Best Practices: Doing it right in Dixieland

In the mid-’90s, a TV producer was making the rounds visiting child protection agencies around the country. When she got to Alabama, she witnessed something unusual.

Paul Vincent, then-director of Child Protective Services at the Alabama Department of Human Resources, remembers the producer telling him that caseworkers in this agency “talk about their families like they like them and respect them, and we’re not accustomed to hearing that.”

That’s exactly what Vincent wanted to hear.

The agency was in the midst of a federally mandated overhaul of its system. The Bazelon Center for Mental Health Law filed a class-action lawsuit against the human resources department in 1988, claiming it was failing the children in its care. That was the same year the American Civil Liberties Union filed its lawsuit against the Illinois Department of Children and Family Services.

While DCFS remains noncompliant with its settlement agreement more than 20 years later, Alabama’s human resources department was released from federal supervision in 2007 and continues to rank highest in the nation in one measure of child safety.

From 2008 to 2010, Alabama boasted the lowest rate—1.2 percent in 2010—of children who were mistreated again within six months of agency intervention, according to the U.S. Department of Health and Human Services. The number of children dying due to abuse or neglect in the state has been nearly halved since 2006, with 13 deaths reported in 2010 compared with 24 in 2006.

Lauded as national models for reform, many of Alabama’s strategies have been implemented in other states. But the ideas were pioneering at the time, said Ivor Groves, federal court monitor for the case. “The [settlement] agreement wasn’t, ‘We’re going to add this many dollars or this many caseworkers.’ It was, ‘We’re going to figure out what we have to do to get better results,’” he said.

The settlement’s principles aimed for a dramatic shift in practice culture. Families were incorporated as partners in service planning, and services were tailor-made for each situation instead of a one-size-fits-all solution.

“We knew more about families in that approach than when we were relying on coercion to change the way they were parenting,” Vincent said.

And knowing more about families is what leads to identifying when a situation can become dangerous—or lethal—for a child, Groves said.

“There’s no screening instrument that will do that for you,” he said. “The culture of the organization has to be focused on the detail of each child and family in the sense that following procedures is not sufficient. You have to know that child and family, and you have to know the circumstances and be in regular enough touch to determine when circumstances change.”

The caseworkers received training on practical skills through simulations as opposed to lecture-based training, an approach Vincent said he doesn’t see commonly replicated today with the same kind of intensity Alabama strove for.

“It’s the difference between a college course on theory and a trade school curriculum,” Vincent said. “You’re actually taught the skills of craft, not just presented with theories and information. A lot of lip service is paid to engaging families in the process, and in many systems it never goes beyond that. It’s a slogan of expressed value, but the training of staff tends to be much more procedurally focused.”

Carolyn Lapsley, the current deputy commissioner for the human resources department’s Children and Family Services, emphasized that assessing families’ protective capacities and circumstances can’t be done in isolation; it is a community effort.

Multidisciplinary teams provide an outside perspective necessary to protecting children. Made up of attorneys, members of law enforcement, child advocacy center personnel and other professionals, the team weighs a child’s best interest when it determines how abuse investigation should be pursued.

“If everybody’s at the table … each participant can lend their particular expertise to securing that child’s safety,” said Paul Butler, current director of the human resources department’s Division of Family Services.

Citizen review panels, made up of volunteers such as teachers, mental health professionals and police officers, review a random sample of cases each year and make recommendations for improvement in practice. These panels, known as quality assurance teams, are now federally mandated, but some states still have confidentiality laws that prevent them from accessing all information, Butler said.

Ultimately, being open to criticism, even if it is uncomfortable at first, is what keeps a child-welfare system on a path of improvement, Lapsley said.

“You really have to listen to people who interact with the system—more importantly the family and kids—to see what they feel is working well and what we need to do different,” she said. “That was a struggle early on to say, ‘What do you mean you want to ask them?’ … Now that’s just second nature.”

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