Best Practices Summaries

Department of Children and Family Services: Phase Two Management Audit

Price Waterhouse Coopers

November 19, 1998

Best practices were identified in the following locations:

• Santa Clara, California

• San Diego, California

• Harris County (Houston), Texas; and

• St. Louis, Missouri

Harris County Children's Protective Services

Best Practices:

• Assessment center

• Volunteer programs

• Public information programs

Background

While child welfare in Texas is State-managed, in Harris County (Houston) there has been a long tradition of County-level involvement. In Houston, State workers handle case intake and screening and State workers carry all of the open cases. The County provides services that fill in the gaps, such as assessment of new cases, training, school-based outreach, medical services, and representation of the State in court.

Assessment Center

The Children's Crisis Care Center (known as the 4C's Program) is a collaborative partnership aimed at improving and enhancing services provided to abused and neglected children. Partners in the 4C's Program include Harris County Children's Protective Services, Texas Department of Protective and Regulatory Services, Baylor College of Medicine: ChildTrauma Programs, and Mental Health and Mental Retardation Association (MHMRA) of Harris County.

The 4C's Program provides for a proactive, up-front, multi-disciplinary assessment of children referred to the child welfare agency. The assessment is performed by the staff of a special unit which is completely separate from either the intake/investigation unit or the family maintenance/reunification unit. The results of the assessment are reported to the case carrying social worker and the court for consideration in the case plan. The assessment facilitates early intervention and therapeutic services to meet the specific needs of each family and child.

Two separate types assessments are performed:

• Immediate family assessment. The family assessment is completed within 72 hours of a child entering custody. The family assessment includes three standardized psychological assessment tools that measure family functioning, parent functioning, and child functioning, as well as a semi-structured clinical interview.

• Developmental/psychological child assessment. Children who enter custody complete a multi- dimensional developmental (for children under age 6) or psychological (for children age six or above) screening within 10 to 14 days. Clinicians for Harris County, Baylor, or MHMRA may conduct the screening. Written reports in the standard format (primarily bullets and scaled scores with 1 1/2 pages of narrative) are provided to the case carrying social worker within 20 days of the date the child was taken into custody so they may be considered at the dispositional hearing.

Information from both the family in child assessments are used to make recommendations regarding treatment and placement. Members of the assessment team, which include clinicians from Harris County Children's Protective Services, Baylor College of Medicine: Department of Psychiatry, and Mental Health Metal Retardation Authority, confer as a team in developing recommendations.

The program has been evaluated with a fair degree of rigor, and findings suggest that the 4C’s Program had the following positive effects:

• Children experienced fewer placement disruptions:

• The average time between initial emergency placement and a longer-term placement was reduced (49.2 days for children in the comparison group vs. 32.1 days for children in the 4C’s program):

• Children were more likely to be placed with relatives:

• Children returned home at higher rates.

It is also notable that prior to the 4C's Program, it took up to six weeks for social workers to obtain a psychological assessment for children in custody.

There are two critical success factors for the 4C's Program:

• The program was formulated collaboratively by the partners. As result, there was a high degree of buy-in to the pilot project, which has carried over as the program has been institutionalized.

• The assessment is not performed by the Texas Department of Protective and Regulatory Services, the agency responsible for taking children into protective custody. By having clinicians from other agencies perform the assessments, families are more cooperative. The clinicians emphasize that they are not part of CPS operations.

Funding for the family assessment is through Title IV-B. Medicaid covers much of the cost of the child assessments. Services provided by the MHMRA trigger funding directly to that agency through mental health funding streams. The ChildTrauma Programs donates staff time, partly because it anticipates that the data collected through the 4C's Project will provide a rich source of future research material.

For more information about this model
and The ChildTrauma Academy,
please visit www.ChildTrauma.org