COOK COUNTY, IL – Cook County Health’s Project CHILD (Collaboration of Helpers Lowering Deaths of Children), today released their final evaluation report for the Child Safety Forward initiative funded by the Department of Justice (DOJ) with technical assistance led by Social Current. Child Safety Forward is a multi-year demonstration initiative, launched in October 2019 by the DOJ’s Office for Victims of Crime, that engaged five sites across the United States in research, planning, and implementation around strategies aimed at reducing child injury and fatality from abuse and neglect.

“Our data review indicated that an average of 10,000 serious child injuries or deaths due to suspected abuse or neglect are reported annually in the state of Illinois with higher rates in rural counties such as Peoria and Vermilion than the more densely populated Cook County,” noted Verleaner Lane, project director for Cook County Health’s Project CHILD. “We also found that 50 percent of the children who die from fatal injuries caused by maltreatment are unknown to the child welfare system. This data led us to take a public health approach by convening a multi-disciplinary group of community stakeholders who work to support families in a variety of different settings. The identified stakeholders included healthcare providers, community health workers, maternal infant health providers, educators, and social service providers.”

The late Marjorie Fujara, a world-renowned child abuse pediatrician, who led Project CHILD before her passing in 2021, noted during the initial planning phase of the project: “Child protective services, law enforcement, and medical professionals have worked together to investigate and respond to cases of child maltreatment and resulting deaths, but none have produced lasting results in terms of preventing child fatalities because of the lack of communication and bureaucratic nature between each agency; this has produced gaps in the system that have led to dire consequences. This project aims to identify the gaps and barriers to current approaches, policies, and procedures that exist to address child abuse and neglect in children aged three years and younger in three specific Illinois counties (Cook, Vermilion, and Peoria), to determine what prevention and intervention strategies work best for families in this area, and to ultimately decrease the number of child fatalities, near fatalities, and recurring child injuries caused by child abuse and neglect in those three Illinois counties.” 

Key elements of the project strategy included:

The multi-disciplinary team (MDT) was comprised of the following organizations: Children’s Advocacy Center of Illinois; Chicago Children’s Advocacy Center; Office of the Inspector General Illinois; Hoyleton Youth and Family Services; The University of Illinois: Child Protection Training Academy Simulation Lab; Lurie Children’s Hospital of Chicago: Child Abuse Pediatrics -Telehealth Partnership for Resilience (Educators); Be Strong Families (parent engagement); Illinois Department of Children and Family Services; EverThrive Illinois; Calumet Public School District 132; IL State Police- Effingham; Alton Police Dept. Force Commander of the Southern IL Child Death Investigation Task Force; Southern Investigations Commander Division of Criminal Investigation 18; and more.

Among the insights from the Project CHILD strategies was the importance and impact of simulation training. The Child Protection Training Academy, located on the University of Illinois  Springfield campus had created a simulation training model for DCFS Child Protection Investigators, which they deployed on behalf of the Project CHILD team. The simulation training utilized the “Hailey” scenario – one of the four cases created in partnership with the University of Missouri STL as part of a project with the Substance Abuse and Mental Health Services Administration (SAMHSA) called FORECAST. The Hailey case involved training for recognizing elements of unsafe sleep practices based on a fictional family with numerous underlying conditions including domestic violence, mental health concerns, substance use disorder, and suspicions of sexual & physical abuse. 

The first MDT participated in simulation training on October 20, 2021, with 12 participants representing law enforcement, child protection, CAC staff, and prosecution. To draw attention to unsafe sleep practices, the environment was staged with a pack and play that was cluttered with clothing, bedding, and other objects. In addition to the pack and play concerns, the team strategically placed the simulation doll on a soft couch, to draw attention to other risk factors for unsafe sleep. Though the training was conducted on Zoom, the teams were able to “investigate” the environment through the use of the “proxy” who walked through the home with a camera, enabling the participants to see the home and its contents. Team members could ask for close up examination of particular items in order to determine what questions they might need to ask to gather additional evidence. Later trainings added additional risk factors within the house, such as a premature infant, smoking, and an additional toddler.

One of the key takeaways from the simulation training was that safe sleep issues were often not the primary concerns of members of the MDT as they observed the family’s home. In fact, upon interviewing the team, Project CHILD learned that safe sleep practices are rarely included in law enforcement training. 

“The work of the Cook County Health Project CHILD team has shed new light on developing and implementing a true multi-disciplinary, public health approach to preventing child abuse and neglect injuries and fatalities,” noted Amy Templeman, director of the Within our Reach team at Social Current and the head of the technical assistance team. “Their use of simulation training to identify not just risk factors but areas of needed improvement in training across multiple disciplines offers us a road map to help inform the field of child welfare and partners in best practices moving forward.”

“We have known for some time that reducing child maltreatment injury and death is a goal that encompasses a wide range of systems and cannot be solved by child welfare alone,” noted Stacy Phillips, Victim Justice Program Specialist with the Office for Victims of Crime (OVC) within the U.S. Department of Justice. “The Cook County Project CHILD initiative is helping us identify the stakeholders who have an important role to play in keeping children safe and the tools and resources they need to be effective.”

In addition to Cook County Health, the other Child Safety Forward demonstration sites include St. Francis Hospital in Hartford, Connecticut; Indiana Department of Health; Sacramento County CA’s Child Abuse Prevention Council; and the Michigan Department of Health and Human Services. The final report from St. Francis Hospital was released in February 2023 and can be accessed here. The remaining final reports will be issued in the summer/fall of 2023. The technical assistance team is led by Within Our Reach, an office at Social Current.

About the Within Our Reach Office 

Within Our Reach is an office established within Social Current (formerly the Alliance for Strong Families and Communities) to further the recommendations of the federal Commission to Eliminate Child Abuse and Neglect Fatalities. The goal of Within Our Reach is to equip policymakers, practitioners, and advocates with the tools they need to fundamentally reform child welfare. Based on the commission’s national strategy, desired reform includes a proactive public health approach—a shared family and community responsibility to keep children safe. Within Our Reach is made possible through collaboration with Casey Family Programs, whose mission is to provide, improve, and prevent the need for foster care.   

About Social Current

Social Current activates the power of the social sector by bringing together a dynamic network of human/social service organizations and partners. Leveraging the collective experience of the field and research, we energize and activate the sector and drive continuous evolution and improvement. Social Current amplifies the work of the social sector through collaboration, innovation, policy, and practice excellence. We offer access to intellectual capital of thousands of professionals within our network through peer groups, learning opportunities, collective advocacy, individualized consultation, tools, and resources that address the sector’s most critical challenges.  

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Disclaimer: This product was supported by cooperative agreement number 2019-V3-GX-K005, awarded by the Office for Victims of Crime, Office of Justice Programs, U.S. Department of Justice. The opinions, findings, and conclusions or recommendations expressed in this product are those of the contributors and do not necessarily represent the official position or policies of the U.S. Department of Justice. 

PHILADELPHIA, PA – The Philadelphia Department of Human Services (DHS) has awarded a contract to the Health Federation of Philadelphia — which will partner with Social Current, a network of social sector organizations working together to activate the power of the social sector —  to create a learning community and deliver trauma-informed training and technical assistance to DHS staff and contractors. The award is responsive to Pennsylvania’s 5-year Title-IV E Prevention Plan outlining the state’s vision for becoming a trauma-informed, healing-centered state as explained in the Family First Prevention Services Act of 2018 and Governor Tom Wolf’s 2019 Executive Order on protecting vulnerable populations.  

The training will be targeted to DHS staff, Community Umbrella Agency staff and provider agencies, including kinship care/foster care, residential (congregate) care, and juvenile justice providers. Efforts will include establishing a trauma-informed framework for child welfare service delivery to serve children and families who have had chronic adverse childhood or other serious, traumatic experiences. Additionally, the goal of the training will be to support and enhance workforce well-being and resilience, and to address disparities in the percentage of families of color who are reported to child welfare agencies.

“The Health Federation of Philadelphia has a 40-year history of supporting health and human services systems in Philadelphia to ensure high quality and equitable access to care for all residents” CEO Natalie Levovich said. “These deep local roots, along with our strong partnership with nationally recognized Social Current and a team of diverse local consultants with expertise in trauma-informed care, anti-racism, child welfare training and research and evaluation, sets the stage for meaningful, effective work that will result in a stronger, more equitable child welfare network in Philadelphia.”

“Social Current works across the human services sector to apply learnings from neurosciences and trauma-informed curricula to enhance workforce resilience, support equity, diversity and inclusion, and build the capacity of the human services workforce to thrive in the systems in which they serve,” noted Jody Levison-Johnson, president and CEO of Social Current. “We are thrilled to partner with the Health Federation of Philadelphia, our long-standing partner Public Health Management Corporation and others to develop and support individual, collective and organizational resilience for those in the Philadelphia DHS staff and partners.” 

The relationship between the Health Federation, Social Current, and our other partners brings together local and national expertise on trauma informed care and leading effective learning communities. Building on the Health Federation’s experience working with DHS and many other key organizations in the region, Social Current draws their expertise at the national level working with the full range of human service agencies, with a strong focus on those serving children and youth.

About the Health Federation of Philadelphia The Health Federation of Philadelphia serves as a keystone supporting a network of Community Health Centers, as well as the broader base of public and private-sector organizations that deliver health and human services to vulnerable populations. HFP promotes community health by improving access to and quality of health care; by identifying, testing and implementing solutions to health disparities; and by providing training and technical assistance to help other organizations operate more efficiently and effectively. 

After repeated warnings from the Treasury Department that the federal government could run out of money and default on its debts as soon as June 1, lawmakers are scrambling to come up with a deal to keep the government solvent. In exchange for raising the debt ceiling, Speaker of the House Kevin McCarthy (R-Calif.) and the House GOP caucus insist the president agree to spending cuts for fiscal year 2024 – a non-starter, according to the president. However, given the prospect of a default, top staffers of McCarthy and President Joe Biden are working around the clock to come up with a compromise, with both sides hinting progress has been made. The outline of a potential deal revolves around the following issues:

An agreement on top-line spending numbers for fiscal year 2024 must be reached; however, members of both parties are opposed to decreasing portions of the discretionary budget, including military, environmental, and health care spending. Unspent funds of approximately $56 billion, according to the Congressional Budget Office, from previous COVID-19 packages are on the table for clawbacks, risking money already allocated to economic assistance. While Biden says he will not consider any changes to Medicaid access, McCarthy is pushing to include new work requirements for benefits programs, including Medicaid, food stamps, and TANF. Finally, members of both parties support reform to the permitting process for energy and other projects, but disagreements remain over the details.

President Biden cut his trip to Japan for the G7 meeting short so he could be back in Washington, D.C. to finalize the deal early this week.

HHS Reveals New Website to Find Mental Health Resources

The Department of Health and Human Services (HHS) launched a new website, FindSupport.gov, to help the public find resources and treatment for challenges related to mental health, drugs, or alcohol. The website offers visitors information on coping strategies, types of treatment, ways to help others, and payment options for treatment. The Substance Abuse and Mental Health Services Administration and the Centers for Medicare and Medicaid Services partnered to create the website after research showed the public sought a reliable and objective resource for dealing with mental health and substance use issues. Over the course of the project, HHS engaged 50 subject matter experts and collected feedback from people of all races, ethnicities, genders, education levels, and ages. FindSupport.gov is another national resource in addition to SAMHSA’s national helpline, 1-800-662-HELP, and the 988 Suicide and Crisis Lifeline. According to SAMHSA, almost one in three adults suffer from mental health and/or substance use isues.

New Fact from HHS on the End of the Public Health Emergency

To mark the end of the public health emergency (PHE) on May 11, 2023, the Department of Health and Human Services (HHS) released a new fact sheet called “End of the COVID-19 Public Health Emergency,” which details what will stay the same and changes to occur after over three years of the COVID-19 pandemic. In the fact sheet, the administration touted its accomplishments: 270 million people who received at least one dose of the vaccine as well as 750 million free COVID-19 tests, among other things. Since Jan. 2021, COVID-19 deaths are down by 95 percent and hospitalizations have decreased by 91 percent. With the end of the PHE, HHS says certain factors will remain the same, including telehealth flexibilities under Medicare through Dec. 2024 and indefinitely under Medicaid. However, Medicare and Medicaid will no longer have some of the other major flexibilities implemented during the pandemic. Certain waivers that expanded access and facility capacity, for example, will be halted. Moreover, the requirement of private insurance companies to cover COVID-19 testing without cost sharing ended on May 11.

New Low-Income Housing Bill Gains Bipartisan, Bicameral Support

On May 11, the Affordable Housing Credit Improvement Act made a comeback in the House of Representatives and the Senate with bipartisan support. Reps. Darin LaHood (R-Ill.), Suzan DelBene (D-Wash.), Don Beyer (D-Va.), Brad Wenstrup (R-Ohio), Jimmy Panetta (D-Calif.), and Claudia Tenney (R-N.Y.), along with Sens. Maria Cantwell (D-Wash.), Ron Wyden (D-Ore.), Todd Young (R-Ind.), and Marsha Blackburn (R-Tenn.) introduced the bill, which would increase the Low-Income Housing Tax Credit, an important tool for incentivizing private investment in the construction and renovation of affordable housing. The Affordable Housing Credit Improvement Act would increase the available credits by 50 percent, spurring the construction of 1.94 million additional affordable homes over the next ten years. It would also create almost three million jobs, increase tax revenue by $115 billion and support $333 billion in wages and business income. The bill would also incorporate stronger protections for veterans, victims of domestic and dating violence, as well as other underserved communities into the Low-Income Housing Tax Credit.

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The 2023 edition of updates to the standards for COA Accreditation, a service of Social Current, is now available. These targeted enhancements to the standards are the result of our annual process and include changes based on ongoing collection and analysis of feedback received from our network, collaboration with diverse groups of subject matter experts, and a review of research and professional literature on identified trends and evolving practices.

Our collaborative update process is designed to ensure the standards remain up-to-date, research-based, and field-informed, promoting improved outcomes for individuals, families, and communities.

Who’s Affected

These changes impact private, public, and Canadian accredited organizations. The 2023 edition of updates will not impact organizations that are currently pursuing accreditation or re-accreditation and have already been assigned standards in the MyCOA portal.

When It is Happening

Standards assignments for COA Accreditation using the new standards began April 20, 2023.

What’s Changing in Our Standards

Revised Standards for Residential Treatment Services

We have revised our standards for Residential Treatment Services (RTX) to better address important topics in the field, including encouraging appropriate use of residential treatment, centering resident voice and choice, maximizing family involvement, creating a trauma-informed service culture, reducing the use of restrictive interventions, and working with residents to develop the skills they need to manage challenges and live successfully at home and in the community. The 2023 updates to RTX include:

Revised Standards for Equity, Diversity, and Inclusion

We have released equity, diversity, and inclusion (EDI) enhancements to our standards to advance administrative and service delivery practices that embed EDI and promote the delivery of equitable services for all people through physically and psychologically safe, inclusive, and trauma-informed environments. The 2023 EDI updates include new or enhanced content on:

Additional Revisions

In response to feedback from our network, we are also releasing a collection of revisions throughout the COA Accreditation standards to provide clarity and/or remain current with trends in the field. Highlights include:

A full list of standards impacted by the 2023 updates can be found here.

Our Process

The 2023 COA Accreditation standards updates reflect changes made based on evolving practices, ongoing review of relevant literature, and the continuous feedback we receive from our network, including volunteer reviewers and accredited organizations. More specifically, updating the 2023 Standards involved:

Questions?

If you are currently pursuing accreditation or re-accreditation, reach out to your accreditation coordinator.

If you are seeking accreditation for the first time, please contact Joe Perrow.

For additional information about COA Accreditation standards, please contact Melissa Dury.

On Tuesday, May 2, the Senate Homeland Security and Governmental Affairs Committee hosted an “Improving Access to Federal Grants for Underserved Communities” hearing. There is a growing interest at the federal level in reforming the federal grants space to make it more transparent, efficient, and accessible, particularly for entities that don’t have the resources or capacity to apply but need access the most.

Social Current CEO Jody Levison-Johnson and Senior Director of Government Affairs Blair Abelle-Kiser submitted written testimony detailing the challenges and opportunities in the federal grants space. We will continue to gain insights from our network and build upon the increasing attention to this topic from our federal elected officials.

Key Hearing Takeaways

Continue reading for more takeaways on the witness statements and the questions from senators on the Senate Homeland Security and Governmental Affairs Committee.

Child Care Bill Introduced in Congress

On April 22, Sen. Patty Murray (D-Wash.), chair of the Senate Health, Education, Labor, and Pensions (HELP) Committee, and Rep. Robert C. “Bobby” Scott (D-Va.), chair of the House Education and Labor Committee, introduced the Child Care for Working Families Act (CCWFA), which would provide considerable resources to expanding the child care sector and making child care more affordable. According to the press release, in 29 states and the District of Columbia, infant care costs are more than the average cost of in-state college tuition at public four-year institutions. Child care workers–disproportionately women of color–are unfairly paid and forced to participate in public assistance programs. 50 percent of families live in so-called “child care deserts.” The CCWFA would create federal-state partnerships to ensure no family living under 150 percent of the state median income would pay more than seven percent of their income on child care. The bill would also give 3- and 4-year-olds access to preschool programs, increase salaries for child care workers, and bolster Head Start programs. The bill’s proponents say the bill would lift one million families out of poverty and create 700,000 new child care jobs.

U.S. Surgeon Gen. Presents National Framework to Combat Loneliness

U.S. Surgeon Gen. Vivek H. Murthy published an op-ed in the New York Times entitled “We Have Become a Lonely Nation. It’s Time to Fix That.” Murthy wrote about his own struggles with loneliness as well as the fact that at any time one out of every two Americans experiences loneliness. He stated loneliness leads to increased risk of heart disease, dementia, and stroke, and that the risk of death associated with loneliness is similar to that of smoking daily or suffering from obesity. Murthy introduced his “national framework to rebuild social connection and community in America,” which provides advice to individuals, parents, community-based organizations, schools, workplaces, public health professionals, governments, and researchers on how to invigorate relationships and connection. The framework calls on community-based organizations to create programs aimed at inclusive social connection, to build partnerships with other social institutions that foster relationships, and to elevate the topics of connection and loneliness in their communities. It also urges governments to make social connection a public health priority by reversing policies that encourage detachment and incorporating social connection into the health care system.

Debt Ceiling Negotiations Update

After the House GOP released its proposal to cut the budget for FY2024 in exchange for lifting the debt ceiling, President Joe Biden invited House and Senate leadership to the White House for negotiations on Tuesday, May 2. The Treasury Department said the federal government could be in default as soon as June 1, ramping up calls for a deal to be reached. Democrats are reiterating calls to immediately lift the debt ceiling without conditions and to negotiate the budget later in the year. House GOP, who recently passed a bill including their desired budget cuts, are hoping to get concessions from President Biden as the deadline fast approaches. The Council of Economic Advisers released an analysis stating a prolonged default could lead to a GDP contraction of 6.1 percent and the unemployment rate to rise by five percentage points.

Subscribe to the Policy and Advocacy Radar to receive our biweekly policy roundup, which includes commentary on issues in Social Current’s federal policy agenda, opportunities to take action, and curated news and opportunities.

On Tuesday, May 2, the Senate Homeland Security and Governmental Affairs Committee hosted an “Improving Access to Federal Grants for Underserved Communities” hearing. There is a growing interest at the federal level in reforming the federal grants space to make it more transparent, efficient, and accessible, particularly for entities that don’t have the resources or capacity to apply but need access the most. Social Current CEO Jody Levison-Johnson and Senior Director of Government Affairs Blair Abelle-Kiser submitted written testimony detailing the challenges and opportunities in the federal grants space. We will continue to gain insights from our network and build upon the increasing attention to this topic from our federal elected officials.

Key Hearing Takeaways

Committee Chairman Gay Peters (D-Mich.) opened the hearing by emphasizing the enormous impact of federal grants. Specifically, over $1 trillion in federal grant money was awarded last year to 131,000 recipient organizations by over 50 different federal agencies. There are over 1,900 grant programs with their own application procedures, portals and technical assistance capabilities, and award processes. He acknowledged that the current system is plagued by complex language, demanding applications, and technical challenges – all of which deter many organizations from applying in the first place. Chairman Peters stated that the purpose of the hearing was to address these barriers and present opportunities to reform the grants system to allow enhanced accessibility.

The first witness, Jeff Arkin, director of strategic issues with the Government Accountability Office, outlined the main challenges in the grant-making process. He said that grant recipients’ human capital, organizational and financial capacity is sometimes limited. He proposed that federal technical assistance at the front end and administrative and oversight assistance during grant implementation could be the answer. He also said that streamlining and creating more transparency in the grant process would reduce redundancies, enable data-driven decision-making, and ensure accountability.

Meagan Elliott, deputy chief financial officer of the City of Detroit, spoke about her office’s comprehensive strategy towards bringing more efficiency and transparency to the grant application process. The city combined all grant staff into one entity, which worked closely with federal, state, and local funders, including charitable and corporate partners. These changes led to an increased success rate for grant applications and more efficient communications through a centralized office. Drawing from her experience, Elliot recommended that federal grants enhance flexibility, allowing local leaders to decide how best to allocate funds based on the community’s pressing needs. She cited the American Rescue Plan Act State and Local Fiscal Recovery Funds as a model for this. She also stressed the need for clarity around grant expectations and consistency across federal portals.

Matthew Hanson, associate managing director at Witt O’Brien’s LLC, detailed his experience assisting federal, tribal, state, local, and community-based organizations to access government grants for the past 30 years. In his experience, the federal government has expanded technical and training assistance for grantees, but not uniformly. Moreover, little effort has been invested in helping new entities apply for grants, especially those with limited resources. Hanson recommended, among other things, mandates for technical assistance, more grant management capacity, and the creation of a grant Helpdesk for pre- and post-award support.

The witness statements were followed by an enlightening question period from senators on the committee. In response to a question from Senator James Lankford (R-Ok.) about the ease of search terms on the grants.gov portal, Mr. Arkin said that recommendations had been made to the Office of Budget and Management concerning the simplification of search parameters within the portal. Senator Jacky Rosen (D-Nev.) noted that her state continues to underperform in federal dollars per capita. Mr. Arkin testified that the GREAT Act passed in 2019 helped standardize grant language and ease prepopulated information, which should help increase the number of grant applications. However, he also urged that lack of awareness about grants is a continuing issue.

Senator John Ossoff (D-Ga.) discussed the challenges facing rural and Black communities in his state regarding accessing federal grants. Mr. Arkin responded that the new Rural Partners Network, a group of federal agencies and states, was created to overcome barriers to grants and opportunities in rural communities and that some aspects of the American Rescue plan have emphasized racial equity and should be explored in the context of grant awards.

The Child Welfare League of America publishes a bimonthly issue of Children’s Voice, a magazine that features a wide array of topics that encourage public discussion and debate among those who are committed to helping children and families. In their first issue of 2023, Social Current leaders were among those voices in two different feature articles:

Read both articles and consider purchasing the rest of the Children’s Voice issue to learn from what others are doing in the sector.

By: Jody Levison-Johnson and Amy Templeman

All families need help sometimes, and to deliver that help, we must understand the external conditions that impact their lives. The human and social services sector is at the forefront of an evolutionary change, one that aims to realign social services to be more preventative with greater upstream resources that focus more directly on addressing the social determinants of health (SDoH) to achieve better outcomes.

While we have increased our understanding of the importance of addressing external conditions, including social and economic opportunities, access to community-based resources and supports, greater health equity and more, our nation’s investment in place-based supports has not kept pace.

For example, the COVID-19 pandemic has shed a harsh light on the public health disparities in our nation. Communities of color are more at risk of getting sick and dying from COVID-19 (Centers for Disease Control and Prevention, 2022), demonstrating that ZIP codes are still the top determinant of how we live, work, and play (Ducharme & Wolfson, 2019). The opportunities lie in examining the discriminatory practices that undermine well-being so that systems can better address root causes.

The potential to improve health outcomes and more fully address SDoH through greater investments in human services could transform a range of systems, including health, education, welfare, and criminal justice systems and ultimately result in greater well-being for all families.

To achieve this will require a tremendous shift in resources, both at the federal funding level to redirect funding to more front-end resources, through policies that adapt to a more preventative approach, and in the way that place-based services are delivered by community-based organizations. Too many of our social systems were structured to respond only after harm occurs; by realigning our nation’s social service delivery systems and reimagining the power and impact of the social sector, we can deliver on the promise of equitable access to health and well-being for all people.

Our Nation Under Invests in Social Services

The Commonwealth Fund recently released a report that ranks the United States last in health care systems among 11 of the wealthiest countries in the world, despite having the highest percentage spending of its GDP on health care. The United States spends twice as much on health care as other developed nations and yet, fares the worst in key health metrics, such as life expectancy and maternal and infant mortality. In fact, a recent report from the CDC found that the United States has the highest rate of maternal death of any developed nation (Kekatos, 2022).

How can that be? According to data from the Bassett Healthcare Network and University of Wisconsin Population Health Institute, only 20% of health outcomes are attributable to actual health care while 80% are attributable to SDoH, including environmental, behavioral, and socioeconomic factors (Bassett Healthcare Network, n.d.).

It’s telling that our nation’s investment in human services that address SDoH is among the lowest in developed nations (Alliance for Strong Families and Communities, 2018). Researchers have begun to draw a direct linkage between that investment disparity and health outcomes, noting that “states with higher ratios of social to health spending had better health outcomes one and two years later” (Bradley et al., 2016).

The pandemic helped us all understand that no family is immune to stress or challenges. Stress can overload families and contribute to greater risk of adversity. Times of turmoil often pave the way for key societal shifts. Today, we have the opportunity to shift our focus more toward addressing social determinants and realign our systems to better support all families.

Supporting the Shift from Child Welfare Systems to Child and Family Well-being Systems

A blueprint for this can be found in the shift from child welfare systems to child and family well-being systems that offer families the support they need to prevent harm before it occurs. The transformation that we see today is moving away from the idea that it is solely the function of the child protection agency to keep kids safe. Instead, CPS is one component in a shared, community-wide responsibility for child and family well-being with an emphasis on prevention and a public health approach that addresses SDoH.

For our child welfare system to truly move to a preventive approach, upstream resources must be rooted in community and not tied to intervention by a government system to access them. This would require communities working in partnership with funders (often governmental entities) to identify their specific needs and design supports that effectively respond to them.

In fact, in December 2021 researchers from Tufts Medical Center found that incidents of child abuse actually dropped during the pandemic at the start of the lockdown, despite many pundits suggesting that incidents would rise due to children being isolated at home (Sege & Stephens, 2021). Evidence suggests that while the pandemic increased familial stress for many, it also afforded families access to additional financial supports and increased time at home contributing to enhanced parent-child attachment. These factors, the researchers believe, potentially account for this drop in abuse and maltreatment.

We are at a unique moment in history. Our deepening understanding of what it takes to weather the storms of a global pandemic is resulting in a shift in the way we think about supporting families. In fact, we are more primed than ever before to think about economic and family supports and to tackle child welfare in a way that emphasizes supporting families over penalizing them.

And that thinking is supported by an ever-growing body of research. Chapin Hall at the University of Chicago recently released a brief on the impact of concrete economic supports for families and its correlations to reducing involvement with the child welfare system (Wiener et al., 2021). Their research identified poverty as a key driver of child welfare system involvement and suggested that even modest economic supports could help stabilize families and prevent the need for removing children from the home.

Systems Transformation is Complex but Achievable

Reshaping child welfare systems into child and family well-being systems that can address SDoH will require a broad focus on system transformation. With shared values focused on equity, diversity, and inclusion, we must modernize child welfare systems through redesign with parent and youth partners, drive cross-system integration and operations, provide sustainable financing, and remove systemic and structural barriers upholding racist practices and policies that contribute to poor health outcomes.

In 2021, with those goals in mind, key leaders in the social service sector and Social Current convened a group of human service sector leaders to develop guiding policy principles for the social sector’s work through the lens of SDoH. The group identified seven guiding principles that are critical to addressing SDoH across the child welfare sector. They are:

Partnering with the Entire Health Ecosystem

Changing Power Dynamics

People-centered Focus

Addressing Root Causes

Anti-racist Approaches

Forming and Scaling Solutions

Prevention and Early Detection

System transformation is never easy, but these guiding principles can be applied as a roadmap for change and help transform a broad range of social sector systems in a way that is responsive where it needs to be and fair in its treatment and decision-making for children and families. And these lessons are applicable across the entire social and human-serving ecosystem, including child welfare, health care systems, juvenile justice, education, and more.

Jody Levison-Johnson is the President and CEO of Social Current, an organization focused on advancing the work of the social sector through collaboration, innovation, policy, and practice excellence. Jody is a longstanding champion for systems change that helps individuals and communities thrive. Over several decades, her career has crossed a variety of settings including private providers and state and local governments. Jody holds a MSW degree from Syracuse University and a MA and PhD in Leadership and Change from Antioch University.

Amy Templeman, a kinship and adoptive parent, is the director of Within Our Reach and director of practice excellence at Social Current. In these roles, she works to support families and promote equity. Before joining Social Current, Amy served as executive director of the federal Commission to Eliminate Child Abuse and Neglect Fatalities, leading the effort to produce a report to the president and Congress. Amy helped to establish the Office of Well Being at the District of Columbia’s child welfare agency. She gained research experience at The Urban Institute and Johns Hopkins University.

References

READ PDF VERSION

This article was originally posted in CWLA’s Children’s Voice Magazine – Vol. 32 #1, 2023. To read through the entirety of Vol, 32, purchase the issue on the Child Welfare READ of America’s website.

By Karen Johnson and Kelly Martin

A mid our day-to-day work to partner with families and children, especially during an ongoing pandemic, it often is challenging to stay apprised of and incorporate the advancing knowledge, research, and evidence around brain science. However, brain science holds great promise in helping us to increase equity, support all families, and strengthen our workforce. The science is clear—adversity and toxic stress can change the brain’s architecture—and preventing and mitigating both are critical in every facet of our work (National Scientific Council on the Developing Child, 2005/2014).

The Texas Change in Mind initiative, convened and led by Social Current, supports 10 community-based organizations that are working to create impact through intersecting levels of change (Social Current, n.d.). Funded by the Episcopal Health Foundation, The Powell Foundation, St. David’s Foundation, and an anonymous donor, the initiative uses a learning collaborative model that allows the organizations to learn from one another, Social Current, and other experts. The Texas organizations are using brain science and equity practices to effect transformative change by promoting the foundations of safe, stable relationships; positive childhood experiences; healthy development; and individual and collective resilience.

This work is guided by the Texas Change in Mind initiative’s theory of change that includes six key areas: Brain science, racial equity, organizational resilience, community impact, communications, and evaluation. Through a wide array of learning engagements over two years, the teams are incorporating new knowledge into their own organizational theories of change and determining their paths forward.

Staff and Organizational Resilience

As the initiative launched in spring 2021, in the middle of the COVID-19 pandemic, many of the participating organizations noted this opportunity could not have come at a better time. They already had been working to embed brain science and equity and were eager for additional support in building capacity and resilience in their workforces.

“So many staff have experienced firsthand inequities regarding COVID-19 in their families and personal lives,” said Nadine Scamp, CEO of Santa Maria Hostel. “We have been thinking about how we can support our staff so they can support our families. Change in Mind is an opportunity to put thought and resources behind this question.”

To equip staff with resilience-building tools, organizations are teaching them brain science concepts, including executive functioning (National Scientific Council on the Developing Child, 2020), and the sequence of engagement: regulate, relate, reason (Perry, 2020). These concrete strategies are being integrated into work with families and helping staff to stay regulated, build psychological safety, and engage in conversations that advance equity practices.

Hand in hand with embedding brain science principles, the Texas organizations are advancing their equity, diversity, and inclusion (EDI) journeys by administering the Intercultural Development Inventory® (IDI®; see www.idiinventory.com) to key staff. This cross-cultural assessment of intercultural competence is a first step in developing a plan for personal growth. In addition, the organizations’ executive leaders are receiving consultative support from Social Current’s EDI experts on advancing their organizational efforts. This work is stretching teams to, “reach across the organization, be inclusive of staff and team up with cultural proficiency and inclusion folks,” noted Dr. Teri Wood, a Trust Based Relational Intervention (TBRI) clinician and coordinator with the Austin Ed Fund, which supports the Austin Independent School District (AISD).

“Working to grow our EDI skills can be uncomfortable at times and is often hard, but we know you can’t have trauma-informed, brain-based learning/services without EDI. They are interwoven,” said Karen McWhorter, director of development at Family Service Center of Galveston County, who is seeking funding to expand administration of the IDI® across the organization.

Children’s Museum Houston (CMH) has been advancing the work of its Diversity, Equity, Accessibility, and Inclusion (DEAI) Committee, which was started before the pandemic and seeks to make improvements to how it designs and provides programs. The CMH team is adding brain science modules to its new employee onboarding and equity training and regularly engaging with all staff in advancing racial equity.

Texas Change in Mind

“We think of this as a journey—a process. It’s called “Change in Mind” for a reason—it’s really a shift. It makes us put things in perspective,” said Lisa Williams, director of gallery programs at CMH. “Children in this pandemic have suffered in a way that we don’t even know at this point. We are trying to position ourselves to give our families and communities what they need from us.”

Child and Family Well-Being

By focusing on supporting staff, building capacities, and strengthening organizational resilience—all through the lens of brain science and a commitment to equity and justice—the participating organizations are already seeing positive impacts in organization culture shifts and their ability to support children and families.

“We have appreciated the intentionality of bringing the equity, diversity and inclusion conversation into brain science conversations,” said Scamp. “Having the space for staff to wrestle with their perceptions and to support participants in moving beyond stigma and bias regarding their substance use and mental health challenges is foundational change.”

Santa Maria Hostel primarily works with mothers who are experiencing the interwoven challenges of substance use, housing insecurity, and mental health concerns. Santa Maria Hostel’s recent work has focused on supporting healthy relationships between parent participants and their infants and toddlers. They also are building out-of-schooltime programming to focus on school age children.

Originally this looked like a traditional afterschool program. However, given what the team is learning about brain science and intentionally centering families in their children’s development, the program is morphing into a family-based afterschool program with an emphasis on strengthening attachment and serve-and-return communication (National Scientific Council on the Developing Child., n.d.).

The multi-generation approach, a hallmark of brain science-based strategies, is also being used by the Austin Independent School District. As Becky Murillo, LCSW and TBRI clinician, said, “This is going to make our support to schools, students, and families even stronger.” They are working with a group of parents to help them learn about brain development and how they can support their children’s cognitive, social, and emotional development. “Parents understand how it better equips them as caregivers and as parents,” said Murillo. “As they learn, they say, ‘We need to get more parents at this table!’ It feels like an empowerment model to me.”

As the work of the initiative continues, NORC at the University of Chicago (see www.norc.org) is overseeing multiple evaluation objectives, including evaluating the effectiveness of the Change in Mind learning collaborative model in helping sites achieve positive results at individual, organization, and community system levels; building the capacity of sites to use developmental evaluation; and assessing the uptake of racial equity at organizational and community network levels.

We will know more about impact of this work as evaluation results come in. For now, we can attest that the Texas Change in Mind Learning Collaborative is an exciting opportunity to accelerate the application of brain science and equity into systems change efforts in the communities served by the 10 participating organizations. These leaders are being supported to rethink, reflect, and reimagine at all levels of their work—personally, organizationally, and systemically. They’re sharing ideas, supporting each other, and creating a ripple effect in their networks. As Dr. Wood says, “This has brought life, excitement, and hope to our work. Our team is excited for every meeting and asking, ‘What can we do next?”

Karen Johnson, MSW, LCSW leads the development of Social Current’s Change in Mind Institute (see https://www.social-current.
org/engage/change-in-mind-institute/) and the Texas Change in Mind Learning Collaborative.

Kelly Martin, MS, is the Director of Practice Excellence at Social Current. Her work focuses on applied developmental psychology,
educational success, policy, and advocacy, and supporting the work of the Change in Mind Institute.

References

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This article was originally posted in CWLA’s Children’s Voice Magazine – Vol. 32 #1, 2023. To read through the entirety of Vol, 32, purchase the issue on the Child Welfare League of America’s website.

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