State Part C Agencies and the Child Abuse Prevention and Treatment Act CAPTA - PowerPoint PPT Presentation

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State Part C Agencies and the Child Abuse Prevention and Treatment Act CAPTA

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States receiving CAPTA funds must develop and implement 'provisions and ... 40% of children under 3 exhibited serious developmental or behavioral risk ... – PowerPoint PPT presentation

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Title: State Part C Agencies and the Child Abuse Prevention and Treatment Act CAPTA


1
State Part C Agencies and the Child Abuse
Prevention and Treatment Act (CAPTA)
  • Aubyn C. Stahmer, Ph.D.
  • Rady Childrens Hospital
  • Child and Adolescent Services Research Center
  • Collaborators Danielle Thorp Sutton, PhD., Lise
    Fox, PhD. and Laurel K. Leslie, MD, MPH

2
CAPTA 2003
  • States receiving CAPTA funds must develop and
    implement provisions and procedures for referral
    of a child under the age of 3 who is involved in
    a substantiated case of abuse or neglect to early
    intervention services funded under part C of the
    Individuals with Disabilities Education Act
    106(b)(2)(A)(xxi).

3
IDEA 2004
  • States must provide a description of the State
    policies and procedures that require the referral
    for early intervention services under Part C of a
    child under the age of 3 who is involved in a
    substantiated case of child abuse or neglect
    637(a)(6)(A)

4
What this means-1
  • -Not ALL children under age 3 with substantiated
    cases receive an evaluation.
  • -Screening can be used to determine whether an
    evaluation is needed.
  • -Spirit of the law These children will receive
    special attention to determine whether an early
    intervention referral is needed.

See Keller-Allen (2007) inForum Brief Policy
Analysis www.projectforum.org and Child Welfare
Policy Manual www.acf.hhs.gov/j2ee/programs/cb/law
s_policy/laws/cwpm/index.jsp
5
What this means-2
  • -Referral can come from child welfare (CW) OR CW
    can use other referral sources (e.g., physicians)
    to screen and refer
  • -No requirement to refer siblings under age 3 who
    are not the subject of abuse or neglect, but
    encouraged to refer siblings who may have delays.

6
Why implement links between child welfare and
Part C?
  • Highest rates of abuse and neglect occur in
    infants and toddlers
  • 16.1 per 1000 children under age 3
  • High rates of developmental delay in this
    population
  • 23-61 of children known to CW have delays in
    development, communication, behavior

7
Underuse of EI in CW
  • Rosenberg et al, 2004
  • 17 of children in CW eligible for Part C were
    receiving services
  • Stahmer et al., 2005
  • 40 of children under 3 exhibited serious
    developmental or behavioral risk
  • Only 13 of these children received any early
    intervention services

8
Possible Impact on Part C
  • As much as
  • 70 increase in referrals to Part C
  • 167,000 infants and toddlers
  • 20 increase in Part C enrollment
  • 44,000 infants and toddlers
  • Rosenberg Rosenberg, 2004

9
Challenges for Part C
  • Increasing capacity
  • Coordination of screening and evaluations
  • Multiple placements
  • Infant mental health issues
  • Complex needs of biological families
  • Multiple caregivers--consent
  • Part C as a voluntary service

10
Current Research Project
  • Referral methods from CW to Part C
  • Screening and evaluation procedures
  • Service delivery modifications needed for this
    population
  • Methods of tracking and referral

11
Measure
  • 23 questions in the 4 areas of interest
  • Yes/no, multiple choice or short answer
  • No child specific information
  • State level data
  • Survey is available on the website for the call

12
Participants
  • 43 (84) states (of 51) responded
  • 37 via email
  • 2 via fax
  • 4 via telephone
  • Part C Coordinators (69) or their
    representatives
  • 20 Part C administrative staff
  • (manager, supervisor, director)
  • 10 consultant or program specialist

13
Referral Receipt and Response
  • 71 reported multiple referral methods

14
Referral Receipt and Response
  • Most frequently used method

15
Sibling Referrals
  • Wide variability
  • 38 referred all siblings under age 3 as
    involved in the case
  • 40 only referred if developmental concerns in
    the sibling
  • 21 did not routinely refer siblings

16
If parent refuse to consent
  • 62 reported refusal to social services or the
    legal system
  • One state only if medical concern
  • 29 took no action
  • Part C agencies felt CW was responsible for
    following up on court-mandated participation

17
Foster Parent Consent
  • Depends on
  • Meet IDEA criteria for foster parent
  • Appointed as a surrogate
  • Respected right to refuse consent
  • 58 reported refusal to social services.

18
Screening Assessment
  • 71 of states implemented screening
  • 27 specific protocol for CAPTA referrals
  • 1 state screened all children except CAPTA
    referrals
  • 2 states in the process of developing screening
    policy for CAPTA referrals

19
Who conducts screening?
20
Social/Emotional Assessment Tool
  • 71 specified use of S/E tool
  • 28 of these had a specific tool
  • ASQ-SE (7 states)
  • TABS (1 state)
  • DECA (1 state)
  • Others had S/E component of developmental
    assessment or left choice up to clinician
  • 29 did not have guidelines for S/E assessment

21
Collection of Info from CW
  • 29 had policies requiring collection of
    developmental info from CW as part of evaluation
    process
  • 8 states had general polices that included CW
  • 4 states had policies specific to CW
  • 3 states referred to need to obtain parental
    permission to obtain collateral info
  • At least 2 states automatically received
    collateral info as part of the referral process

22
Service Delivery
  • 95 of states did not require permanent residence
    before IFSP or services began
  • IFSP transfers across counties / areas
  • Service interruption if Part C not informed of
    change in residence
  • 95 of states attempted to include biological
    parents in the IFSP process
  • Dependent on CW directive locating parents
    parent desire to participate
  • No inclusion if parental rights terminated

23
Parent Training / Education
  • If PT offered
  • 100 to foster parents
  • Biological parents
  • 38 always
  • 43 if child at home
  • 30 if child out-of-home but reunification a goal

24
Training for Part C Providers
  • 19 offered training in how to work with families
    referred through CW
  • 12 in the process of developing training
  • Training focused primarily on administrative
    issues rather than clinical
  • One state had liaison position to coordinate
    services
  • 3 states mentioned trainings in interventions
    specific to this population

25
Collaboration Between Agencies
  • 84 report collaboration efforts for IFSP
    development and/or service delivery
  • Forms of collaboration
  • Consultation regarding assessments/services
  • Joint evaluations/staffing
  • Sharing of information
  • Combined home visits
  • Inclusion of CW in IFSP

26
Methods of Tracking
27
Recommendations
  • Referral Process
  • Screening and Assessment
  • Service Delivery
  • Tracking

28
Referral Process
  • Standardized referral forms
  • Voluntary vs. mandated service provision
  • System for sibling referral
  • Legal issues around consent

29
Screening and Assessment
  • Legality of screening in Part C
  • Possible duplication of screening services
  • Guidelines for appropriate assessment of
    social/emotional issues
  • Difficulty sharing information

30
Service Delivery
  • Training in working with children in CW
  • Infant mental health training
  • Care-giving skills of parents in this population
  • Parent Training
  • Collaborative Care

31
Tracking
  • Development of consistent tracking methods in all
    areas
  • Coordination with AFCARS and Part C data
    collection systems already in place

32
Funding
  • Advocacy is needed for funding the CAPTA
    regulations in order to make the appropriate
    changes
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