Present: Verne Johnson (chair), Janis Clay, Paul Gilje, Bill Kelly, Sallie Kemper, Dan Loritz, Tim McDonald, Clarence Shallbetter, Curtis Johnson.
A. Welcome and introductions - David Thompson is program manager of the Child Safety and Permanency Division of the Minnesota Department of Human Services. He has worked at the Department since 1999. He is responsible for the division's child safety and child welfare reform efforts including Minnesota's differential response and early intervention programs.
Thompson has a BA in sociology and an MSW from the University of Minnesota. He has been involved in the development and implementation of innovative early intervention programs using strength based and collaborative intervention models in addressing child maltreatment.
In 2007 David was awarded the Children's Bureau Commissioner's Award for his work on implementing in Minnesota the practice of "differential response", which allows for a more flexible and targeted approach to child welfare cases. He has been a community faculty member for the departments of Social Work at the College of St. Catherine and the University of St. Thomas.
B. Discussion - During the course of the discussion the following points were raised:
Organization of Minnesota's child welfare system outlined.
Minnesota has a state-administered, county-delivery system, Thompson said. The system is paid for mostly by counties, which contribute about 50 percent of costs. The federal government pays 35 percent and the state pays 15 percent.
Thompson described the traditional way of doing business in child welfare as "investigative and punitive". Previously, State employees would respond to a complaint, perform interviews, and see if there were criminal issues at hand. That protocol of the investigative process had its genesis in the 20 th century estimation that children suffering criminal abuse numbered in the thousands per year. Today, it is estimated that six million children are reported for child maltreatment in the country each year.
"The protocol that was developed 50 years ago was never designed for severe abuse and not for the majority of neglect issues we have today."
Most of what is seen publicly in the media, Thompson observed, has to do with the parents abusing or failing to protect a child, or the state failing to protect a child. Those are a small minority of the cases that occur. Sexual and physical abuse has fallen over the years, while neglect has grown.
Most cases today have to do with issues of neglect, Thompson said. There is a correlation between neglect and both poverty and lack of other resources. Families in poverty are seven times more likely to have issues of neglect of children. Presently as poverty is growing, the concentration of poverty is growing as well. This requires a new look at the way the state responds to child welfare issues.
An alternative approach developed.
Thompson and his colleagues recognized the problem emerging as a child protection protocol developed for one set of issues was being applied in an entirely different context. They worked to develop a more effective approach.
Social workers in the new paradigm try to engage families in a very respectful, non-accusatory way. They ask families what kinds of things they need to be successful in meeting the needs of their children. As many of the families' struggles stem from issues having to do with poverty, social workers work to address those issues through finding the local services that address their particular needs and connecting families to those services.
Family Assessment Response piloted.
Twenty counties began a pilot program incorporating the new approach in 2000, and by 2004 all 87 counties in the state were active in the program. The "family assessment response", as it is known, is now the preferred response for the child welfare cases that do not involve immediate child endangerment.
The purpose of the pilot was to test the impact of early intervention services for families that demonstrate risk factors for child safety. The pilot was structured to test the systems and processes for reaching out to families that were not served well by the heavy-handed intervention of the traditional child welfare system.
One of the main tasks of the pilot was to connect at-risk families with various community programs that can provide ongoing support. Eligible families were contacted and offered participation in the program. Families that accepted services went through a process with a social worker to assess the well being of their children and needs of the family. Following that assessment, families worked with social workers to find services in the community to assist with the needs. The social worker checked in with the family six months later to follow up.
The types of services provided include poverty-related services (housing, food, employment); drug and alcohol treatment services; counseling and domestic violence; educational and health care-related services; and childcare.
The agency is relying more on community programs. Social workers partner with local community groups to reach out to families. There is an intervention called "signs of safety" that brings extended families, neighbors, coaches, and pastors into a risky situation to decide as a group how they will help to keep the child safe. "There's only so much government can do," Thompson said. "Sometimes what's most effective as a means of protecting a child also has the most trauma attached to it, like removing a child from the home." They are trying to find the most effective ways to protect children while minimizing their trauma.
Positive signs emerge-better results for less money.
The team set up a four-year implementation and research plan for the pilot, aided by the McKnight Foundation. "The research was the most rigorous kind you can have," Thompson said, both random trial and longitudinal.
The study of the program ran from April 2005 through the end of December 2008. It included 38 participating counties and served 5,000 families. Pilot counties received $1,000 per family in the form of service grants funded by foundations.
The research has shown that if child protection reaches out to the family with a non-adversarial approach they are likely to encounter less resistance, and if they provide appropriate interventions the child is less likely to need foster care.
Agency employees found that either issues of income and employment, management of household and control of children, or maintaining the safety and health of children were improved for 62 percent of those families that accepted services.
In a survey of families 37 percent reported they were somewhat better off and 42.5 percent said they were much better off as a result of the program.
Over the time of the research participating families required 35 percent less of public dollars. "The families are less likely to come back needing intervention, less likely to need expensive public services," Thompson said.
The differences are subtle, he argued, but significant: Having a social worker come to the door instead of a law enforcement officer, or getting a phone call saying "I heard you're having a difficult time," is significantly less threatening to troubled families.
"In many cases when we're called to intervene, the families are struggling and mistakes are being made, but it's really not yet child mistreatment," Thompson said. "They just need help, and once we provide that, for many we never receive a call again."
The new response approach is applied to over 70% of all the new child maltreatment reports. Re-reporting rates remain low as do the need for out of home placements.
The program spreads nationally.
Minnesota has continued the program since the pilot ended, continuing to expand it into all counties and codifying it in legislation. Ohio adopted Minnesota's program and statute, and provided researchers to follow it; it has been replicated successfully there and now in other states. The federal government was so impressed it changed the Child Abuse Prevention and Treatment Act to require states to be working to reform their welfare programs toward this model of "differential response".
"Since we've started this program there has been a 10 percent drop in child maltreatment reports and 35% reduction in out of home placements," Thompson said, though their work has increased in the prevention programs.
"The way out of poverty is eased with services like health care and basic support from family and community," he added, and child welfare improves as a result.
The agency is no longer telling families that child welfare workers are the experts and will come in to fix families-but instead they offer what they know about available help and can work with families to problem solve in a way that gains the families' trust and cooperation. "The research shows the agency is most effective when it partners with families," Thompson said. "Families and communities often know better than we do about how to get things done," he added, and so the program represents movement toward government as facilitator and away from government as fixer.
Sustainability of Family Assessment Response becomes a top concern.
To a question about the ability of the program to sustain over time, Thompson answered that they have tried to build incentives into it so counties have a reason to continue. There is a financial incentive for counties to do this work too, he said, and it's in legislation now that the counties must engage in this type of intervention program.
Even given the improved service, the program is susceptible to budget pressures. "I don't think the counties can sustain much more budget cuts before we start losing the capacity to do effective prevention," Thompson said, "or have the discretionary funds which are essential for getting out ahead with families before their problems escalate to crisis level."
There are people in government from all levels that have something to add to improvements in the delivery of these services, Thompson said in closing. The greatest satisfaction for him has been the ability to do child welfare work in Minnesota.
"I was born in St. Paul, went to the University of Minnesota, have taught at St. Thomas and St. Catherine's. While child protection seems like a difficult job, a very difficult societal issue with which to grapple, if you're going to do this work then Minnesota is a great place to do it." Here it is possible for people to work together to accomplish change and bring about real, measurable improvement in the way these critical services are delivered.
The chair thanked Mr. Thompson for the visit.