Cumulative Rates of Child Protection Involvement and Terminations of Parental Rights in a California Birth Cohort, 1999-2017.

Objectives. To document the cumulative childhood risk of different levels of involvement with the child protection system (CPS), including terminations of parental rights (TPRs).Methods. We linked vital records for California's 1999 birth cohort (n = 519 248) to CPS records from 1999 to 2017. We used sociodemographic information captured at birth to estimate differences in the cumulative percentage of children investigated, substantiated, placed in foster care, and with a TPR.Results. Overall, 26.3% of children were investigated for maltreatment, 10.5% were substantiated, 4.3% were placed in foster care, and 1.1% experienced a TPR. Roughly 1 in 2 Black and Native American children were investigated during childhood. Children receiving public insurance experienced CPS involvement at more than twice the rate of children with private insurance.Conclusions. Findings provide a lower-bound estimate of CPS involvement and extend previous research by documenting demographic differences, including in TPRs.Public Health Implications. Conservatively, CPS investigates more than a quarter of children born in California for abuse or neglect. These data reinforce policy questions about the current scope and reach of our modern CPS.

A prospective study of sudden unexpected infant death after reported maltreatment.

OBJECTIVE: To examine whether infants reported for maltreatment face a heightened risk of sudden infant death syndrome (SIDS) and other leading causes of sudden unexpected infant death (SUID). STUDY DESIGN: Linked birth and infant death records for all children born in California between 1999 and 2006 were matched to administrative child protection data. Infants were prospectively followed from birth through death or 1 year of age. A report of maltreatment was modeled as a time-varying covariate; risk factors at birth were included as baseline covariates. Multivariable competing risk survival models were used to estimate the adjusted relative hazard of postneonatal SIDS and other SUID. RESULTS: A previous maltreatment report emerged as a significant predictor of SIDS and other SUID. After adjusting for baseline risk factors, the rate of SIDS was more than 3 times as great among infants reported for possible maltreatment (hazard ratio: 3.22; 95% CI: 2.66, 3.89). CONCLUSION: Infants reported to child protective services have a heightened risk of SIDS and other SUID. Targeted services and improved communication between child protective services and the pediatric health care community may enhance infant well-being and reduce risk of death.

Caseworker documentation of mothers in foster care: A case study in California.

BACKGROUND: Young people in foster care frequently experience early parenting, and U.S. law requires the documentation of parents in care. The extent to which the child protection system (CPS) has accurately collected information on parents in care remains largely unknown and has ramifications for the planning and delivery of services. OBJECTIVE: Using California as a case study, this study documented young mothers in care using birth records, determined the proportion of mothers correctly identified in CPS records, and compared characteristics and placements of mothers who were or were not identified. POPULATION: All mothers aged 15-21 years documented by vital birth records (2014 and 2019) were probabilistically linked to CPS records, yielding 3199 mothers in care. METHOD: We compared mothers who were or were not identified in CPS records using bivariate statistics. A chi-square test for trends examined differences in documentation over time. RESULTS: A third of mothers were not identified as such in CPS records (n = 1136). The proportion of mothers identified by caseworkers rose from 50 % in 2014 to 71.5 % in 2019 (p < .001). Nonminor dependent mothers and those placed in supervised independent living programs were more likely to be misclassified in CPS data. CONCLUSIONS: Motherhood may not be documented in CPS records; however, significant improvements were evident. Results suggest that all nonminor dependents should be informed of available services for expectant and parenting individuals, especially if they are living in less restrictive placements, given they are more likely to give birth and less likely to be identified in CPS records than minor dependents.

Children ever in care: an examination of cumulative disproportionality.

Most studies of ethnic disproportionality in child welfare examine data in one of two ways: a point in time approach or an entry cohort approach. While each provides insight into disproportionality, neither gives a full picture of the differences among ethnic groups in the experience of the child welfare system over time. This study uses longitudinal administrative child welfare data to examine ethnic disproportionality in involvement with the child welfare system during the first seven years of life at three levels of contact: (1) initial referrals, (2) substantiated referrals, and (3) first entries. Findings suggest the experience of African American families, and probably Native American families, with the child welfare system is much different from other families.

Measuring racial disparity in child welfare.

Overrepresentation of certain racial/ethnic groups in the foster care system is one of the most troubling and challenging issues in child welfare today. In response, many states have started reporting outcomes by race and ethnicity to identify disproportionately high rates of system contact. The identification of disproportional representation is the first step in developing targeted strategies to address disproportionality--highlighting where resources should be directed and guiding future research. However, present and future efforts to address disproportionality must be accompanied by statistically sound and meaningful methods of measurement. In this article, we argue for the adoption of a relative rate measure of representation--a "Disparity Index"--as the primary instrument for assessing racial disparity in child welfare.

Age and other risk factors related to reentry to care from kin guardian homes.

Although kinship guardianship is an increasingly important foster care exit pathway for children in the United States, research on the factors leading to kinship guardianship breakdown is lacking. This study examines the factors associated with guardianship breakdown for children who exited foster care to kinship guardianship in California between 2003 and 2010 (N = 18,831). Specifying time-dependent Cox relative risk models, children's age trajectories are directly accounted for in the analysis. This allows differentiation between duration dependence (i.e., time spent in guardianship) and children's development (expressed as age). Overall, 17.3% of children reentered care by 2017. Early adolescents, age 13-15 years (HR = 1.63, p < .001), and late adolescents, age 16-17 years (HR = 1.93, p < .001), had an increased hazard of reentry compared with children under the age of six. Children with a history of mental health concerns had more than twice the hazard of reentering than children without such a history (HR = 2.18, p < .001). Our findings indicate that transition to adolescence was associated with increased risk of reentry into care, highlighting the need for guardianship support services leading up to, and during, this child developmental stage.

Data on children reentering foster care from kinship guardianship.

This article describes a dataset containing information on children exiting to kinship guardianship in California between 2003 and 2010 (N = 18,831). Children and young people in the sample were followed for up to fourteen years. The data presented here show summary statistics of the sample included in the analysis. Furthermore, the data consist of life tables showing counts of children at risk of reentry, counts of children who reentered the foster care system as well as nonparametric estimates of the survival function and the cumulative hazard function for the period 2003-2017.

Risk of re-reporting among infants who remain at home following alleged maltreatment.

Maltreatment that begins during infancy is likely to be chronic in duration and developmentally consequential if the appropriate intervention is not delivered. Repeated reports of maltreatment may signal unmet service needs. This study prospectively followed infants who remained at home following an initial report of maltreatment to determine the rate of re-reporting within 5 years. Birth records for all children born in California in 2006 were linked to statewide child protection records through 2012; 5.2% (n = 29,135) of children were reported for abuse or neglect prior to age 1. Following an initial report, 81.9% of infants remained in the home, the majority (60.7%) of whom were re-reported within 5 years. The highest rate of re-reporting was observed among infants whose initial allegation was substantiated and who had a case opened for family maintenance services (69.1%). Infants whose initial allegation was not investigated had re-reporting rates that were equal to or higher than other infants remaining in the home without services. Findings highlight that most families with infants reported for maltreatment are not formally served through the child protection system. High rates of re-reporting underscore the challenge of delivering services that remedy conditions necessitating child protection follow-up and call attention to the importance of accessing data from community service providers.