© 2010 by NCCD, All Rights Reserved 426 South Yellowstone Drive, Suite 250, Madison, WI Phone (608) / Fax (608) Children’s Research Center is a nonprofit social science research organization and a division of the National Council on Crime and Delinquency Structured Decision Making ® (SDM) System Overview Presented by Deirdre O’Connor, Children's Research Center Structured Decision Making ® and SDM ® Registered in the U.S. Patent and Trademark Office

© 2010 by NCCD, All Rights Reserved SDM® Systems Comprehensive case management Structured critical decision points Research- and evidence-based assessments

© 2010 by NCCD, All Rights Reserved SDM® Systems Adult corrections Juvenile justice Child protection Foster care placement support Adult protection Economic self-sufficiency (TANF)

© 2010 by NCCD, All Rights Reserved “Risk assessment establishes a foundation for virtually everything we do in the child protection system. A meaningful and consistent tool is essential for all of us to do our job properly. [The SDM system] clearly provides us with that tool.” Judge Michael Nash, Presiding Judge of the Los Angeles Juvenile Court

© 2010 by NCCD, All Rights Reserved SDM® Systems Goals Reduce subsequent negative event CPS: harm to child JJ: delinquent act Stabilize CPS: expedite permanency JJ: functional behavior Objectives Structure critical decision points Increase consistency in decision making Increase accuracy in decision making Target resources to families most at risk Characteristics ReliableValidEquitableUseful

© 2010 by NCCD, All Rights Reserved Reduce Subsequent Harm: Outcomes for All Cases in Study, 12-month Follow-up The Michigan Department of Social Services Risk-based Structured Decision Making System: An Evaluation of Its Impact on Child Protection Services Cases, 1995

© 2010 by NCCD, All Rights Reserved CMC Evaluation Results From Florida Revocation Rates, Community Control Admissions (N = 45,346) Florida Department of Corrections Research and Data Analysis: Leininger, “Effectiveness of Client Management Classification,” December 1998

© 2010 by NCCD, All Rights Reserved Expedite Permanency: Recent Research in Los Angeles County 39% Decrease Median Time to Reunification in Months

© 2010 by NCCD, All Rights Reserved Improve Decision Making All information Information learned Information needed for decision at hand

© 2010 by NCCD, All Rights Reserved A Bit More About SDM® Objectives Objectives Structure critical decision points Increase consistency in decision makingIncrease accuracy in decision makingTarget resources to families most at risk

© 2010 by NCCD, All Rights Reserved Structuring Critical Decisions in Juvenile Justice

© 2010 by NCCD, All Rights Reserved 1.Detention screening 2.Risk classification/supervision levels 3.Strengths/needs for case planning 4.Disposition recommendations 5.Reassessment of risk and needs 6.Institutional placement decisions 7.Release/transition decisions SDM® Assessments: Graduated Sanctions for Juvenile Justice

© 2010 by NCCD, All Rights Reserved Response priority Safety assessment Initial risk assessment Family strengths and needs assessment Screening criteria Risk reassessment Reunification reassessment Family strengths and needs reassessments Intake Investigation/ Assessment Is the child safe? Is it child abuse/neglect (CA/N)? How quickly do we need to respond? What is the likelihood of future maltreatment? What should the service plan focus on? Ongoing Should the case remain open or be closed? Structuring Critical Decisions in Child Protective Services

© 2010 by NCCD, All Rights Reserved A Bit More About SDM® Objectives Objectives Structure critical decision points Increase consistency in decision making Increase accuracy in decision makingTarget resources to families most at risk

© 2010 by NCCD, All Rights Reserved Consistency (Reliability) Sample: Four independent ratings of 80 cases. Child Abuse and Neglect: Improving Consistency in Decision Making, 1997

© 2010 by NCCD, All Rights Reserved A Bit More About SDM® Objectives Objectives Structure critical decision points Increase consistency in decision making Increase accuracy in decision making Target resources to families most at risk

© 2010 by NCCD, All Rights Reserved Accuracy (Validity) Sample: Four independent ratings of 80 cases. Child Abuse and Neglect: Improving Consistency in Decision Making, 1997 (n = 138) (n = 541) (n = 250) (n = 442) (n = 304) (n = 130) (n = 202) (n = 475) (n = 231)

© 2010 by NCCD, All Rights Reserved Validity in Juvenile Justice: Recidivism by Risk Classification Percentage of Youth With Subsequent Delinquent Adjudication Within 15 Months

© 2010 by NCCD, All Rights Reserved State Commitment Sample Wisconsin

© 2010 by NCCD, All Rights Reserved A Bit More About SDM® Objectives Objectives Structure critical decision points Increase consistency in decision makingIncrease accuracy in decision making Target resources to families most at risk

© 2010 by NCCD, All Rights Reserved Targeting Resources Reduces Risk Wisconsin Urban Caucus, 1998 (n = 562) (n = 48) (n = 347)(n = 79)(n = 105)(n = 89)

© 2010 by NCCD, All Rights Reserved CMC Research Results Revocation Rates: Milwaukee, Wisconsin

© 2010 by NCCD, All Rights Reserved The SDM® System as Part of a Family-centered Practice Framework Tools do not make decisions; people do. Research and structured tools combine with clinical judgment and experience to support decision making. Should be integrated within the context of solution-focused, family- centered practice. Family Research Structured Tools Clinical Judgment Experience

© 2010 by NCCD, All Rights Reserved SDM® Implementation in Louisiana Fall 2007 OCS workgroups modified: »SDM initial risk assessment »In-home risk reassessment »Out-of-home reunification reassessment January 2008 Training for OCS supervisors and trainers July 2008All parish offices trained and using SDM assessments August 2009Initial risk assessment integrated into ACESS, completed on all investigations January 2010 Screening and response time assessment field-tested June 2010Screening and response time assessment implementation statewide

© 2010 by NCCD, All Rights Reserved Louisiana SDM® Assessments Screening and response time assessment Initial risk assessment In-home risk reassessment Reunification reassessment Integrated into Focus on Four initiative

© 2010 by NCCD, All Rights Reserved SCREENING AND RESPONSE TIME ASSESSMENT

© 2010 by NCCD, All Rights Reserved SDM® Screening and Response Time Assessment Screen in or screen out Screening Criteria How quickly to go out? Response Time

© 2010 by NCCD, All Rights Reserved Screening and Response Time Assessment Structuring decision to improve consistency No change in statutes or policy »Elements of child abuse or neglect report »Specific allegations »Response times Change in documentation Change in decision-making process Expected increase in alternative response assessments

© 2010 by NCCD, All Rights Reserved Elements of a Child Abuse and Neglect Report Currently a minor Minor when alleged incident occurred and allegation creates concern for another minor Alleged victim In a caretaker role (parent, guardian, foster parent, daycare provider) Other adult living in the home Adult in dating relationship with parent (live-in or not) Daycare home provider Alleged perpetrator Abuse: inflict or attempt to inflict harm that endangers health and safety of child Neglect: refusal/unreasonable failure to meet child’s needs, which endangers child’s health or safety Incident occurred or substantial risk of harm Reporter observed incident or has firsthand information Abuse or neglect Current incident or circumstance Sexual abuse, serious physical abuse within past 12 months Less serious physical abuse within past 3 months Neglect within past month Differ for current/former foster children and certified foster homes Time limits

© 2010 by NCCD, All Rights Reserved INITIAL RISK ASSESSMENT Is this a family that needs ongoing support/intervention?

© 2010 by NCCD, All Rights Reserved Definitions of Key Terms in the SDM® Model: Different Decision Points Likelihood of immediate harm (current/near term) Safety: Likelihood of future harm (12–24 months following investigation/assessment) Risk: Domains of functioning in which a caregiver must demonstrate behavioral change to increase capacity to meet the safety, well-being, and permanency of his/her children Needs:

© 2010 by NCCD, All Rights Reserved Actuarial Risk Assessment A statistical procedure for estimating the probability that a “critical” event will occur. In the auto insurance industry, the critical event is a car accident involving a driver insured by the agency. Among breast cancer patients, the critical event is recurrence of cancer. In this case, the critical event is the likelihood of future child maltreatment.

© 2010 by NCCD, All Rights Reserved Risk Level by Initial Safety Assessment N = 69, California Combined Report

© 2010 by NCCD, All Rights Reserved California Risk Study Results N = 2,511 investigations conducted in 1995, followed for two years. California Risk Assessment Validation: A Retrospective Study, 1998

© 2010 by NCCD, All Rights Reserved Informing Decisions and Targeting Resources Risk classifies families by likelihood of subsequent abuse/neglect. High and very high risk families are significantly more likely to experience subsequent maltreatment. Using risk to decide whether to provide services, and the intensity of services, can reduce repeat maltreatment.

© 2010 by NCCD, All Rights Reserved Risk Level vs. Substantiation (N = 110) (N = 173) (N = 360) (N = 365) (N = 146) (N = 154) (N = 58) (N = 84) N = 1,450 New Mexico, 1997

© 2010 by NCCD, All Rights Reserved *Moderate and low risk cases with unresolved safety issues should always be transferred for ongoing services. Final Risk LevelRecommended Decision Very HighOpen for ongoing services HighOpen for ongoing services Moderate*Close Low*Close SDM® Case Open/Close Guidelines

© 2010 by NCCD, All Rights Reserved Ongoing Service Assessments In which areas does the family need help? What strengths can the family draw upon? Assessment of Family Functioning What is the family trying to achieve? What services will help them get there? Case Plan Should the case remain open or be closed? Can children be returned to the removal home? Risk Reassessment OR Reunification Reassessment

© 2010 by NCCD, All Rights Reserved SDM® ReassessmentWhich CasesDecision In-home Risk Reassessment All children remain in the home or have been returned home Remain open for services or not? Intensity of services Out-of-home Reunification Reassessment Cases in which at least one child in out-of-home placement has a goal of reunification Considering risk, access, and safety, can child be reunified with parent? Which SDM® reassessment?

© 2010 by NCCD, All Rights Reserved In-home Cases RISK REASSESSMENT

© 2010 by NCCD, All Rights Reserved Risk Reassessment What is the new risk level? » Research-based items with strongest relationship to outcomes » Assessment of progress » New incidents Should case continue to receive services or be closed? If services continue, what level of services should be provided?

© 2010 by NCCD, All Rights Reserved Foster Care REUNIFICATION REASSESSMENT

© 2010 by NCCD, All Rights Reserved Reunification Reassessment Reduce time to stable, long-term care arrangement Achieve reunification whenever it is safe to do so

© 2010 by NCCD, All Rights Reserved New Foster Care Cases With a Return Home Goal: Achievement of Stable, Long-term Care Arrangement 15 Months After Entering Foster Care Michigan Foster Care Evaluation, 2002 (N = 885) (N = 1,222) Care Arrangement Outcomes

© 2010 by NCCD, All Rights Reserved Reentry for Children Returned Home Michigan Foster Care Evaluation Addendum, 2002 (N = 236) (N = 263) (N = 131) (N = 311)

© 2010 by NCCD, All Rights Reserved Is risk low or moderate? Is visitation adequate? Is the child safe or conditionally safe? Reunify Yes No Should we continue reunification services? Should we pursue another long-term care goal? Reunification Reassessment

© 2010 by NCCD, All Rights Reserved Building Toward the SDM ® Model’s Goal Completing the tools Completing tools accurately, supported by narrative evidence Using tools to guide decisions Reduced harm

© 2010 by NCCD, All Rights Reserved For more information, please contact: Deirdre O’Connor, Senior Researcher Children’s Research Center