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privatization of child welfare/ community based care/ managed care and child welfare



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<DIV><FONT size=2>Hello. </FONT></DIV>
<DIV><FONT size=2>I am looking for information regarding managed care 
initiatives and programs in child welfare.&nbsp; I have followed the information 
that was provided in Children and Youth Services Review (Feb. 2000) and have 
used that as a basis for getting information on the 29 initiatives.&nbsp; 
However, I have been unable to locate any of the evaluations of these programs, 
or information that goes past just a basic description.&nbsp; Specifically, I am 
looking for information on programs in </FONT></DIV>
<DIV><FONT size=2>Milwaukee County, Wisconsin</FONT></DIV>
<DIV><FONT size=2>Texas (project PACE)</FONT></DIV>
<DIV><FONT size=2>Georgia&nbsp; (project MATCH)</FONT></DIV>
<DIV><FONT size=2>Illinois </FONT></DIV>
<DIV><FONT size=2>Alabama</FONT></DIV>
<DIV><FONT size=2>New York City</FONT></DIV>
<DIV><FONT size=2>North Carolina</FONT></DIV>
<DIV><FONT size=2>Oklahoma</FONT></DIV>
<DIV><FONT size=2>California</FONT></DIV>
<DIV><FONT size=2>and any others that you may know about. </FONT></DIV>
<DIV><FONT size=2></FONT>&nbsp;</DIV>
<DIV><FONT size=2>Your help in locating this information would be greatly 
appreciated.&nbsp; </FONT></DIV>
<DIV><FONT size=2></FONT>&nbsp;</DIV>
<DIV><FONT size=2>Thanks</FONT></DIV>
<DIV><FONT size=2>Scottye Cash</FONT></DIV>
<DIV><FONT size=2></FONT>&nbsp;</DIV>
<DIV><FONT size=2>++++++++++++++++++++++++++<BR>Scottye J. Cash, Ph.D.<BR>School 
of Social Work<BR>Florida State University<BR>Tallahassee, FL 
32306-2570<BR>++++++++++++++++++++++++++</FONT></DIV></BODY></HTML>
</x-html>From ???@??? Fri Oct 02 09:42:50 1998
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From: SEDLAKA1@westat.com (SEDLAKA1)
To: Child Maltreatment Researchers <CHILD-MALTREATMENT-RESEARCH-L@cornell.edu>
Subject: Re[2]: Researchers as mandated reporters
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X-To: Child Maltreatment Researchers <CHILD-MALTREATMENT-RESEARCH-L@cornell.edu>,MARY I BENEDICT <mbenedic@welchlink.welch.jhu.edu>
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     I've watched this discussion with interest, as it is a relevant issue 
     in studies we've done.  Certainly the project director always bears the 
     primary legal and moral/ethical responsibility when a report is 
     warranted.  While there is conceptual and practical distinction between 
     legal responsibility and moral/ethical responsibility, both must be 
     addressed.  
     
     Before the study begins, if we expect to be doing interviews in a 
     delimited geographical area (or set of areas), we preemptively contact 
     the CPS agencies that would be involved should we have to report a 
     case.  This way they are alerted to the possibility that our study may 
     uncover cases that would require their involvement.  We ask how they 
     would prefer we submit any cases we encounter.  Often, they prefer to 
     identify a specific liaison person in their agency who can work with 
     us and our interviewing team, receiving our reports about any cases 
     our team uncovers.  This engenders their confidence in our good faith 
     efforts to ensure that we report appropriately (leaving the 
     investigation of suspected cases to them, while at the same time not 
     overwhelming them with cases that they will automatically screen out 
     in accordance with their intake standards).   
     
     Interviewers are often very worried about carrying the burden of 
     awareness of suspected abuse or neglect, and do not want to be put 
     in a situation where they are responsible for making the official 
     report themselves. They lose faith and confidence in the study if 
     they feel there are not clear, appropriate, and consistent 
     procedures set up to handle all cases that raise concerns.  For 
     this reason, and to ensure that the project director is cognizant 
     of (and responsible for) all reports to CPS that stem from study 
     interviews, we have them report all suspected cases to home office 
     supervisory staff and the supervisory staff alert the project 
     direct and report them to the CPS agency liaison, (with conference 
     call tie-ins for direct input from the observing interviewer, as 
     needed).  
     
     Informed consent is an important consideration in these studies.  We 
     notify respondents, as part of our informed consent statement, that we 
     will report any suspected child abuse.  The federal Certificate of 
     Confidentiality is helpful in assuring respondents that we will do 
     everything in our power to maintain the confidentiality of their 
     responses.  However, I understand that it has never been legally tested 
     as a 'shield' against reporting child abuse and neglect.  Moreover, even 
     if worked for that purpose, it would only contend with the legal 
     responsibility angle of this situation, not the moral/ethical side of it. 
      In fact, we both obtain the certificate and inform the respondent of our 
     intention to report abuse.  We read them the statement, have them sign 
     two copies, and leave one signed copy with them.  One recent study 
     included the following in our "consent to participate" statement:
     
        "....Westat has obtained a Special Certificate of Confidentiality for 
     this study...Westat will employ this certificate to ensure that the 
     information you provide will not be disclosed or released to anyone 
     without your consent, with one exception--if we learn that a child has 
     been abused or is endangered we would report this to the appropriate 
     authorities, which might result in official action in accordance with 
     State law...."
     
     Our IRB required that we insert the last phrase to clarify the 
     consequences that might accrue ("...which might result...), so we did 
     so.  We cannot recall a respondent who refused to participate on the 
     basis of this statement. We did report suspected abuse/endangerment and 
     it was a case where our report led to the removal of the children. 
     Having the signed consent form turned out to be important during the 
     sequelae.   
     
     Hope this account of our current operating mode is helpful to Tiz and 
     to others who face what must be a fairly common dilemma.
     
  * * * * * * * * * * * * * * * * * * * * * * * * * *
*       Andrea J. Sedlak, Ph.D., Associate Director   * 
*       Human Services Research Group                 * 
*       Westat, Inc.                                  * 
*       RA1230, 1650 Research Blvd.                   * 
*       Rockville, MD  20850                          * 
*       (301) 251-4211;  fax:  (301) 294-4475         * 
*       e-mail:  sedlaka1@westat.com                  *
  * * * * * * * * * * * * * * * * * * * * * * * * * *
     
     
     
     
______________________________ Reply Separator _________________________________
Subject: Re: Researchers as mandated reporters
Author:  MARY I BENEDICT <mbenedic@welchlink.welch.jhu.edu> at Internet-E-Mail 
Date:    9/29/98 5:12 PM
     
     
Sharon, as you say, the only ethical and legal response is to report a 
suspicious situation, which we would do.  The question is should it be the 
interviewers themselves who make the report or, as our system is set up, 
would the interviewer discuss the situation with me - the senior 
researcher, but not the person in the field, and I would decide whether to 
make the report or not.  Apparently in Texas, my interprtation of their 
law is that the
person in the field is responsible for making the report, although I would 
still have discussion with them first.  Thanks for your concern, Tiz 
Benedict
     
On Tue, 29 Sep 1998, Sharon Carnahan wrote:
     
> MARY I BENEDICT wrote:
> > 
> > We are doing an evaluation study of an early intervention program that 
> > includes
> > home visits - home assessments and some videotaping of parent-child
> > interactions in South Carolina and Texas. We have set up procedures in
> > case the interviewers see something that concerns them while in the home, 
> > but I am not clear whether researchers (the interviewers
> > themselves) are included as mandated reporters in those two states? I 
> > would appreciate any information anyone has.
> > 
> > Tiz Benedict
> > Johns Hopkins School of Public Health
> If not considered reporterds under the law, I would think taht
> researchers ethically should report evidence of abuse and neglect to
> authorities.  COnsider, for example, the ethical guidelines for research 
> with children published by SRCD.
>