Substance Use and Family Preservation Services In the Texas Child Welfare System

Some of the papers I have been working on the past few months for TexProtects have been published! Pamela McPeters, our Vice President of Public Affairs gave testimony on Thursday, Aug. 9, to a joint hearing of the Texas House Committees on Public Health and Human Services on the impact substance use has had on the Child Protective Services (CPS) system and the children and families it serves. I helped work on the two written testimony briefs we submitted to legislators at the hearing. I am very proud of the work we're doing at TexProtects to advocate for the state's most vulnerable children and families. Below are a sampling and links to the briefs.

Parental Substance Use in Child Welfare System

National and local data reveal that up to 80 percent of adults associated with a child welfare case have a substance use problem that contributes to the abuse or neglect of their children. From 2015 to 2017, 51 percent of all child fatalities in Texas involved a caregiver who was actively using or under the influence of substances at the time of the child’s death.2 Figure 1 shows an increase in overall rates of removing children from their biological homes by child welfare systems in Texas and across the U.S. The Adoption and Foster Care Analysis and Reporting System of the U.S. Department of Health and Human Services found in 2016 that more than 34 percent of children nationally were removed due to parental alcohol or drug use, while in Texas 63 percent of children were removed for the same reason. Preliminary data provided by the Texas Department of Family and Protective Services indicates that the rate of returning children to live in their biological homes for families with alcohol or drugs as a
risk factor are much lower than reunification without this factor present.

In Texas, substance use in child welfare is classified as “neglectful supervision” under the Texas Family Code. Specifically, neglectful supervision means "placing a child in or failing to remove a child from a situation that a reasonable person would realize requires judgment or actions beyond the child's level of maturity, physical condition, or mental abilities and that results
in bodily injury or substantial risk of immediate harm to the child." In 2017, 71 percent of all cases with confirmed instances of abuse and/or neglect in Texas involved neglectful supervision; however, it is difficult to determine what percent of these confirmations and any
subsequent removals are related to parental substance use as a primary factor. In addition, research indicates that the prevalence of specific substances used by adults involved with child welfare systems is frequently underreported and challenging to track.6 In many states, for example, alcohol and overall substance use is tracked, but the type of drug used may not be
indicated as often. 

Texas’ program for families referred from DFPS as needing prevention and intervention services, Family Based Safety Services (FBSS), are designed to maintain children safely in their homes or make it possible for children to return home. FBSS includes substance use treatment services and seeks to strengthen protective factors of families and reduce risks to the safety of children. (See the summary of FBSS report below for more information.)

Whether the substance use is by a parent or by another adult caregiver in the home, the behaviors of adults while under the influence of alcohol or drugs can have life-long effects on children. Children who are impacted by an adult caregiver using substances could experience unmet developmental needs, impaired attachment, economic hardship and legal problems in the home, emotional distress, and sometimes violence. Children have an increased risk of
developing a substance use disorder themselves. Children affected by parental substance use are at higher risk for nearly every diagnosable childhood mental and emotional disorder in the Diagnostic Statistical Manual of Mental Disorders (DSM-5). Thus, it is important for child welfare workers to recognize when alcohol or drug use is a factor in the case of child abuse or
neglect in order to help parents obtain appropriate treatment and understand the process of recovery in the context of child safety. 

Many families involved in the child welfare system are negatively impacted by parental substance use. Although identifying and meeting the complex needs of parents with substance use disorders and those of their children can be challenging, innovative approaches along with new research and program evaluation can guide the state in implementing more effective, collaborative, and holistic service delivery to support both parents and children. To be successful in reducing and preventing the number of children and families suffering from substance use and the negative social and economic consequences, including children entering the foster care system, Texas must ensure access to and implementation of community-driven, cost-efficient and proven prevention, intervention, and treatment programs and practices.

Read the full substance use research brief, including recommendations for the Texas legislature.

Preserving and Building Strong Families: Improvements to Family Based Safety Services

Children need a protective and stable family in order to thrive. Separating them from their biological family can be traumatic, often leaving lasting negative impacts. When a child welfare case is opened with the state, the health and safety of the child remains the paramount concern. However, Texas Family Code requires reasonable efforts to be made with respect to preventing or eliminating the need to remove a child from their biological home or to make it possible for the child to return. Family preservation services are short-term, family-centered services designed to provide needed support to families in crisis by strengthening caregiver and family functioning while safeguarding children. Such services build upon the knowledge that many children can be safely protected and treated within their own homes when parents are provided with effective support and tools that empower them to change their lives. Family preservation programs strengthen the adaptive, nurturing, and protective capacities of parents and caregivers to better ensure the overall well-being and long-term success of the child. 

Through the federal Family First Prevention Services Act (Family First), Texas has significant opportunity to strengthen the effectiveness and utilization of its existing family preservation services. Through the implementation of evidence-based services, the state will be able to reduce reliance on the foster care system and the negative human and societal consequences and financial costs that result. It is well established that foster care can be profoundly injurious to a child’s mental and physical health, and that “children in foster care have more compromised developmental outcomes than children who do not experience placement in foster care.” Family First implements a key strategy in safely reducing the number of children in the costly foster care system by preventing children’s entry into care whenever possible.

Family Based Safety Services (FBSS) is a Family Preservation stage of service in the Texas Child Protective Services (CPS) system after an investigation of alleged child abuse. FBSS provides preservation services that focus on keeping children with their families in instances of less serious child maltreatment cases, rather than removing them from the home, by increasing safety and reducing risk factors for child maltreatment. After the conclusion of a CPS investigation, if safety and risk factors are identified, a family can be referred to FBSS with the goal of preventing children from entering the foster care system. Risk is mitigated by connecting parents to community services, incorporating strengths of families, and building resources.

Between fiscal years 2013 and 2017, the number of referrals of cases to FBSS has risen an average of five percent. In addition, during the same period the number of children removed during an investigation and placed in foster care has risen an average of five percent. In both situations, children and families receive services to either strengthen and preserve or reunify them. Although DFPS is opening more cases requiring services than in recent history, DFPS has not increased the funds needed for purchased client services. As a result, the current quality and array are inadequate.

After a family is referred to FBSS, either the family follows the strategic plan of training and prevention services and is able to meet the needs of the child, or the family fails to cooperate with their service plan and/or fails to protect their child (read full brief for an in-depth look at the process for assigning a CPS case to FBSS). In case of the latter outcome, the family can either be court ordered to follow their service plan or CPS may begin the removal process with the family. As the chart below shows, 22 percent of children in 2017 were removed from the home after their family was referred to FBSS (statistically flat from 23 percent in 2013). This high ratio suggests that the services these families have received are not effective in preventing further abuse and/or neglect of already at-risk children.

Chart: Number of Cases Assigned to Family Based Safety Services or Removal of Children From Their Home (5-year)

Source: TexProtects (2018). Preserving and building strong families: Improvements to family based safety services. 

Source: TexProtects (2018). Preserving and building strong families: Improvements to family based safety services. 

The number of families in Texas with children at risk for entering the foster care system is growing, as are the needs of these families for programs and services. Although the state has made some progress in providing FBSS, limitations and challenges still exist, such as insufficient length of services, high caseworker turnover, insufficient caseworker training, and a lack of data on face-to-face meetings between caseworkers and at-risk families. However, newly available Title IV-E funding through Family First provides an opportunity for DFPS to expand its in-home prevention services.

Read the full Family Based Safety Services research brief, including recommendations for the Texas legislature.