Submit a copy of the annual report(s) from the citizen review panels and a copy of the State agency’s most recent response(s) to the panels and State and local child protective services agencies, as required by section 10(c)(6) of CAPTA.

Program Purpose

This report provides a summary of the activities by the Texas Citizen Review Teams from October 2008 to September 2009. It is being submitted as required by the Child Abuse Prevention and Treatment Act Section 106 “Grants to States for Child Abuse and Neglect Prevention and Treatment Programs” [42 U.S.C. 5106a]. This information will be included in the Title IV-B Child and Family Services Plan for the Texas Department of Family and Protective Services.

Background

There are 18 Citizen Review Teams as established by the Texas Family Code (TFC §261.312). Four of these teams are designated as meeting the requirements of Child Abuse Prevention and Treatment Act, Appendix I. This report consists of information concerning the issues addressed only by the four Child Abuse Prevention and Treatment Act teams. All four teams were incorporated as CAPTA teams as of June 1, 1999. They are located in Amarillo (Region 01), Fort Worth (Region 03), Austin (Region 07), and El Paso (Region 10). These sites represent a mixture of urban and rural communities, and reflect the broad range of issues encountered by Child Protective Services (CPS) statewide.Structure

As required, the Child Abuse Prevention and Treatment Act team members are volunteers who represent a broad spectrum of their communities. The members are nominated locally and approved by the DFPS Commissioner. CPS state office staff provide assistance in the areas of coordination, team development, training, and statewide distribution of team reviews and recommendations. Local CPS staff facilitate the exchange of case-specific information, ensure that confidentiality is maintained, perform the required background checks on nominated members, and arrange for meeting space and clerical support.

Reporting Process

 To coincide with the federal fiscal year reporting period, this report covers the period from October 2008 to September 2009. Information presented here consists of data gathered by the Child Abuse Prevention and Treatment Act teams. The teams utilize the Citizen Review Team Reporting form, a standardized form that was developed by CPS state office for the teams, put into use in April 2000, and modified to be more user-friendly in May 2009.

Agency Response

 Citizen Review Team recommendations are placed on the DFPS website. In addition to the recommendations from the Child Abuse Prevention and Treatment Act teams, recommendations and concerns expressed by other, non-CAPTA teams are also on the website. The web page for the recommendations contains a Citizen Review Team specific mailbox that the public can use to comment on the recommendations. The webpage is located at http://www.dfps.state.tx.us/Child_Protection/CRT/.

State office program staff review Citizen Review Team recommendations and those recommendations are considered when developing policy, training, and procedures.  The Child Abuse Prevention and Treatment Act teams often have recommendations for the local CPS direct delivery staff about actions they would like to see taken in a particular case. These case-specific recommendations are communicated during the Citizen Review Team meeting to the CPS representatives who are present and are recorded on the standardized reporting form. Actions on case-specific recommendations are handled at the regional level.

Panel Activities

During the 2009 fiscal year, the Citizen Review Team/ Child Abuse Prevention and Treatment Act teams made significant efforts to meet regularly.   Three of the Child Abuse Prevention and Treatment Act teams were able to meet quarterly in compliance with the requirements of the Child Abuse Prevention and Treatment Act. The Tarrant County Child Abuse Prevention and Treatment Act team had significant changes including a change in the coordinator and difficulty recruiting volunteers for the team.

The coordinators are CPS staff assigned to this project.  In addition to acting as Citizen Review Team coordinators, their other duties are CPS supervisors, program directors, program administrators, and program specialists. The Citizen Review Team Coordinators focused on local and statewide strategic planning, more frequent and regular meetings of active teams, and formation of new teams. The Citizen Review Team coordinators meet regularly with state office program staff to discuss better ways to engage the community in the review process.  A Citizen Review Team member manual is in the process of development.  A Citizen Review Team coordinator's manual has been developed and is available as a resource for each team.

Two new teams have been developed in Region 03 (Dallas) and Region 06 (Houston). Although these two teams were recommended last fiscal year, they have now been fully staffed and are meeting regularly.  These two teams are focusing on disproportionality issues regarding children that have been removed from their families.
The four Citizen Review Team/ Child Abuse Prevention and Treatment Act teams met as follows from October 2008 through September 2009:

  • Region 01 (Amarillo/Potter County) — December 12, 2008; April 17, 2009, July 10, 2009, and September 25, 2009
  • Region 03 (Fort Worth/Tarrant County) — None
  • Region 07 (Austin/Travis County) — March 24, 2009, May 26, 2009, July 28, 2009, and September 23, 2009 (only one member attended so the review could not take place).
  • Region 10 (El Paso/El Paso County) — March 26, 2009, August 6, 2009, July 30, 2009, and August 20, 2009

The Child Abuse Prevention and Treatment Act team coordinators continue to work with their communities to engage and encourage volunteers to become involved in our efforts to gain feedback from the public.

Summary of Findings

The findings of the Child Abuse Prevention and Treatment Act Citizen Review Teams that have statewide implications (as opposed to recommendations aimed at local procedures and issues) are summarized below.

Region 01 focused their concerns on a child death.  Specifically, there were serious concerns about the lack of communication between the Psychiatric hospital and the residential facility staff upon discharge of the deceased child. It was recommended that STAR Health managers and regional nurses be utilized to improve communication surrounding discharge planning and medication orders.  

Region 07 focused on multiple areas of concern:  staff turnover and high caseloads, engagement of non-resident fathers during CPS cases, lack of drug treatment resources for parents, lack of training for frontline staff on disproportionality issues, and lack of training for staff on identifying risks and how to work with families with special needs children.

Specific recommendations included:

  • Management should take steps to assure there is consistency for families when there are multiple changes in staff on the family's case.
  • Staff need training and guidance on how to engage non-resident fathers.
  • Staff need more resources for drug testing parents.
  • Frontline staff need training on disproportionality issues.
  • Staff need more guidance about working with children with special needs.

Region 10 focused on three areas including community resources for children with primary medical needs, drug treatment resources for their clients, and training for staff on identifying drug effects.

Specifically they recommended:

  • More community resources for children with primary medical needs should be developed.
  • More community drug treatment resources for parents that have drug issues should be developed so the treatment can be accessed in a timely manner.
  • Staff need training on drug effects and how to evaluate these effects on child safety.

CPS Protection Initiatives

The following chart describes CPS actions that relate to Citizen Review Team-identified issues. Each initiative reflects CPS efforts to respond to and improve the quality of the services it provides to the children and families of Texas.

 

Region

Issue Addressed

Recommendation

CPS Initiative

1

Lack of clear communication between psychiatric hospital and residential staff upon child's discharge. Medication changes were not discussed and the child died within two days of discharge.

Use regional nurses and STAR Health to improve discharge planning and communication between the hospital staff and the child's facility staff.

 

The Medical Services Division was moved to Child Protective Services in September 2009.  The CPS Director of Services, Health and Human Services Commission managers and STAR Health managers meet monthly to strengthen collaboration and improve the medical services process for the children in DFPS custody.
A case review of fatalities for children with primary medical needs began in April 2010.  Findings from the review of records, case actions and decisions will further inform practice and policy. Regional nurses, investigation representatives, and Medical Services Division staff are participating in the case review.

7

Staff turnover and high caseloads have an affect on the outcomes for the families we are working with.

Recommend that management take steps to provide consistency for the families when there are multiple changes of staff on cases.

The Department of Family and Protective Services (DFPS) have been involved in the Workforce Support and Retention Initiative to improve our selection of staff so we hire persons that know the kind of work being done in this agency and to find ways of retaining the staff that are hired. This workgroup focused on implementing proactive strategies, policies, procedures and practices that:

  • Promote employee communication and input
  • Improve hiring practices
  • Strengthen supervision
  • Manage workloads
  • Enhance work environment; and
  • Value employees

Some of the accomplishments are:

  • An employee communication reporting tool
  • Method to ask questions of the DFPS Commissioner
  • Enhanced the job preview to provide a realistic job overview for perspective new hires
  • Developed a skilled-based Core training for new caseworkers
  • Developed a skilled-based Supervisor Core Training
  • Developed a Managing Workload Clearinghouse Web site
  • Established policy for teleworking
  • Identified means for employee recognition

7

Staff are having difficulty engaging non-residenct fathers while working their case.

Staff should receive training and guidance on how to engage and work with non-resident fathers.

The Fatherhood Program Specialist with the Department of Family and Protective Services is involved in providing training and guidance for staff throughout the state. This includes:

  • Presenting information about engaging non-resident fathers in every region;
  • Giving presentations at different conferences such as the Strengthening Families conference, the Conservatorship conference, the Fatherhood Symposium;
  • Partnering with outside agencies to provide services to the non-resident fathers; and
  • Developing a Fatherhood web site where staff can gain information about identifying and engaging fathers.
  • Participating in the Fatherhood Roundtable with fathers from Child Protective Services, members of the judiciary, and other child welfare system stakeholders  from around the state.

 

7

Staff lack resources for treatment of parents with drugs issues

Develop more in-patient and out-patient treatment programs for these parents.

The Department of State Health Services and the Department of Family and Protective Services are actively pursuing the expansion of drug courts, especially in rural areas. Expansion of resources is also being pursued through the Access to Recovery Grants to assist those people without a license such as "Victory Outreach", who provide assistance to people addicted to drugs. The Drug Demand Reduction Advisory Committee is also working to increase treatment services.  A substance abuse website has been created for staff on the DFPS intranet that provides online information regarding available statewide drug treatment resources. A million dollars was added for more drug testing for parents.

7

Staff lack an understanding of the disproportionality issues that may affect their work with families

It is recommended that all staff receive training on disproportionality.

Staff will continue to participate in the cultural diversity training "Knowing Who You Are" during Basic Skills Training. This training has been made available to all Family Based Safety Services and Conservatorship staff that did not receive the training in Basic Skills Development. "Knowing Who You Are" training is available to Investigation staff, as there is room, in Basic Skills Development.
Each region has at least one Disproportionality Specialist available to participate in conferences, staff meetings, and other gatherings to discuss the topic of disproportionality and its impact on work with youth and families. The video produced by the Public Broadcasting Service, "Race: The Power of Illusion", is also being used to help staff understand the ongoing issues regarding poverty and institutional racism.

7

Staff having difficulty understanding the risk factors regarding children with special needs.

It is recommended that caseworkers have training on how to identify the special needs children and how to follow through with steps needed to make sure their needs are met.

A CPS statewide work group has been formed to review cases for trends and patterns regarding cases involving children with special medical needs and disabilities. Currently available to staff is a Webinar training to help identify medical neglect issues. In each region there are specialized staff available to provide consultation to caseworkers on cases involving children with special needs. Each region has a Regional Nurse, a Developmental Disability Specialist, and a Well-being Specialist who can assist staff when they have questions about special medical and disability needs for children. Caseworkers also have access to the Forensic Assessment Center Network to them answer questions about multiple issues including children's special medical and disability needs.

10

 

There is a lack of resources to provide for special needs children in their community

 

It is recommended that more resources be developed to provide services for children with special needs in their communities.

 

The Department of Family and Protective Services continues to seek providers that can provide the needed services for children with special needs within their home community. If a child is not placed within their community of origin, regional staff must make efforts to assist with maintaining the family connection. These efforts include assisting with transportation for visits between the parents and the children.  Parents are also requested to participate when consultations occur with their child's providers.

10

There are a lack of drug treatment services within the community for parents with drug issues to access treatment in a timely manner.

Develop more community based drug treatment resources.

The Department of State Health Services and the Department of Family and Protective Services are actively pursuing the expansion of drug courts especially in rural areas. Expansion of resources is also being pursued through the Access to Recovery Grants to assist those people without a license, such as "Victory Outreach", who provide assistance to people addicted to drugs. The Drug Demand Reduction Advisory Committee is also working to increase treatment services.  A substance abuse website has been created for staff on the DFPS intranet that provides online information regarding available statewide drug treatment resources.   

10

Staff have difficulty identifying the effects drugs have on their clients

Staff should receive training on identifying drug effects and how these effect the child's safety.

A statewide work group was formed in 2009. Through this workgroup an internet site was created that contains a wide range of information for staff to help in working with families with drug issues. Contained on this site are the following categories:

  • Drug screening and referral tools
  • Who to contact for information in each region and state office
  • Information about specific drugs and there effects
  • Information about Drug Endangered Children
  • General information about drugs
  • Treatment criteria
  • Recovery process

PSI 09-022 went out on 8/17/2009 to inform staff about the internet site and how to access it.

Conclusion

The Citizen Review Teams are an important component as DFPS continues to improve outcomes and services for children, youth and families involved in the Texas child welfare system. Members voluntarily take time to review the cases with care to continue to hold the agency to high investigation standards. By considering innovative ways the community can work together with CPS for child protection, members have shown that improvement of the system is needed and possible. The issues identified and recommendations made by the Child Abuse Prevention and Treatment Act Citizen Review Teams are critical to identifying opportunities for statewide improvements in CPS policy, practice and training.