomplish this. In turn, well-meaning doctors put another strain on an already strained system by asking child welfare to investigate too many cases that have nothing to do with abuse, while failing to recognize the more subtle signs of abuse that may cross their paths. While I give credit and support to my medical colleagues who provide thoughtful care to children and their families, and work diligently to uncover abuse when it exists, we too have more work to do.

1 Jenny C, Hymel KP, Ritzen A, Reinert SE, Hay TC. Analysis of missed cases of abusive head trauma. JAMA 1999; 281: 621-626.

2 Lane WG, Rubin DM, Monteith R, Christian CW. Racial differences in the evaluation of pediatric fractures for child abuse. JAMA, 2002; 288: 1603-09.

3 Sedlak AJ, Broadhurst DD. The third national incidence study of child abuse and neglect. Washington DC: U.S. Department of Health and Human Services, 1996.

4 Levi BH, Brown G. Reasonable suspicion: A study of Pennsylvania pediatricians regarding child abuse. Pediatrics 2005; 116: e5-e12.

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This is not legal advice;hopefully wisdom

To put it in simple terms…when the authorities ARE the perpetrators and the perpetrators ARE the authorities, there is no earthly justice or recourse, at the end of the day (unless the American people wake up).

Therefore, those who have achieved the highest levels of power seek to ‘enjoy’ the most grievous and extreme injustices. For many of those in the highest circles of power, the greatest statement of power is to perpetrate the greatest possible injustice…the savage, brutal traumatization and abuse of an innocent child.
http://themurkynews.blogspot.com/ MattTwoFour

"Ultimately, the law is only as good as the judge" --- D.X. Yue, 2005, in "law, reason and judicial fraud"
http://www.parentalrightsandjustice.com/index.cgi?ctype=Page;site_id=1;objid=45;curloc=Site:1

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