Wednesday, April 25, 2018

The Texas Department of Family Protective Services Brings Hope to the Efforts Against Child Abuse

By Courtney Welch, MD Candidate
Texas Tech University Health Sciences Center School of Medicine, 2019

April is National Child Abuse Prevention Month. Over the past few years, Texas has made a tremendous effort to address the poignant issues surrounding child abuse and neglect. Great thanks goes to Judge Janis Graham Jack (senior United States district judge of the U.S. District Court for the Southern District of Texas). The attention she brought to the flaws in the Texas foster care system resulted in drastic changes to the state’s policies and infrastructure.

Now the Texas Department of Family Protective Services (DFPS) and its Prevention and Early Intervention (PEI) division are beginning to implement and review these changes, and are being rewarded with measured success. However, the need for evidence-based recommendations and research-confirmed results is still great. Below is a review of past mistakes, an overview of present efforts, and a projection for the future regarding Texas’ attempt to tackle one of the most daunting issues facing children today.

An Acknowledgement of Historical Need

Only three short years ago, Judge Jack accused the state of Texas of violating children’s constitutional right to be free from harm while in custody. The investigation and ruling were prompted by an alarming number of deaths as a result of child abuse and neglect. In 2015, Texas saw 171 confirmed cases of child death due to maltreatment or neglect, some of these occurring while children were under the care of the state. Though this number was down from the all-time high of 280 deaths during 2009, Judge Jack accused the state of Texas of having a broken system. She demanded reform.

The ruling sent a shockwave through Texas, prompting the state, and especially DFPS, to make swift changes. Since 2015, the DFPS has made incredible strides — in great thanks to the efforts of the PEI division. PEI houses the Office of Child Safety, oversees the Texas Home Visiting Program, and works with other community programs and nonprofits around the state. Its mission is “[to help] create opportunities for children, youth, and families to be strong and healthy by funding community-level, evidence-informed programs and systems of support upstream from crisis and intensive interventions.” Simply stated, its goal is to work with communities to intervene before child abuse happens.

An Overview of Current Efforts

After Judge Jack’s 2015 ruling, PEI set itself to work on a five-year strategic plan, published in 2016. The plan created the following seven overall goals:

  1. PEI will adopt a public-health framework to prevent child abuse and fatalities and support positive child, family, and community outcomes. 
  2. PEI will maximize the impact of current investments and seek additional resources to serve more children, youth, and families and strengthen communities. 
  3. PEI will make and share decisions about investments in families and communities based on an analysis of community risk and protective factors as well as community-developed needs assessments. 
  4. PEI will utilize research findings to improve program implementation, to direct program funding toward the most effective programs, and ultimately to achieve better results for children and families. 
  5. PEI will measure and report on the effectiveness of its programs on an annual basis and will make timely course corrections based on available data.
  6. PEI will maximize its impact by collaborating with other state entities and external organizations working with similar populations. 
  7. PEI will be transparent and inclusive in its planning and operations and will proactively publish its strategic plan and progress towards its goals.

Communities around Texas can feel the presence of PEI through programs like:

  • Community-Based Family Services, 
  • Community Youth Development,
  • Fatherhood-oriented programs (such as Fatherhood EFFECTS),
  • Home Visiting, Education and Leadership (HEAL), 
  • Help for Parents, Hope for Kids (Help & Hope), 
  • Helping Through Intervention and Prevention (HIP), 
  • Healthy Outcomes Through Prevention and Early Support (HOPES), 
  • Military Families and Veterans Pilot Prevention Program, 
  • Texas Nurse-Family Partnership, 
  • Safe Sleep Public Awareness Campaign (Room to Breathe),
  • Safe Babies Evaluation, Service to At-Risk Youth (STAR),
  • Statewide Youth Services Network, 
  • Texas Families Together and Safe, and
  • Texas Home Visiting Program. 

Each of these organizations is specifically paired with a research and evaluation partner — usually a department in an institution of higher education — that reviews the goals of PEI in relation to the program, summarizes the program’s outcomes, and makes recommendations for improvement. A review of the previous fiscal year — as well as business strategies for the upcoming years — are published each year by PEI on the Texas DFPS website as is more information about PEI and its associated programs.

A Charge for the Future

The changes and growth in DFPS and its PEI division have played a substantial role in how the state addresses the public health issue of child abuse and neglect. Many agencies associated with PEI have worked tirelessly with the division to set measurable goals in answer to the charge Judge Jack placed upon the state in 2015. Many of these brainstorming efforts have led to good and noble ideas.

But good ideas without plans and the means to execute them are just dreams with no promise of accomplishment. The Texas Legislature moved in the right direction by offering financial support to many of the aforementioned programs under PEI, increasing funding by more than $25 million from 2016-17 to 2018-19. With these funds, DFPS and PEI have increased their capability to serve their mission, but the final question DFPS, PEI, and lawmakers must ask themselves is, “Are we making a measurable and positive difference in the lives of families and children in Texas?”

Remember: At stake here is not just public approval or taxpayer dollars but also the health and lives of children. Therefore DFPS and PEI must implement a solid plan based on evidence of its efficacy. There are not enough funds to ensure the policymakers’ dreams do not become another child’s nightmare. It is tempting to set goals, measure accomplishments, and stop when those tasks have been completed, but it has never been more important to resist the urge to self-congratulate in the face of assumed achievement. The work does not end when the checklist is complete. The need to edit, refine, reframe, and execute new and improved plans will never fade where child abuse and maltreatment is concerned.

To further emphasize the necessity of continued monitoring and revision, it should be noted that this is not the first time Texas has made sweeping changes to its foster care system. One of the most disheartening discoveries in Judge Jack’s 2015 ruling was reviewed under the Findings of Facts and Law section. This section noted that in 2009, then-Gov. Rick Perry commissioned a committee to review and make recommendations on the Texas foster care system. That 2009 committee proposed 14 recommendations in response to its review. After its proposal was completed, the committee unearthed a 1996 report from a similarly charged committee under the direction of former Gov. George W. Bush. The 2009 committee found that 11 of the 14 recommendations it had just written were nearly identical to recommendations made in 1996. This finding effectively accused a well-meaning system of failing our youth. Since 1996, all the wishful thinking, recommendations, and even executed plans had not changed some of the broken system’s underlying flaws.

This time around must be different. It is up to us — as legislators, policymakers, community leaders, health care workers, parents, and Texans — to be honest and critical with ourselves. We cannot wait for another Judge Jack to hold up a mirror to us so we can see our ugly reflection once it is already too late. We must admit that trial is rarely without error and that mistakes will be made. We must be humble enough to acknowledge our weaknesses and courageous enough to make changes for the future.

7,311,923 Texans are children. 66,721 of them are confirmed victims of child abuse and neglect. 17,151 Texas children are placed in substitute care, according to the 2015 DFPS Databook. Children cannot speak or act on behalf of themselves. So now I ask you with a spirit of hope and a hunger for positive change: Are you willing to be their advocate?

Special thanks to Desiree Ojo, Texas Tech University Health Sciences Center candidate, 2019, dual-degree master’s in public health and public administration, who shared with me for this article resources and research she has gathered in preparation for her upcoming round table, Saving the Texas Foster Care System: A Special Panel. Find out more information about the panel and Facebook live stream on May 8, and join the discussion.

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