Special performance audit, Department of Economic Security, Division of Children, Youth and Families, Child Protective Services

              A REPORT
TO THE
ARIZONA LEGISLATURE
Debra K. Davenport
Auditor General
Department of
Economic Security
Division of Children, Youth and
Families—Child Protective Services
Performance Audit Division
NOVEMBER • 2002
REPORT NO. 02 – 10
Special Performance Audit
The Auditor General is appointed by the Joint Legislative Audit Committee, a bipartisan committee composed of five
senators and five representatives. Her mission is to provide independent and impartial information and specific
recommendations to improve the operations of state and local government entities. To this end, she provides financial
audits and accounting services to the State and political subdivisions, investigates possible misuse of public monies, and
conducts performance audits of school districts, state agencies, and the programs they administer.
The Joint Legislative Audit Committee
Representative Roberta L. Voss, Chair Senator Ken Bennett, Vice Chair
Representative Robert Blendu Senator Herb Guenther
Representative Gabrielle Giffords Senator Dean Martin
Representative Barbara Leff Senator Peter Rios
Representative James Sedillo Senator Tom Smith
Representative James Weiers (ex-officio) Senator Randall Gnant (ex-officio)
Audit Staff
Dot Reinhard, Manager and Contact Person
Sandra Tulloss, Team leader Steve Jackson
Anne Hunter Lori Babbitt
Copies of the Auditor General’s reports are free.
You may request them by contacting us at:
Office of the Auditor General
2910 N. 44th Street, Suite 410 • Phoenix, AZ 85018 • (602) 553-0333
Additionally, many of our reports can be found in electronic format at:
www.auditorgen.state.az.us
2910 NORTH 44th STREET • SUITE 410 • PHOENIX, ARIZONA 85018 • (602) 553-0333 • FAX (602) 553-0051
DEBRA K. DAVENPORT, CPA
AUDITOR GENERAL
STATE OF ARIZONA
OFFICE OF THE
AUDITOR GENERAL
WILLIAM THOMSON
DEPUTY AUDITOR GENERAL
November 1, 2002
Members of the Arizona Legislature
The Honorable Jane Dee Hull, Governor
Mr. John L. Clayton, Director
Department of Economic Security
Transmitted herewith is a report of the Auditor General, A Special Performance Audit of the
Department of Economic Security, Division of Children, Youth and Families—Child Protective
Services. This audit specifically addresses a legislative request approved by the Joint Legislative
Audit Committee on August 9, 2001. I am also transmitting with this report a copy of the Report
Highlights for this audit to provide a quick summary for your convenience.
As outlined in its response, the Department agrees with all the findings and recommendations.
My staff and I will be pleased to discuss or clarify items in the report.
This report will be released to the public on November 4, 2002.
Sincerely,
Debbie Davenport
Auditor General
Enclosure
The Office of the Auditor General has conducted a special performance audit of the
child removal process, and the substantiation and appeals process used during
Child Protective Services (CPS) investigations of child abuse and neglect reports.
CPS is a function of the Division of Children, Youth and Families within the Arizona
Department of Economic Security. This audit specifically addresses a legislative
request approved by the Joint Legislative Audit Committee on August 9, 2001.
Legislative request and scope
In accordance with the legislative request, this special performance audit focuses
primarily on two CPS functions: (1) the child removal process—the process by which
CPS and other involved parties determine whether a child should be removed from
his/her parents’ or guardians’ home, and (2) the substantiation and appeals
process—the process by which CPS and other involved parties determine whether
abuse or neglect incidents should be substantiated. The legislative request also
directed auditors to investigate several other closely related items, including:
􀁺􇩄 Decision tree, or what is the process for removing children and substantiating
allegations of abuse or neglect, including who makes these decisions and the
standard of evidence used;
􀁺􇩌 Legal and compliance issues, including the constitutional basis for child
removal, due process rights of accused parents, and compliance with federal
guidelines established for the child removal process, and the substantiation and
appeals process; and
􀁺􇩏 Other areas including placement with family members, public versus
confidential information contained in case files, and selection and oversight of
service providers such as psychiatrists and medical doctors who are used
during the removal and substantiation processes.
page i
Office of the Auditor General
SUMMARY
Child removal process (see pages 5 to 13)
One of CPS’ most crucial responsibilities is determining whether it is necessary to
protect children by temporarily removing them from their parents’ or guardians’
custody. In 2001, CPS conducted about 25,500 investigations and removed
approximately 3,900 children from their homes.1
Numerous court cases over the past 50 years in Arizona, including one in the Arizona
Supreme Court, have upheld the State’s right to remove a child when it is necessary
to protect the child. However, courts have also found that parents have a
fundamental natural right to their children that is entitled to constitutional protection
such as due process. Therefore, before removing a child, a CPS investigator must
determine that the child is in imminent danger.
Specifically, state statutes allow that a child may be removed if he or she is either
“suffering or will imminently suffer abuse or neglect” or “suffering a serious physical
or emotional damage that can only be diagnosed by a medical doctor or
psychologist.” Arizona Administrative Code further defines what constitutes imminent
harm. However, not all conditions that the general public might consider abuse or
neglect are defined. For example, neither statute nor code specifies that substance-exposed
newborns can be removed from their home or that they should
automatically be considered abused or neglected. Therefore, the Division has
provided its workers further guidance on imminent harm and the type of evidence
needed to substantiate abuse or neglect through policies and directives. Again,
using the case of substance-exposed newborns, a division memo outlines five
questions that an investigator must answer in order to substantiate neglect, including
required “medical documentation that the exposure created a substantial risk of
harm to the child’s health or welfare.”
If the investigator, in consultation with his or her supervisor, determines the child is in
imminent danger, he or she has the authority to remove the child from the home. CPS
must then follow additional procedures required by federal and state laws. These
procedures include:
􀁺􇩁 A mandatory administrative review by a removal review team before a
dependency petition, which seeks temporary custody of the child, is filed with
the Juvenile Court;
􀁺􇩁 An administrative review, at the parents’ request, of the removal decision by the
Department’s Family Advocacy Office; and
page ii
1 This only includes children for whom a dependency petition was necessary. The Department must file a dependency
petition with the Juvenile Court within 72 hours of a child’s removal or the child must be returned home. A dependency
petition asks the court to award temporary custody of a child to the State.
State of Arizona
􀁺􇩁 A judicial review by the Juvenile Court when the Department determines that
continued out-of-home placement is necessary. In such cases, the Department
must file a dependency petition within 72 hours of the removal.
When children are removed, CPS attempts to locate relatives to care for them, rather
than placing them in traditional foster care. A previous Auditor General study (see
Auditor General Report No. 02-03) found that about 24 percent (or 1,450 of 6,100) of
the children in foster care in Arizona at the end of calendar year 2001 were placed
with relatives. However, the Auditor General’s Office recommended that the Division
provide additional training to case managers on the requirements of the kinship
foster care legislation; develop additional monitoring mechanisms to help ensure
compliance with these requirements; and use, when appropriate, its current goals,
objectives, and performance measures to assess the outcomes of kinship foster
care placements.
Auditors noted no instances where the procedures the Division has established did
not adhere to federal guidelines and found that the Division’s use of removal review
teams exceeds federal guidelines. Additionally, parents can receive government-funded
legal representation when the court finds that they cannot reasonably afford
it. Government-funded legal representation is handled by each county.
The Legislature should consider further clarifying in statute the definitions of abuse or
neglect and what criteria should be considered in removal decisions. For example,
about 13 other states have laws or codes that either include substance-exposed
newborns in the definitions of abuse or neglect, or indicate that substance exposure
constitutes a criteria for removal. Additionally, auditors identified two ways the
Division can improve the child removal process: (1) The Division should ensure that
parents receive sufficient information to understand how to properly request an
administrative review of their child’s removal from the Family Advocacy Office. From
July 18, 2000, to May 31, 2002, only 49 requests were made for a Family Advocacy
Office review. During this same period, state law would have allowed a Family
Advocacy Office review for about 7,400 children. Auditors found that the written
information provided to parents about the Office’s optional removal review was
inadequate. (2) The Division should evaluate the value and effectiveness of removal
review teams. Although removal review teams were designed to provide additional
oversight of the child removal process, their impact is unknown because the Division
has not compiled or analyzed existing information. The federal government does not
require the Division to form removal review teams.
Substantiation and appeals process (see pages 15 to 23)
In addition to determining whether a child can safely remain in his or her home, when
conducting investigations, CPS must also determine whether the specific allegations
page iii
Office of the Auditor General
of abuse or neglect occurred and should be substantiated. Legislation was enacted
in 1997 to provide accused parents an opportunity to appeal substantiated
allegations of abuse or neglect. In response to that legislation, the Department
created the Protective Services Review Team to review the evidence gathered by
CPS and to determine whether it is consistent with Arizona’s standard of evidence
and the statutory definitions of abuse and neglect. If the team staff agrees with CPS’
decision, the case is referred to the Office of Administrative Hearings. However, the
alleged abuser must request the review and hearing process when he or she is
notified of the proposed substantiated allegations.
To substantiate an allegation of abuse or neglect according to Arizona’s standard of
evidence, the CPS case manager must identify facts that provide reasonable
grounds to believe the abuse or neglect occurred, also known as probable cause.
Case managers can seek the advice of medical professionals such as psychiatrists
and doctors to help make their decision, and case managers also conduct other
activities including interviewing the victim, family members, neighbors, and teachers,
and examining prior CPS reports. The Division acted to clarify both its definitions of
abuse and neglect and its standards regarding the type of evidence needed to
substantiate reports. For example, the Division clarified, through a memo to all staff
in January 1999, that reports should not be substantiated when the accused
person’s behavior created only “the potential” for abuse or neglect. The Division also
issued a memo to clarify its practices in November 2001 and required case
managers to obtain assertions from medical professionals that children exposed to
drugs prior to birth had been harmed as a direct result of their mother’s drug use.
The percentage of reports that are substantiated has declined from approximately 23
percent in 1998 to 16 percent in 2001. Although the exact reasons for this decline are
unknown, the Division’s clarifications of its definitions and standards for determining
abuse and the addition of the Protective Services Review Team may be contributing
to this decline. Substantiated reports of abuse or neglect are listed on the State’s
Central Registry, and consistent with federal law, the State has enacted procedures
specifying who can access certain types of information from the Registry and case
files. Access to the Registry is limited and unavailable to the general public. Further,
by law, most of the information contained in case files is considered confidential
because it contains personal identification and other sensitive information. For
example, a case file might include information developed during the investigative
process, such as a child’s school records or an accused person’s criminal history
and medical records.
Auditors identified two steps that the Division can take to improve the substantiation
process. Specifically, the Division should provide additional training to all case
managers on the standards that should be met to substantiate a report. Interviews
with division staff indicated concerns about case managers’ understanding of what
is needed to substantiate a report. For example, 9 of the 31 investigative case
managers responding to an auditor phone questionnaire disagreed or strongly
page iv
State of Arizona
disagreed with the statement that “the current standard of evidence for substantiation
is clear.” Second, the Division should improve its process for providing to all case
managers and supervisors information about the reasons cases proposed for
substantiation are being overturned. During the past 2 calendar years, the team
overturned the largest percentages of proposed substantiations for the same four
reasons, including that the incident did not meet the statutory definition of abuse or
neglect or probable cause was not established.
pagev
Office of the Auditor General
page vi
State of Arizona
page vii
Office of the Auditor General
TABLE OF CONTENTS
continued
1
5
6
10
10
12
13
15
16
19
20
20
21
23
Introduction & Background
Chapter 1: Child removal process
Decision tree and standard of evidence
Placement with family members
Compliance and legal issues
Actions needed to improve the child removal process
Recommendations
Chapter 2: Substantiation and appeals process
Decision tree and standard of evidence
Oversight of service providers
Compliance and legal issues
Public records versus confidential information
Division can enhance supervisor and case manager
knowledge of standards
Recommendations
Agency Response
page viii
State of Arizona
TABLE OF CONTENTS
concluded
Figures:
1 Situations indicating imminent harm and need for removal
Arizona Administrative Code R6-5-5512
2 Child removal process
3 Substantiation and appeals process
4 Percentage of investigated reports substantiated years ended
December 31, 1998 through 2001
5 Protective services review team reasons for overturn of
proposed substantiations received in 2001
154 total allegations overturned
6 Protective services review team reasons for overturn of
proposed substantiations received in 2000
251 total allegations overturned
7
8
17
19
22
22
The Office of the Auditor General has conducted a special performance audit of the
child removal process, and substantiation and appeals process used during Child
Protective Services (CPS) investigations of child abuse and neglect reports. CPS is a
function of the Division of Children, Youth and Families within the Arizona Department
of Economic Security. This audit specifically addresses a legislative request
approved by the Joint Legislative Audit Committee on August 9, 2001.
Legislative request and scope
In accordance with the legislative request, this special performance audit focuses
primarily on two CPS functions: (1) the child removal process process by which CPS
and other involved parties determine whether a child should be removed from his or
her parents’ or guardians’ homes; and (2) the substantiation and appeals process—
the process by which CPS and other involved parties determine whether abuse or
neglect incidents should be substantiated. The legislative request also directed
auditors to investigate several other closely related items, including:
􀁺􇩄 Decision tree, or what is the process for removing children and substantiating
allegations of abuse or neglect, including who makes these decisions and the
standard of evidence used;
􀁺􇩌 Legal and compliance issues, including the constitutional basis for child
removal, due process rights of accused parents, and compliance with federal
guidelines established for the child removal, and substantiation and appeals
processes; and
􀁺􇩏 Other areas including placement with family members, public versus
confidential information contained in case files, and selection and oversight of
service providers such as psychiatrists and medical doctors who are used
during the removal and substantiation processes.
page1
Office of the Auditor General
INTRODUCTION
& BACKGROUND
This report organizes the various information gathered in the following two chapters:
􀁺􇩃 Chapter 1: The child removal process—This chapter provides information on
the overall removal process, and answers to the legislative questions pertaining
to child removal. It also recommends two ways that the Division can improve the
child removal process.
􀁺􇩃 Chapter 2: The substantiation and appeals process—This chapter provides
information on the overall substantiation process, and answers to legislative
questions, and indicates two actions that the Division can take to enhance the
substantiation process.
Methodology
Auditors used a variety of methods to obtain information about the areas outlined in
the legislative request such as reviewing Arizona Revised Statutes, administrative
code, federal law, and division materials such as policy and procedure manuals. In
addition, the following specific methods were used:
􀁺􇩏 Observing proceedings of the Protective Services Review Team, the Family
Advocacy Office, the Arizona Office of Administrative Hearings, individual
removal review team meetings, and CPS investigations in order to gain first-hand
knowledge of the procedures, processes, and time frames involved in
child abuse and neglect substantiation and removal processes;
􀁺􇩃 Conducting a phone questionnaire with 31 CPS investigators from throughout
the State to obtain information about removal and substantiation processes
such as case managers’ familiarity with standards of evidence;
􀁺􇩃 Collecting, validating, and analyzing selected data from three separate
automated data sources. Specifically, data was obtained from the Division’s
automated case management information system, the Children’s Information
Library and Data Source (CHILDS), to determine the number of reports CPS
received and investigated. Second, data was obtained from the Protective
Services Review Team’s database to identify the number of requests for review
and the outcomes of those reviews. Third, data was obtained from the Family
Advocacy Office to identify the scope and results of parents’ requests to review
child removal decisions;
􀁺􇩓 Surveying 12 other states to obtain comparative information on removal and
substantiation processes, and to identify best practices in these areas. States
were selected for contact based on their geographic proximity to Arizona,
information provided by division staff, and population size. Auditors contacted
page2
State of Arizona
Colorado, Illinois, Michigan, Minnesota, Missouri, Nevada, New York, Oregon,
Texas, Utah, Virginia, and Washington;
􀁺􇩉 Interviewing division staff statewide, including unit supervisors, program
managers, and other staff including representatives of the Protective Services
Review Team, the Family Advocacy Office, the Child Abuse Hotline, the policy
unit, and the legislative services unit to gain an understanding of their specific
responsibilities and practices; and
􀁺􇩉 Interviewing individuals knowledgeable about CPS processes, including
representatives from the Arizona Attorney General’s Office, the Arizona Office of
Administrative Hearings, the Foster Care Review Board, child welfare advocacy
organizations, and the Ombudsman-Citizen’s Aide Office.
This audit was conducted in accordance with government auditing standards.
The Auditor General and staff express appreciation to the director and staff of the
Department of Economic Security for their cooperation and assistance during the
audit.
page3
Office of the Auditor General
page4
State of Arizona
Child removal process
One of CPS’ most critical responsibilities is determining whether it is necessary to
protect children by temporarily removing them from their parents’ or guardians’
custody. In 2001, the Department’s Child Abuse Hotline received approximately
34,100 reports of potential child abuse and neglect. Of these, approximately 25,500
were investigated by CPS and approximately 8,600 were referred to the Family
Builders Program for assessment.1 During the same year, CPS removed
approximately 3,900 children.2 This chapter addresses questions related to the
process used by CPS to temporarily remove children from their parents’ or
guardians’ custody. Specifically, it describes:
􀁺􇩔 The decision tree, or process, CPS uses to remove children from their homes,
including the standard of evidence used to decide if a child should be removed
from the home;
􀁺􇩗 When children are removed, CPS’ efforts to place them with family members; and
􀁺􇩌 Legal issues regarding child removal including the constitutional basis for child
removals, CPS’ adherence to federal requirements, and accused parents’
access to legal representation.
While gathering this information, auditors identified two ways the Division can
improve the child removal system: (1) The Division should ensure that parents
receive sufficient information to understand how to properly request an administrative
review of their child’s removal. (2) The Division should evaluate the removal review
team’s role by compiling and analyzing existing information about their results.
page5
1 A.R.S. §8-816 established the Family Builders Program, which allows CPS to refer selected low- and potential-risk child
abuse reports to a network of community-based providers for family assessment, case management, and services after
CPS screening.
2 This only includes children for whom a dependency petition was necessary. The Department must file a dependency
petition with the Juvenile Court within 72 hours of a child’s removal or the child must be returned home. A dependency
petition asks the Court to award temporary custody of a child to the State.
Office of the Auditor General
CHAPTER 1
Decision tree and standard of evidence
State statutes define two conditions under which CPS may remove a child from his
or her parents’ or guardians’ custody. Arizona Revised Statutes §8-821 provides that
a child may be removed if he or she is either:
“Suffering or will imminently suffer abuse or neglect.”
Or
“Suffering serious physical or emotional damage that can
only be diagnosed by a medical doctor or psychologist.”
The Arizona Administrative Code further defines what constitutes imminent harm and
additional factors to consider when deciding whether to remove a child. As shown in
Figure 1 (see page 7), this can include situations where no caregiver is present and
a child cannot care for himself or herself, a child has severe or serious nonaccidental
injuries that require immediate medical treatment, or the physical or mental condition
of the caregiver endangers a child’s health or safety. In a phone questionnaire with
31 investigative case managers from across the State, auditors found that most, 25,
could identify and explain Arizona’s standard of evidence for removal, imminent
harm.
However, not all conditions that the public might consider abuse or neglect are
defined. For example, Arizona Revised Statutes and the Administrative Code do not
specify that newborn children exposed to alcohol or illegal substances can be
removed from their parents’ or guardians’ custody, nor that such children can be
assumed to be abused or neglected.1 The lack of definition on areas such as this is
not uncommon. According to a 2001 study published in the Yale Journal of Health
Policy, Laws, and Ethics, about 35 other states also do not address substance-exposed
newborns in either their removal criteria or definitions of abuse or neglect.2
The Department has provided additional guidance for its investigators through policy
memos and manuals. For example, a division memo outlines five questions that an
investigator must answer to substantiate neglect in the case of a substance-exposed
newborn. Under these questions an investigator must not only establish that the child
tested positive for drugs, but also that “there is medical documentation stating that
the exposure created a substantial risk of harm to the child’s health or welfare.”
page6
State of Arizona
1 Although substance-exposed newborns are not automatically considered abused or neglected under Arizona law, A.R.S.
§13-3620(B) requires regulated health professionals to report to CPS under several circumstances, including when a
positive toxicology screen of a newborn child gives the professional “reasonable grounds to believe that the newborn
infant may be affected by the presence of alcohol” or illegal substances.
2 “Synopsis of State Case and Statutory Law” compiled by/published in the Yale Journal of Health Policy, Laws, and Ethics.
Volume I: Spring 2002. Symposium issued on Current Racial and Ethnic Disparities in Health.
page7
Office of the Auditor General
Figure 1 Situations Indicating Imminent Harm and Need for Removal
Arizona Administrative Code R6-5-5512 (B) and (C)
B. The following situations indicate imminent harm and require CPS to intervene as provided in R6-5-5513:
1. No caregiver is present and a child cannot care for himself or herself or for other children in the household;
2. A child has severe or serious nonaccidental injuries that require immediate medical treatment, such as:
3. A child requires immediate medical treatment for a life-threatening medical condition or a condition likely to result in
impairment of bodily functions or disfigurement, and the child’s caregiver is not willing or able to obtain treatment;
4. A child is suffering from nutritional deprivation that has resulted in malnourishment or dehydration to the extent that the child
is at risk of death or permanent physical impairment;
5. A doctor or psychologist determines that a child’s caregiver is unable or unwilling to provide minimally adequate care;
6. The physical or mental condition of a child’s caregiver endangers a child’s health or safety, such as a caregiver who:
􀁺􇩅 Exhibits psychotic behavior and fails to take prescribed medications,
􀁺􇩓 Suffers from a deteriorating physical condition or illness, or
􀁺􇩔 Takes prescribed or nonprescribed drugs that result in a child being neglected;
7. The home environment has conditions that endanger a child’s health or safety, such as human or animal feces,
undisposed-of garbage, exposed wiring, access to dangerous objects, or harmful substances that present a
substantial risk of harm to the child;
8. A doctor or psychologist has determined that:
􀁺􇩁 A child’s caregiver has emotionally damaged the child;
􀁺􇩔 The child is exhibiting severe anxiety, depression, withdrawal, or aggressive behavior due to the emotional
damage; and
􀁺􇩔 The caregiver is unwilling or unable to seek treatment for the child;
9. A CPS Specialist has probable cause to believe that a caregiver has engaged in sexual conduct with a child or has
allowed the child to participate in sexual activity with others.
􀁺􇩈 Head injury, with risk of damage to the
central nervous system;
􀁺􇩉 Internal injuries;
􀁺􇩁 An injury resulting in coma;
􀁺􇩍 Multiple plane injuries indicative of battering;
􀁺􇩆 Facial bruises;
􀁺􇩆 Fractures or bruises in a nonambulatory child;
􀁺􇩉 Instrumentation injury with risk of impairment; or
􀁺􇩉 Immersion burns.
C. In situations not listed in Subsection (B), a CPS specialist shall determine the risk of imminent harm and need
for removal by:
1. Doing a family assessment to identify family strengths and risk factors; and
2. Evaluating all facts and circumstances surrounding a child and family situation, including the following:
a. Whether a law enforcement official or medical professional expresses concern about risk to the child victim if the child
victim returns to or remains in the home;
b. The alleged abuser’s behavior towards the child victim;
c. Other adults in the household’s behavior towards the child victim;
d. Whether the child victim resides with a parent or other adult who is willing and able to protect the child;
e. The conditions of the home environment and whether those conditions threaten the child victim’s safety or physical
health;
f. Whether there has been a pattern of maltreatment, particularly a pattern of incidents of increasing severity;
g. The nature and severity of the alleged maltreatment;
h. Whether DES is able to provide services to the child or family to alleviate conditions or problems that pose a risk of
maltreatment, without the need for removal;
i. Whether the child’s caregiver refuses access to a child or declined an offer of in-home services;
j. The family’s strengths and risk factors;
k. The child’s current physical and mental condition; and
l. Whether the child victim has injuries that require immediate medical treatment.
page8
State of Arizona
Child Protective Services case manager conducts an
investigation and consults with his or her supervisor
to determine whether child needs to be removed
Is the child suffering or will the
child suffer imminent harm?
YES NO
Child stays in the home
Services may be provided
Case manager continues
investigation into allegation of
abuse or neglect
(see Figure 3, page 17, describing the
substantiation process)
Does the parent request a
Family Advocacy Office
review prior to CPS filing a
dependency petition?
NO YES
Family Advocacy Office
informs case
manager and unit
supervisor of their
involvement and reviews
removal
Does Advocacy Office
agree with removal?
Removal review team
conference
YES
Family Advocacy Office
informs case manager of
the outcome and makes any
recommendations
NO
Family Advocacy Office may
direct unit supervisor to return
the child to home or consider
other alternatives
Does team believe
continued
out-of-home placement
is necessary?
YES
Child remains in out-of-home
care and dependency petition
may be filed. Case manager
consults with Attorney General's
Office
NO
Child returned to home
and a dependency
petition may still be filed.
Case manager consults
with Attorney General's
Office
Source: Auditor General staff analysis and summary of Division's removal process as described in A.R.S. §§8-802, 8-821,
8-822, and 8-828 and the Division's Children's Services Manual.
During calendar year 2001, there were approximately:
• 25,500 CPS investigations
• 3,900 removals 2
• 17 Family Advocacy Office reviews
Child removed from home
Services provided
Case manager continues
investigation into allegation of
abuse or neglect
(see Figure 3, page 17, describing the
substantiation process)
1
1 If timing allows, the Family Advocacy Office review may occur in conjunction with the removal review team conference.
2 This only includes children for whom a dependency petition was necessary.
Figure 2 Child Removal Process
page9
Office of the Auditor General
If the CPS investigator, in consultation with his or her supervisor, determines that a
child is in imminent harm, he or she has the authority to remove the child from the
home and place him or her in the temporary custody of the State. Such a decision is
subject to a number of mandatory or optional reviews from the following entities (see
Figure 2, page 8):
􀁺􇩒 Removal review teams—Arizona changed its child removal process in 1990 to
include a mandatory administrative review of the removal decision before a
dependency petition is filed with the Juvenile Court.1 A dependency petition
asks the court to award temporary custody of the child to the State. Each
removal review team is an ad hoc group assembled by the investigating CPS
case manager or supervisor after a child removal has taken place. The team
assesses whether there are options other than continued out-of-home
placement, such as in-home services, and determines whether a dependency
petition should be filed. Under statute, the team must include a CPS staff
member, a CPS supervisor, a member of the foster care review board, and the
child’s physician if the child has a medical need or chronic illness.2 Typically, the
investigating case manager and his/her supervisor are the ones who represent
CPS. This administrative review is not federally required, and of the 12 states
auditors contacted, only Utah has adopted a similar mechanism.
􀁺􇩆 Family Advocacy Office—Arizona revised its child removal process again in July
2000 to include an administrative review by the Family Advocacy Office, upon
parents’ request, prior to the filing of a dependency petition.3 If a parent
requests the review prior to the filing, Family Advocacy staff examine whether
imminent harm existed during a removal, whether options other than removal
were considered, and whether continued out-of-home placement is needed.
Reviewers either determine that CPS met the criteria for removal or disagree. If
they disagree, reviewers may direct that the child be returned to the parent or
suggest other alternatives. If timing allows, this review may take place in
conjunction with the removal review team. In calendar year 2001, 19 review
requests were made. In 17 cases, the Family Advocacy Office staff approved of
the removal decision. In the remaining 2 cases, a review could not be completed
because research found that the child had never been removed or CPS had
already filed a dependency petition.
􀁺􇩊 Juvenile Court—When CPS determines that continued out-of-home placement
is necessary, it must file a dependency petition with the Juvenile Court within 72
hours of the child’s removal. Once a petition has been filed, the court holds
various conferences and hearings within required time frames to determine such
things as the need for continued out-of-home placement, placement options,
services for the child and family, and visitation. States vary as to when the courts
1 Added as A.R.S. §8-546.08 by Laws 1990, Chapter 237, A.R.S. §11. Renumbered as A.R.S. §8-822 by Laws 1997,
Chapter 222, §53(B).
2 A.R.S. §8-822(3).
3 A.R.S. §8-828.
page10
State of Arizona
review child removal decisions. Similar to Arizona, Minnesota, Nevada, and
Washington require judicial reviews within 72 hours of child removals. Other
states, including New York, Oregon, and Texas, require a judicial review within
24 hours. In contrast, all child removals in Missouri must be court-ordered.
Placement with family members
When children are removed, CPS attempts to locate relatives to care for them, rather
than placing them in traditional foster care. A recent review (see Auditor General
Report No. 02-03) found that relative care is an important option for children who
must be removed from their homes. At the end of calendar year 2001, about 24
percent (or 1,450 of 6,100) of the children in Arizona foster care were placed with
relatives. The Auditor General’s Office recommended that the Division provide
additional training to case managers on the requirements of the kinship foster care
legislation; develop additional monitoring mechanisms to help ensure compliance
with these requirements; and use, where appropriate, its current goals, objectives,
and performance measures to assess the outcomes of kinship foster care
placements.
Compliance and legal issues
CPS’ child removal system is guided by the court system, federal requirements, and
state statutes. For example, numerous state and federal courts have ruled on the
legal basis for governments’ ability to interfere in parent-child relationships. Similarly,
CPS must meet federal requirements for child removal processes. Additionally, the
Juvenile Court decides which parents are eligible to receive publicly funded legal
counsel.
Constitutional basis for removing children—One of the most complex and
critical issues facing welfare agencies is the need to balance the rights of children to
adequate care and freedom from harm with the rights of parents to retain custody of
and responsibility for their children. Numerous court cases over the past 50 years in
Arizona, including one in the Arizona Supreme Court, have upheld the State’s right to
intercede in the parent-child relationship because of the State’s interest in the future
well-being of minor children.1 This includes removing children from their guardians’
custody when it is necessary to protect the child. However, courts have also found
that parents have a fundamental, natural right to their children that is entitled to
constitutional protection, such as due process.2
1 Matter of Appeal in Gila County Juvenile Action No. J-3824 (1981) 130 Ariz. 530, 637 P.2d 740.
2 Appeal in Pima County Juvenile Action No. J-46735 v Howard, 112 Ariz. 170 P.2d 642 (1975) and Matter of Appeal in
Maricopa County Juvenile Action No. JS-5209 and No. JS-4963, 142 Ariz. 178, 692 P2d 1027 (App. 1984).
About 24 percent of
children in foster care
at the end of 2001 were
placed with relatives.
page11
Office of the Auditor General
To ensure that parents receive an opportunity to be heard early in the process, state
law provides for administrative reviews of child removal decisions, in addition to the
judicial reviews. As noted previously, parents or guardians can request the
Department’s Family Advocacy Office to review CPS’ decision to remove a child from
their custody (see page 9). In addition, all removals that will result in the filing of a
dependency petition are reviewed by a removal review team and the Juvenile Court
(see page 9).
Adherence to federal guidelines—Federal requirements also guide the child
removal process. Auditors examined the federal Child Abuse and Prevention and
Treatment Act requirements related to child removal and noted no instances where
the Division was not adhering to federal guidelines. In some situations, the Division
exceeds federal requirements. For example, Arizona enhanced its child removal
process in 1990 by requiring that all child removal decisions be officially reviewed by
a removal review team before dependency petitions are filed with the Juvenile Court
(see page 9). This review is not required by federal law, and similar administrative
processes appear to be rare in other states.
In addition, the United States Department of Health and Human Services recently
conducted a separate, unrelated review of the Division. It found that the Division is in
substantial compliance with all federal requirements regarding children’s safety. As
of February 2002, Arizona was the only state of ten reviewed that substantially met all
federal requirements regarding children’s safety.
Parents’ legal representation—Parents and other accused parties can access
legal advice in several ways. First, an accused party may seek legal counsel at his or
her own expense during any phase of the investigation, substantiation, and child
removal processes. Additionally, accused parties can receive government-funded
legal representation after their child has been removed. However, the court must
generally find that the accused person cannot reasonably afford to provide his or her
own legal counsel.
Government-funded legal representation is handled by each county. In Maricopa
County, the Legal Defender’s Office represents accused parents. The attorneys in the
Maricopa County’s Legal Defender’s Office are paid county employees. Accused
parents generally cannot select or change which Legal Defender’s Office attorney will
represent them, although the Office may internally choose to reassign attorneys if
problems develop. Additionally, there is an Office of Legal Contract Counsel that can
provide legal representation through private contract attorneys if legal conflicts of
interest arise.
Auditors noted no
instances where the
Division was not
adhering to federal
guidelines regarding the
child removal process.
Actions needed to improve the child removal process
Several actions are needed to improve the child removal process. First, the
Legislature should consider clarifying in statute how CPS should handle substance-exposed
newborn cases. Additionally, the Division should ensure that parents receive
sufficient information to understand how to properly request an administrative review
of their child’s removal. Further, the Division should evaluate the impact of removal
review teams by compiling and analyzing existing information about team results.
Consider clarifying statute—The Legislature should consider further clarifying in
statute the definition of abuse and neglect. This could include such issues as whether
substance exposure constitutes criteria for removal. Based on a review of other
states’ laws as recently published in Yale Journal of Health, Policy, Laws and Ethics,
about 13 states have laws or codes that either classify substance-exposed newborns
in their definitions of abuse or neglect, or indicate that substance exposure
constitutes a criteria for removal.1
Improve information provided to parents—Few parents or guardians are
requesting Family Advocacy Office reviews. The Office has been requested to
complete only 49 eligible reviews since its inception in July 2000, even though state
law would have allowed a Family Advocacy Office review for about 7,400 children
during the same period.2 Auditors identified two reasons that may contribute to the
low number of review requests. One is that parents or guardians may not be fully
aware of their right to request a review or the speed with which they must act. The
second is that some case managers may not be able to explain to parents this
possible review.
CPS provides parents and guardians with written notices and brochures explaining
the process, including one notice which contains a toll-free telephone number for the
Family Advocacy Office. However, these documents do not adequately explain that
parents must request a review before CPS files a dependency petition—a step that
CPS can take in less than the allowed 72 hours.
The Division has since revised some of the written information provided to parents.
For example, it has developed a new form explaining children’s and parent’s rights
including the right to a Family Advocacy Office review which the parent or guardian,
and the child (if over 12), must sign. However, this form does not explain how the
parent can request a Family Advocacy Office review or the need to do so before a
dependency petition is filed. Therefore, it is critical that case managers understand
and can explain to parents the Family Advocacy Office’s role in reviewing removal
decisions. This audit found that some case managers are not familiar with the Office.
page12
State of Arizona
1 Synopsis of State Case and Statutory Law: compiled by/published in the Yale Journal of Health, Policy, Laws, and Ethics.
Volume 1: Spring 2002. Symposium issued on Current Racial and Ethnic Disparities in Health. These 13 states are Florida,
Illinois, Indiana, Iowa, Maryland, Minnesota, Nevada, Oklahoma, South Carolina, South Dakota, Texas, Virginia, and
Wisconsin.
2 Number of requests as of May 31, 2002.
Auditors interviewed 31 investigative case managers from across the State and
found that 15 were not familiar with the Office.
Assess removal review teams’ impact—The impact of removal review teams
on the child removal process is unclear. This additional review is not required by
federal law, and similar administrative processes appear to be rare in other states.
For example, of the 12 states auditors contacted, only Utah has adopted a similar
mechanism that internally evaluates every child removal decision.1 In addition, unlike
the Family Advocacy Office, where a parent must request a review, a removal review
team must be convened to review each CPS removal in which the Division plans to
file a dependency petition.
Although removal review teams were designed to provide additional oversight over
the child removal process, their impact is unknown because the Division has not
analyzed existing information. As a result, key information needed to assess the
ongoing value and effectiveness of removal review teams, such as how often they
direct that children should be returned to their homes, is unknown.
Recommendations
1. The Legislature should consider further clarifying in statute the definitions of
abuse and neglect and what criteria should be considered in removal decisions.
2. The Division should ensure that its forms and brochures contain the sufficient
and accurate information parents and guardians need to exercise their right to
request a review, including information that describes and emphasizes the
limited time frame in which requests for Family Advocacy Office reviews can be
considered.
3. The Division should take steps to ensure that case managers understand, and
thus can explain to parents, the Family Advocacy Office’s role in reviewing
removal decisions.
4. The Division should periodically analyze key statistics about removal review
teams, including the number held, participants attending, and the review
outcomes.
5. The Division should use existing information about removal review teams to
evaluate and assess their impact and value.
page13
1 Auditors contacted child welfare representatives from Colorado, Illinois, Michigan, Minnesota, Missouri, Nevada, New
York, Oregon, Texas, Utah, Virginia, and Washington.
Office of the Auditor General
page14
State of Arizona
Substantiation and appeals process
When conducting investigations, CPS must also determine whether the specific
allegations of abuse or neglect occurred. Each of the approximately 25,500 reports
investigated in 2001, regardless of whether the child was removed or not, resulted in
a “finding” of substantiated or unsubstantiated. Ultimately, after review and appeals,
approximately 3,600 reports received in 2001 were substantiated. This chapter
addresses questions related to the process used to determine whether specific
allegations of abuse or neglect should be substantiated, sometimes referred to as
the appeals process. Specifically, this chapter describes:
􀁺􇩔 The decision tree for the appeals process, including changes that have been
made to the process, and the standard of evidence used to decide whether
specific allegations of abuse or neglect occurred;
􀁺􇩏 Oversight of service providers, such as psychiatrists and medical doctors, who
assist the investigative process;
􀁺􇩃 Compliance and legal issues regarding the appeals process, including the
Division’s adherence to federal requirements, and the due process rights
available to accused parents; and
􀁺􇩐 Public records versus confidential information contained within case files,
including how the Division handles requests for information contained within the
case files.
While gathering this information, auditors identified two steps that the Division can
take to improve the substantiation, or appeals, process: (1) The Division should
provide additional training to case managers on the standards that should be met to
substantiate a report. (2) The Division should improve its process for providing to
case managers and supervisors information about the reasons cases proposed for
substantiation are being overturned.
page15
Office of the Auditor General
CHAPTER 2
page16
State of Arizona
Decision tree and standard of evidence
In addition to determining whether or not a child should be removed, when
investigating a report, the CPS case manager must also determine whether the
specific allegations of abuse or neglect should be substantiated. This is sometimes
referred to as the substantiation and appeals process. The process was changed in
1997 to provide an opportunity for parents or guardians to request a hearing on
proposed, substantiated allegations of abuse or neglect through the Protective
Services Review Team. Steps have also been taken to clarify the standard of
evidence needed to substantiate allegations of abuse or neglect. Over the period in
which these changes have been taking place, the percentage of reports that were
substantiated has declined.
Substantiation and appeals process decision tree—The process by
which CPS investigates and reviews whether specific incidents of abuse or neglect
occurred is known as the substantiation, or appeals, process and involves multiple
steps (see Figure 3, page 17):
􀁺􇩃 CPS investigation—All CPS investigations, whether or not a child is removed,
result in a “finding” of either substantiated or unsubstantiated. To substantiate an
allegation of abuse or neglect, the CPS case manager must identify facts that
provide reasonable grounds to believe the abuse or neglect occurred, also
known as probable cause. Case managers do several things to gather
evidence, including interviewing the victim, family members, neighbors, and
teachers; examining prior CPS reports as well as police and medical records,
and seeking healthcare professionals’ advice. When there is not sufficient
evidence to indicate that the allegation is true, the CPS case manager will not
substantiate the report. Conversely, if the case manager believes there is
sufficient evidence to indicate that the abuse or neglect allegation is true, the
CPS case manager will, with the supervisor’s approval, propose the report for
substantiation. Whether or not the abuse or neglect report is proposed for
substantiation, families may be offered services such as family or substance
abuse counseling to protect the child and strengthen the family. CPS conducted
about 25,500 investigations in calendar year 2001.
􀁺􇩐 Protective Services Review Team review—In 1997, the Legislature required the
Department to add a hearing process to its regular procedures for
substantiating abuse and neglect reports.1 This Department review, conducted
by the Protective Services Review Team, is at the request of the alleged
perpetrator and conducted prior to a formal hearing. In fiscal year 2002, the
Division received $513,900 in State General Fund appropriations, which it uses
primarily to pay for the costs of the Protective Services Review Team.2 The
review and hearing processes are conducted only upon the alleged
CPS conducted about
25,500 investigations in
calendar year 2001.
1 A.R.S. §8-546.12, added by Laws 1997, Chapter 224, §2, renumbered as A.R.S. §8-811 and amended by Laws 1998,
Chapter 276 §20.
2 The Protective Services Review Team has 11 authorized FTE positions.
page17
Office of the Auditor General
Child Protective Services determines whether the child can remain in the
home and continues investigation into allegation(s) of abuse or neglect.
Do the facts provide reasonable grounds to
believe neglect or abuse occurred?
YES
CPS case manager/supervisor
proposes to substantiate one or more
allegations in the report
Proposed substantiated report sent to
the Protective Services Review Team,
who notifies alleged abuser
of right of review
Is the alleged abuser eligible for and has
he/she requested a review?
NO
CPS case manager/supervisor
lists the report as unsubstantiated
YES
Protective Services Review Team
reviews report allegations
and decides whether it
agrees with CPS' decision
NO
Protective Services Review
Team substantiates and lists
perpetrator on Central Registry
YES
Office of Administrative Hearings
reviews and makes recommendation
to Department Director's Office,
which decides whether report should
be substantiated
YES
Report substantiated
and perpetrator listed on
Central Registry
NO
Report unsubstantiated
NO
Protective Services Review Team
lists the report as unsubstantiated
Source: Auditor General staff analysis and summary of the Division's substantiation process as described in A.R.S. §§8-811 and
41-1092.08, the Division's Children's Services Manual, and the Protective Services Review Team's policy manual.
Of reports received during calendar year 2001, there were
approximately:
• 25,500 CPS investigations
• 3,600 reports substantiated
1
1 An alleged abuser's request for a review is eligible if it is received within 14 days of the notification and there is no other legal action
pending regarding the incident.
Figure 3 Substantiation and Appeals Process
page18
1 A single report can involve multiple perpetrators and/or multiple allegations of abuse or neglect.
2 Pursuant to A.R.S. §41-1092.07.
3 Pursuant to A.R.S. §41-1092.08.
4 The remaining decision was certified by the Office of Administrative Hearings because it did not receive a response from
the Director’s Office within the required time frame.
State of Arizona
perpetrator’s request. To initiate this process, team staff send a letter to the
alleged perpetrator indicating CPS’ intent to substantiate and informing him or
her of the right to request a review of CPS’ proposed substantiation decision. In
order to be eligible for review, the alleged perpetrator must submit a request for
the review within 14 days and there must not be any other legal action pending
regarding the incident. If the alleged perpetrator does not request or is not
eligible for a review, the allegations are determined to be substantiated. For
those requesting a review, team staff determine whether information gathered
during the CPS investigation provides reasonable grounds to believe the alleged
abuse or neglect occurred and the evidence collected is consistent with the
statutory definitions of abuse and neglect. Team staff either upholds CPS’
decision or list the report as unsubstantiated. Of the 4,251 reports proposed for
substantiation in calendar year 2001, the team reviewed 354 reports involving
414 allegations and overturned 154 of them.1
􀁺􇩏 Office of Administrative Hearings review—If the Protective Services Review Team
upholds CPS’ proposed substantiation, then the Office of Administrative
Hearings conducts a hearing.2 The Office of Administrative Hearings decides
whether it agrees with CPS’ decision to substantiate the report and makes a
recommendation to the Department’s director, who ultimately decides whether
to accept, accept with modifications, or amend the Office’s recommendation.3
In 2001, the Director’s Office accepted 120 of the 163 decisions and accepted
with modifications another 41 of the decisions rendered by the Office of
Administrative Hearings.4
􀁺􇩃 Central Registry entry—Once the process is completed, substantiated reports
of child abuse or neglect are listed on the State’s Central Registry. Access to the
Registry is limited and unavailable to the general public. CPS case managers
can access the information when investigating child abuse and neglect reports
to facilitate the assessment of whether the child is at risk. Similarly, law
enforcement agencies can use the registry to assist in criminal investigations
and prosecutions of child abuse or neglect. In addition, the Department can use
information contained in the registry to conduct background checks for foster
home licensing, adoptive parent certification, and child care home certification.
Approximately 3,600 of the reports received during calendar year 2001 were
substantiated.
Standard of evidence used to substantiate reports—State statutes and
division policy dictate that one standard of evidence, probable cause, be considered
when determining whether specific instances of child abuse or neglect occurred.
Approximately 3,600
reports received in 2001
were substantiated.
Probable cause refers to evidence that provides reasonable grounds to believe that
an incident did occur. The Division has also acted to clarify both the definitions of
abuse and neglect and its standards regarding the type of evidence needed to
substantiate reports. For example, the Division clarified, through a memo to all staff
in January 1999, that reports should not be substantiated when the accused
person’s behavior created only “the potential” for abuse or neglect. The Division also
issued a memo to clarify its practices in November 2001 and required case
managers to obtain assertions from medical professionals that children exposed to
drugs prior to birth had been harmed as a direct result of their mother’s drug usage.
The substantiation rate is declining—As illustrated in Figure 4, the
percentage of child abuse and neglect reports that are substantiated has decreased
from approximately 23 percent to 16 percent
between calendar years 1998 and 2001.1 The
exact reasons for the decline in the
substantiation rate are unknown. However, the
Division indicates that it has been tightening its
standards to ensure they are in line with the
legal definition of abuse or neglect. In addition,
the added Protective Services Review Team
process may be contributing to some of the
decline in the substantiation rate. Of the
allegations it reviewed between 1999 and 2001,
the team overturned CPS’ proposed
substantiation decisions about 48 percent of
the time. In addition, some case managers may
be reluctant to propose cases for substantiation
due to this process. Although auditors were
unable to estimate the extent to which CPS
case managers were not proposing cases for
substantiation, in interviews with division staff,
five individuals indicated that some cases may
not be proposed for substantiation because of
the Protective Services Review Team process.
Oversight of service providers
Medical and other professionals can play an important role in substantiating
complaints of child abuse and neglect. Case managers can seek the advice of a
variety of professionals to assist them in determining whether a child needs to be
removed from his or her home or if a specific incident of abuse or neglect occurred.
For example, a case manager can ask a psychologist to conduct a mental status
exam for an accused person or request a psychiatrist to determine whether
somebody involved in the investigation suffers from a mental illness. Similarly, case
managers may request a physician to examine a child if he or she suffered injuries
page19
1 To ensure consistency with the Division’s process for calculating the substantiation rate, the lowest category of child
abuse and neglect reports—potential risk—is not included in auditors’ calculation of the substantiation rate.
Office of the Auditor General
16%
21%
23%
23%
0%
5%
10%
15%
20%
25%
Figure 4 Percentage of Investigated Reports Substantiated
Years Ended December 31, 1998 through 2001
1998 1999 2000 2001
Source: Auditor General staff analysis of data derived from the Children’s Information
Library and Data Source, on April 1, 2002.
requiring medical attention or sexual abuse is suspected. When a service provider is
consulted, the case manager would generally provide a summary of the allegations
and an indication of investigative results to date. For example, a psychiatrist would
be told about the behaviors that prompted a case manager to suspect that the client
suffers from mental illness.
CPS divides Arizona into six geographic districts. Each of these districts contracts
and oversees the local service providers it uses. This allows each district to develop
contracts with providers that can meet its unique needs. For example, District 1,
centered in Maricopa County, contracts with St. Joseph’s Hospital for pediatric
physician services. However, because the hospital employs these doctors, it is
responsible for screening their credentials and monitoring their performance.
Similarly, District 1 attempts to rely on the Department of Health Services whenever
possible to provide mental health services. In these circumstances, the local regional
behavioral health authority chooses, oversees, and funds mental health providers’
services.
Compliance and legal issues
Auditors examined federal requirements related to the appeals process and the due
process rights of parents accused of abuse or neglect. Auditors reviewed the federal
Child Abuse Prevention and Treatment Act requirements related to the appeals
process and noted no instances where the Division was not adhering to federal
requirements. In addition, as noted on page 16, legislation adopted in 1997 provides
parents or guardians accused of abuse or neglect an opportunity to request the
Protective Services Review Team to examine cases where CPS is proposing to
substantiate findings of abuse or neglect.
Public records versus confidential information
Auditors also reviewed the Division’s practices for releasing information contained in
case files. By state and federal law, much of the information contained in case files
is considered confidential. For example, a case file might include sensitive
information developed during the investigative process, such as a child’s school
records or an accused person’s criminal history and medical records.Similarly, the
State has enacted procedures, consistent with federal law, specifying who can
access certain types of information. For example, an accused person or a child over
the age of 12 who is the subject of a CPS report can receive information about the
initial report made to CPS, but cannot receive information about the person(s) who
made the report.
page20
State of Arizona
Much of the information
contained in case files is
considered confidential
by state and federal
laws.
page21
Office of the Auditor General
The Division has taken steps to help ensure case file information is provided
appropriately. For example, the Division has worked with the Arizona Attorney
General’s Office to develop guidelines to assist case managers and other division
staff in responding to requests for information. Additionally, the Division developed
forms to facilitate requests for information and worked with the Attorney General’s
Office to provide recent training to staff who handle requests for certain types of
information. These procedures appear appropriate, and several division personnel
indicated that CPS case managers generally contact either their supervisor or the
Attorney General’s Office before releasing information.
Division can enhance supervisor and case manager
knowledge of standards
The Division can take additional steps to ensure that all reports of abuse or neglect
are being properly handled. First, to ensure all case managers and supervisors
clearly understand the standards that must be met to substantiate a report, the
Division should develop and provide additional training about the problems most
commonly uncovered by the Protective Services Review Team during the past 2
calendar years. As shown in Figures 5 and 6 (see page 22), the team overturned the
largest percentage of proposed substantiations for the same four reasons, including
that the incident did not meet the statutory definition of abuse or neglect, or probable
cause was not established. Interviews also identified concerns about case
managers’ understanding of what is needed to substantiate a report. For example, 9
of the 31 investigative case managers responding to an auditor phone questionnaire
disagreed or strongly disagreed with the statement, “The current standard of
evidence required for substantiation is clear.”
Second, the Division should improve its process for providing feedback on the
Protective Services Review Team’s results so that it can continually enhance the
quality of its investigation function. Currently, when the team completes a case
review, it sends the results to the investigating case manager and his/her supervisor.
Additionally, a monthly status report regarding the team’s activities and results is
provided to division and district management. However, the data on the team’s
results over the past 2 years suggests that some case managers still do not
understand the standards required to substantiate reports. Therefore, the Division
should consider periodically supplementing its current efforts with additional
information. The Division is in the process of developing a new report that will include
unit level information so individual CPS units can see how well they are doing. The
Division should also consider including in this report case examples and potential
solutions that could be readily applied by all supervisors and case managers in the
field.
Case managers and
supervisors need
additional training on
the standards that must
be met to substantiate a
report.
page22
State of Arizona
Protective Services Review Team
Reasons for Overturn of Proposed Substantiations
Received in 2000 and 2001
Auditor General staff analysis of data obtained from the Protective Services Review Team database
on May 15, 2002.
Source:
Probable cause not
present, documentation
unclear, or child statement
not credible—32% (49)
Incident of abuse or neglect
does not fit statutory
definition—25% (38)
Corroborating
documentation absent
from CPS file—12% (18)
CPS investigation
incomplete—6% (10)
Substantial risk of harm
not present or
documented—10% (16)
Substance-abused
newborn without medical
complications—6% (9)
Other—9% (14)
Figure 5 154 Total Allegations Overturned
(2001)
Figure 6 251 Total Allegations Overturned
(2000)
Incident of abuse or neglect
does not fit statutory
definition—39% (98)
Corroborating
documentation absent from
CPS file—22% (54)
Probable cause not
present, documentation
unclear, or child statement
not credible—16% (40)
Substantial risk of harm
not present or
documented—12% (30)
Abuse or neglect present,
but alleged perpetrator
unclear—4% (9)
Other—8% (20)
Recommendations
1. The Division should develop and provide some additional training on the
problems most commonly identified by the Protective Services Review Team
over the past 2 years to ensure all case managers and supervisors statewide
understand the statutory definitions of abuse and neglect, how to document
investigative results, and how to establish probable cause.
2. The Division should continue to improve its process for providing feedback on
the Protective Services Review Team’s results so that it can continually enhance
the quality of its investigation function. Specifically, it should consider
supplementing its new report with case examples and solutions that could be
readily applied by all supervisors and case managers in the field.
page23
Office of the Auditor General
page24
State of Arizona
Office of the Auditor General
AGENCY RESPONSE
State of Arizona
__________________ ARIZONA DEPARTMENT OF ECONOMIC SECURITY __________________
1789 W. Jefferson, P.O. Box 6123, Phoenix, Arizona 85005
Jane Dee Hull John L. Clayton
Governor Director
Debbie Davenport, CPA
Auditor General
Office of the Auditor General
2910 North 44th Street, Suite 410
Phoenix, Arizona 85018
Dear Ms. Davenport:
We are pleased to received the Office of the Auditor General’s evaluation of the
Child Removal Review process and the Substantiation and Appeals process used
during Child Protective Services investigations. The rights of children to remain
in the care of their parents, and of parents to raise their children free from
government involvement are among the most fundamental. As a Department,
we are eager to join with concerned stakeholders to meet the challenge of
maintaining family integrity while protecting vulnerable children from harm.
We are hopeful your evaluation will inspire a cooperative effort to meet this
challenge, and we welcome the opportunity to improve the Department’s
processes.
The legal authority to remove children who are at risk of imminent harm from
their parents or other caregivers has, as you have confirmed, been given to the
State, and in turn delegated to our Department. The decision to use this
authority must be made with the utmost caution, and with full consideration of
the consequences to the child, parents, extended family, and community. The
Department is pleased the Report noted that Arizona’s process for reviewing
removal decisions is not only in compliance with federal requirements, but
includes procedures, such as our Removal Review Teams, that exceed federal
requirements.
The Department is also pleased that your Office confirmed Arizona’s compliance
with federal guidelines requiring a process for parents to appeal proposed
substantiated allegations of abuse or neglect, and noted that the Department was
found in substantial conformity in relation to both safety outcomes evaluated
during a recent comprehensive review conducted by the U.S. Department of
Health and Human Services.
Debbie Davenport, CPA
Page 2
The Department views your Office’s recommendations as methods to further
refine an area of strength within our Department, and is able to report activity is
nearly complete with regard to improving the written information provided to
parents and guardians. The Department has recently updated the written
materials provided to parents and guardians when Child Protective Services
conducts an investigation. These materials include a Summary of Client Rights and
Responsibilities (Children’s Rights and Parent’s/Guardian’s Rights). The Department
has also revised written materials to better clarify the purpose of the Family
Advocacy Office, and parents’ rights to have this Office review the circum-stances
pertaining to their child’s removal from the home.
We appreciate that the Report clearly specifies that due process is made available
to parents and guardians prior to substantiating a report of child abuse or
neglect. The Department’s Protective Services Review Team and the Office of
Administrative Hearings provide a multi-step process for determining if
allegations of child abuse or neglect should be substantiated.
The Department’s response to each of the recommendations made by your Office
is attached.
If you have any questions or concerns, please contact me at (602) 542-5678.
Sincerely,
John L. Clayton
Attachment
DEPARTMENT OF ECONOMIC SECURITY’S RESPONSE
to the AUDITOR GENERAL’S RECOMMENDATIONS for the
CHILD REMOVAL PROCESS
and the
SUBSTANTIATION AND APPEALS PROCESS
The Office of the Auditor General’s evaluation of the Department’s Child Removal process and
Substantiation and Appeals process includes seven (7) recommendations, of which five (5) pertain to the
Child Removal process and two (2) pertain to the Substantiation and Appeals process. The Department
of Economic Security is pleased to provide the following comments regarding these recommendations.
The Department’s Division of Children, Youth and Families administers the Child Protective Services
Program, and is referred to as “the Division” in this response.
Child Removal Process
Recommendation 1:
The Legislature should consider further clarifying in statute the definitions of abuse and neglect and
what criteria should be considered in removal decisions.
DES Response:
The Department would welcome the opportunity to work with the Legislature on statutory amendments
in this area.
Recommendation 2:
The Division should ensure that its forms and brochures contain the sufficient and accurate information
parents and guardians need to exercise their right to request a review, including information that
describes and emphasizes the limited time frame in which requests for Family Advocacy Office reviews
can be considered.
DES Response:
The finding of the Auditor General is agreed to and the audit recommendation will be implemented.
The Division is pleased to report that this recommendation is already implemented. On September 9,
2002, the Division revised the brochure entitled “A Guide To Child Protective Services (CPS)”. This
Guide is provided to a parent or guardian when CPS is conducting an investigation and when it is
necessary to remove a child from his or her home. The revised Guide clarifies the purpose of the Family
Advocacy Office (FAO), the parent’s right to request a removal review through this Office, and the
timeframes for requesting the review, as specified in state law. In addition, the revised Guide includes a
copy of the Summary of Client’s Rights and Responsibilities, including Children’s Rights, Parent’s and
Guardian’s Rights, and Parent’s and Guardian’s Responsibilities. The Family Advocacy Office and the
Protective Services Review Team and Appeals Process are included in the Parent’s and Guardian’s
Rights section.
DES Response to Final Report
Page 2
The Division is also pleased to report that on September 16, 2002, the document entitled “Request for
CPS Services” was revised to include the Summary of Client’s Rights and Responsibilities. This document
includes the parent’s right to request the Family Advocacy Office to immediately review the removal of a
child from his or her home. CPS case managers review this document with parents, guardians, and
children age twelve and older and obtain a signature acknowledging the explanation and receipt of
information.
In August 2000, the Division revised the Information for Parents and Guardians section of the Temporary
Custody Notice to include the right to request an immediate review of a child’s removal by the Family
Advocacy Office and the need for requesting this review in a timely manner.
The statewide toll-free telephone number for the Family Advocacy Office is included in these written
materials.
Recommendation 3
The Division should take steps to ensure that case managers understand, and thus can explain to parents,
the Family Advocacy Office’s role in reviewing removal decisions.
DES Response:
The finding of the Auditor General is agreed to and the audit recommendation will be implemented.
As specified in the DES Response to Recommendation 2 (above), the recent revisions to the written
materials entitled “A Guide To Child Protective Services (CPS)” and the “Request for CPS Services” will
greatly assist the case manager when reviewing the role of the Family Advocacy Office with parents, and
documenting this review for the case record. After reviewing the documents with the parent, including
the Summary of Client Rights (also described in the DES Response to Recommendation 2), the case
manager obtains a signature from the parent, which acknowledges the explanation and receipt of the
information. The role of the Family Advocacy Office, and the right of the parent to request a Family
Advocacy Office review of a child’s removal is included in the information for which the parent is
acknowledging receipt.
In October 2002, the Division’s Child Welfare Training Institute will begin using the recently
developed Child Welfare Supervisor Core training curriculum. The new curriculum and training will
provide CPS supervisors statewide with comprehensive information regarding the Family Advocacy
Office, including the policy, role and responsibilities of this Office, and the requirement to inform a
parent whose child has been removed of their right to request a Family Advocacy Office review of the
removal.
In November 2002, the Division’s Policy Unit will issue a statewide Policy Reminder to case managers and
supervisors regarding the role of the Family Advocacy Office. Policy Reminders are an effective
mechanism for disseminating relevant information regarding Division policies and procedures.
DES Response to Final Report
Page 3
Recommendation 4:
The Division should periodically analyze key statistics about removal review teams,
including the number held, participants attending, and the review outcomes.
DES Response:
The finding of the Auditor General is agreed to and the audit recommendation will be implemented.
The Division’s automated child welfare case management system (CHILDS) includes case-specific data
elements for the Removal Review Team process. These case-specific data elements include the names of
the participating Removal Review Team members, both Department of Economic Security members and
non-Department members (such as the Foster Care Review Board representative), the date and time of
the removal team review, and the specific findings/outcome
On a monthly basis, aggregate data is produced and disseminated to the Division’s District Program
Managers statewide. The data summarizes the number of removal reviews held each month (by unit
and District), and summary data regarding the findings/outcome.
As suggested by the Office of the Auditor General, the Division will continue to review the aggregate
data on the monthly Removal Review Report, and enhance the report to better assist with ongoing data
and trend analysis.
Recommendation 5
The Division should use existing information about removal review teams to evaluate and assess their
impact and value.
DES Response:
The finding of the Auditor General is agreed to and the audit recommendation will be implemented.
As specified in the DES Response to Recommendation 4 (above), the Division currently has an automated
report that captures aggregate data (by unit and District) for the Removal Review Team process. The
Division will continue to review the aggregate data on the monthly Removal Review Report, and
enhance the report as needed for data analysis purposes. Information and trends gleaned from the
statewide and District-specific removal review team statistics will be used to assess the impact and value
of this process.
Substantiation and Appeal Process
Recommendation 1
The Division should develop and provide some additional training on the problems most commonly
identified by the Protective Services Review Team over the past 2 years to ensure case managers and
DES Response to Final Report
Page 4
supervisors statewide understand the statutory definitions of abuse and neglect, how to document
investigation results, and how to establish probable cause.
DES Response:
The finding of the Auditor General is agreed to and the audit recommendation will be implemented.
The Department’s Protective Services Review Team (PSRT) Management and Regional Review
Specialists have recently reviewed the training curriculum used by the Division’s Child Welfare Training
Institute. The curriculum review focused on the training provided to new case managers (CPS
investigators) with regard to conducting CPS investigations, accurately documenting the information
gathered throughout the investigation, and understanding the legal and applied definitions of abuse and
neglect. The PSRT Management and Regional Review Specialists are scheduled to observe training
sessions provided to case managers through the Child Welfare Training Institute. By observing the
training, the PSRT can better assess if the information provided to new case managers is sufficient for
developing their investigation and documentation skills prior to receiving a CPS caseload.
In addition to new case manager training, the PSRT will be involved in the development of the new CPS
Supervisor’s Core Training. This will provide CPS Supervisors with current policy-specific information
regarding the statutory definitions of abuse and neglect, how to document investigation results, and how
to establish probable cause.
Recommendation 2
The Division should continue to improve its process for providing feedback on the Protective Services
Review Team’s results so that it can continually enhance the quality of its investigation function.
Specifically, it should consider supplementing its new report with case examples and solutions that could
be readily applied by all supervisors and case managers in the field.
DES Response:
The finding of the Auditor General is agreed to and the audit recommendation will be implemented.
The PSRT database currently captures the relevant information needed to address this recommendation;
however the data base does not produce a report with aggregate data for analysis.
During October 2002, the PSRT and a data base systems analyst will design a report with aggregate data
for review and analysis purposes. When developed, the report will be distributed to each District and
Unit, so supervisors and managers can routinely review and analyze information, such as the number of
PSRT decisions which did not support the case manager’s finding, and the reason for the PSRT
overturning the case manager’s finding.
Currently, the PSRT Regional Review Specialist and the case manager communicate closely (through
telephone and electronic mail) during a PSRT review. When a case manager’s proposed substantiation
finding is overturned, the PSRT immediately informs the case manager and supervisor of the reason and
basis for the decision. The PSRT Manager also provides information to the District Program Managers
DES Response to Final Report
Page 5
statewide with regard to PSRT statistics, trends, and observances. Monthly ad-hoc reports are provided
to the District Program Managers, Program Administrator, and Field Operations Manager with regard to
PSRT statistics and findings.
The Department of Economic Security appreciates the opportunity to respond to the recommendations
contained in the Auditor General’s Report.
01-20 Department of Public Safety—
Highway Patrol
01-21 Board of Nursing
01-22 Department of Public Safety—
Criminal Investigations Division
01-23 Department of Building and
Fire Safety
01-24 Arizona Veterans’ Service
Advisory Commission
01-25 Department of Corrections—
Arizona Correctional Industries
01-26 Department of Corrections—
Sunset Factors
01-27 Board of Regents
01-28 Department of Public Safety—
Criminal Information Services
Bureau, Access Integrity Unit,
and Fingerprint Identification
Bureau
01-29 Department of Public Safety—
Sunset Factors
01-30 Family Builders Program
01-31 Perinatal Substance Abuse
Pilot Program
01-32 Homeless Youth Intervention
Program
01-33 Department of Health
Services—Behavioral Health
Services Reporting
Requirements
02-01 Arizona Works
02-02 Arizona State Lottery
Commission
02-03 Department of Economic
Security—Kinship Foster Care
and Kinship Care Pilot
Program
02-04 State Parks Board—
Heritage Fund
02-05 Arizona Health Care Cost
Containment System—
Member Services Division
02-06 Arizona Health Care Cost
Containment System—Rate
Setting Processes
02-07 Arizona Health Care Cost
Containment System—Medical
Services Contracting
02-08 Arizona Health Care Cost
Containment System—
Quality of Care
02-09 Arizona Health Care Cost
Containment System—
Sunset Factors
Performance Audit Division reports issued within the last 12 months
Future Performance Audit Division reports
Children’s Behavioral Health
Department of Health Services—Health Start Program
Department of Health Services—Nursing Homes Licensure