Moving Forward with Wisconsins Community Response Program Prepared

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Moving Forward with Wisconsin’s Community Response Program Prepared for Wisconsin Children’s Trust Fund Erik

Moving Forward with Wisconsin’s Community Response Program Prepared for Wisconsin Children’s Trust Fund Erik Bakken, Michele Dickinson, Austin Frerick, Kate Grannemann, Marianne Griffin, and Ye Wang

Research Questions 1: How do current practices of CRP sites influence potential for evaluation?

Research Questions 1: How do current practices of CRP sites influence potential for evaluation? 2: Which states have programs similar to Wisconsin’s CRP? 3: How should CTF evaluate CRP to inform statewide implementation?

Risk Factors for Perpetration Individual Family Community Substance Abuse Mental Health Issues Lack of

Risk Factors for Perpetration Individual Family Community Substance Abuse Mental Health Issues Lack of Parenting Skills History of Maltreatment Young Age Low Education Single Parent Low Income Social Isolation Family Disorganization Violence in the Home Parenting Stress Poor Parent-Child Relationships Negative Interactions High Poverty Residential Instability High Unemployment Poor Social Connections

 Mental Health Services Parent Education & Child Development Substance Abuse Services Domestic Violence

Mental Health Services Parent Education & Child Development Substance Abuse Services Domestic Violence Services Employment/ Job Assistance CRP Service Areas Housing Household or Family Needs Family Medical Needs Financial Support

 Referred to CRP Screened Out Referral for Alleged Child Maltreatment No Further Action

Referred to CRP Screened Out Referral for Alleged Child Maltreatment No Further Action Screened In

 Screened Out Referred to CRP No Further Referral for Alleged Child Maltreatment Action

Screened Out Referred to CRP No Further Referral for Alleged Child Maltreatment Action Screened In Traditional CPS Investigation CPS Case Closed Case Opened for Ongoing Services Referred to CRP No Further Action

 Referred to CRP Screened Out No Further Action Referred to CRP CPS Case

Referred to CRP Screened Out No Further Action Referred to CRP CPS Case Closed Referral for Alleged Child Maltreatment No Further Action Traditional CPS Investigation Case Opened for Ongoing Services Screened in Referred to CRP Case Closed Alternative Response No Further Action Case Opened for Ongoing Services

Research Questions 1: How do current practices of CRP sites influence potential for evaluation?

Research Questions 1: How do current practices of CRP sites influence potential for evaluation? 2: Which states have programs similar to Wisconsin’s CRP? 3: How should CTF evaluate CRP to inform statewide implementation?

Areas of Variation #1: Point of Referral GROUP 1 Screened Out No Further Action

Areas of Variation #1: Point of Referral GROUP 1 Screened Out No Further Action Referral for Alleged Child Maltreatment Traditional CPS Investigation Screened in GROUP 2 CPS Case Closed Case Opened for Ongoing Services No Further Action GROUP 3 Case Closed Alternative Response Case Opened for Ongoing Services No Further Action

Areas of Variation #2: Involvement in Referral Process CPS Staff & CRP Staff Community

Areas of Variation #2: Involvement in Referral Process CPS Staff & CRP Staff Community Response Program Only CPS Staff Community Response Program

Areas of Variation #3: Service Type & Provision Service Area Site A Site B

Areas of Variation #3: Service Type & Provision Service Area Site A Site B Site C Site D Domestic violence services R R Employment/job assistance DO/R R Family medical needs DO/R R Financial support DO DO/R Household or family needs DO DO/R R Housing DO R DO DO Mental health services R R Parent education and child development DO DO R DO Substance abuse services R R R: Referral to non-profit organization or other agency DO: Directly offered

Consistency in Defining Success ● Short Term: Completion of family’s service goals ● Long

Consistency in Defining Success ● Short Term: Completion of family’s service goals ● Long Term: Reduction in Re-Referrals to CPS

Research Questions 1: How do current practices of CRP sites influence potential for evaluation?

Research Questions 1: How do current practices of CRP sites influence potential for evaluation? 2: Which states have programs similar to Wisconsin’s CRP? 3: How should CTF evaluate CRP to inform statewide implementation?

All Referrals Accepted Referrals Screened Alabama, Alaska, California, Delaware, District of Columbia, Idaho, Iowa

All Referrals Accepted Referrals Screened Alabama, Alaska, California, Delaware, District of Columbia, Idaho, Iowa , Kansas, Maryland, New York, North Carolina, North Dakota, Ohio, South Dakota, Wyoming Arizona, Arkansas , Colorado, Connecticut, Florida, Georgia, Hawaii, Illinois, Indiana*, Kentucky, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire*, New Jersey, New Mexico, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee*, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin Total: 15 Total: 36 * Denotes insufficient data

Alternative and Traditional Response All Referrals Accepted Referrals Screened Delaware District of Columbia Maryland

Alternative and Traditional Response All Referrals Accepted Referrals Screened Delaware District of Columbia Maryland New York North Carolina Ohio Wyoming Arizona Colorado Connecticut Kentucky Louisiana Minnesota Nevada Oklahoma Texas Vermont Virginia Washington Wisconsin Alabama Arkansas Florida Georgia Hawaii Illinois Indiana* Maine Massachusetts Michigan Mississippi Missouri Montana Nebraska New Hampshire* New Jersey New Mexico Oregon Pennsylvania Rhode Island South Carolina Tennessee* Utah West Virginia Total: 7 Total: 13 Alaska California Idaho Iowa Kansas North Dakota South Dakota Total: 8 Total: 23 * Denotes insufficient data

Alternative and Traditional Response All Referrals Accepted Screened No Formal Response for Screened-Out Referrals

Alternative and Traditional Response All Referrals Accepted Screened No Formal Response for Screened-Out Referrals Delaware District of Columbia Maryland New York Ohio Wyoming Arizona Louisiana Oklahoma Vermont Virginia Washington Total: 6 North Carolina Colorado Connecticut Kentucky Minnesota Nevada Texas Wisconsin Total: 1 Total: 7 Traditional Response All Referrals Accepted Referrals Screened Alabama Alaska Idaho Kansas North Dakota South Dakota Arkansas Florida Hawaii Maine Massachusetts Michigan Mississippi Montana Nebraska New Hampshire* New Mexico Oregon Rhode Island Utah West Virginia Total: 6 California Iowa Total: 2 Total: 15 Georgia Illinois Indiana* Missouri New Jersey Pennsylvania South Carolina Tennessee* Total: 8 * Denotes insufficient data

2011 2014

2011 2014

Research Questions 1: How do current practices of CRP sites influence potential for evaluation?

Research Questions 1: How do current practices of CRP sites influence potential for evaluation? 2: Which states have programs similar to Wisconsin’s CRP? 3: How should CTF evaluate CRP to inform statewide implementation?

Recommendations 1. Randomized Controlled Trial 2. Cost-Benefit Analysis

Recommendations 1. Randomized Controlled Trial 2. Cost-Benefit Analysis

 Design Overview Observational Observation of differences in outcomes for CRP participants as compared

Design Overview Observational Observation of differences in outcomes for CRP participants as compared to nonparticipants Quasi-Experimental Dosage County The measurement of treatment received and the level of problems families had prior to service The measurement of differences in outcomes in CRP and non-CRP counties Randomization Random assignment before consent that creates two similar groups to measure differences between treatment and nontreatment

 Design Overview Internal Threats to Validity Quasi-Experimental Observational Dosage County Observation of differences

Design Overview Internal Threats to Validity Quasi-Experimental Observational Dosage County Observation of differences in outcomes for CRP participants as compared to nonparticipants The measurement of treatment received and the level of problems families had prior to service The measurement of differences in outcomes in CRP and non-CRP counties History bias Maturation bias Omitted variable bias Selection bias Hawthorne effects History Maturation bias Omitted variable bias Selection bias Hawthorne effects Omitted variable bias Randomization Random assignment before consent that creates two similar groups to measure differences between treatment and nontreatment Attrition Omitted variable bias Selection bias

 Design Overview Internal Threats to Validity Quasi-Experimental Observational Dosage County Observation of differences

Design Overview Internal Threats to Validity Quasi-Experimental Observational Dosage County Observation of differences in outcomes for CRP participants as compared to nonparticipants The measurement of treatment received and the level of problems families had prior to service The measurement of differences in outcomes in CRP and non-CRP counties History bias Maturation bias Omitted variable bias Selection bias Cost $ Hawthorne effects History bias Maturation bias Omitted variable bias Selection bias $$ Hawthorne effects Omitted variable bias $$ Randomization Random assignment before consent that creates two similar groups to measure differences between treatment and nontreatment Attrition Omitted variable bias Selection bias $$$

 Design Overview Internal Threats to Validity Quasi-Experimental Observational Dosage County Observation of differences

Design Overview Internal Threats to Validity Quasi-Experimental Observational Dosage County Observation of differences in outcomes for CRP participants as compared to nonparticipants The measurement of treatment received and the level of problems families had prior to service The measurement of differences in outcomes in CRP and non-CRP counties History bias Maturation bias Omitted variable bias Selection bias Cost Strengths Hawthorne effects History bias Maturation bias Omitted variable bias Selection bias Hawthorne effects Omitted variable bias $ $$ $$ Limited change required at agency level and buy-in is typically easier to achieve Demonstrates whether various levels of program participation result in different outcomes for families Provides a nonparticipant comparison group and shows differences in effects Randomization Random assignment before consent that creates two similar groups to measure differences between treatment and nontreatment Attrition Omitted variable bias Selection bias $$$ Allows for causal inferences regarding program effects because it provides a non-participant comparison group

Recommendations 1. Randomized Controlled Trial 2. Cost-Benefit Analysis

Recommendations 1. Randomized Controlled Trial 2. Cost-Benefit Analysis

Project GAIN Cost-Savings Analysis Estimated Program Savings Annual Savings $62, 000108, 000 Societal (nonprogram)

Project GAIN Cost-Savings Analysis Estimated Program Savings Annual Savings $62, 000108, 000 Societal (nonprogram) Total Savings savings $679, 000694, 000 $741, 000802, 000

Cost-Benefit Analysis Data Needs • • CPS administration costs CPS and CRP staff salaries

Cost-Benefit Analysis Data Needs • • CPS administration costs CPS and CRP staff salaries and benefits Re-referral rates among CRP participants and non-participants Substantiated re-referral rates among CRP participants and nonparticipants Out-of-home placements rates among CRP participants and nonparticipants Estimate of time spent by CPS workers on re-referred cases, rereferred cases that are substantiated, and re-referred cases that result in out-of-home placement Out-of-home placement costs CRP costs

Recommendations 1. Randomized Controlled Trial 2. Cost-Benefit Analysis For further information Contact Michele Dickinson

Recommendations 1. Randomized Controlled Trial 2. Cost-Benefit Analysis For further information Contact Michele Dickinson at (608) 516 -6992 or michele. [email protected] gov Visit this website after June 1, 2014 for a PDF copy of our report: www. lafollette. wisc. edu/publications/workshops. html

Variable Savings from reduced re-referrals (total dollars per case) Lower Bound Upper Bound Low

Variable Savings from reduced re-referrals (total dollars per case) Lower Bound Upper Bound Low Estimate $1, 496 Low Estimate $1, 278 High Estimate $1, 538 High Estimate $2, 012 Number of screened-out cases (total number) 6, 661 CRP take-up rate (percent participating) 39% 54 % Case reduction rate (percent reduction) 5% 15% Program costs (total annual dollars) $380, 000 $430, 000 Estimated lifetime societal costs (health care, mental, productivity, criminal justice, etc. )- endangerment only (present value of costs at 3% discount rate) $97, 952 $210, 012