Title: State Part C Agencies and the Child Abuse Prevention and Treatment Act CAPTA
1State 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
2CAPTA 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).
3IDEA 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)
4What 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
5What 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.
6Why 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
7Underuse 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
8Possible 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
9Challenges 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
10Current 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
11Measure
- 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
12Participants
- 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
13Referral Receipt and Response
- 71 reported multiple referral methods
14Referral Receipt and Response
- Most frequently used method
15Sibling 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
16If 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
17Foster 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.
18Screening 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
19Who conducts screening?
20Social/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
21Collection 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
22Service 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
23Parent 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
24Training 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
25Collaboration 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
26Methods of Tracking
27Recommendations
- Referral Process
- Screening and Assessment
- Service Delivery
- Tracking
28Referral Process
- Standardized referral forms
- Voluntary vs. mandated service provision
- System for sibling referral
- Legal issues around consent
29Screening and Assessment
- Legality of screening in Part C
- Possible duplication of screening services
- Guidelines for appropriate assessment of
social/emotional issues - Difficulty sharing information
30Service Delivery
- Training in working with children in CW
- Infant mental health training
- Care-giving skills of parents in this population
- Parent Training
- Collaborative Care
31Tracking
- Development of consistent tracking methods in all
areas - Coordination with AFCARS and Part C data
collection systems already in place
32Funding
- Advocacy is needed for funding the CAPTA
regulations in order to make the appropriate
changes