Baltimore is changing the way it handles cases of alleged child abuse and neglect — part of a broad social-services strategy that has been touted by Maryland officials but abandoned in some other states.
The new approach, which is designed to lessen the adversarial relationship between families and caseworkers, puts cases on different tracks depending on whether they are deemed high or low risk. The tiered response, used in 23 states, is regarded as a best practice by many child advocates.
But some critics say questions remain about whether the two-track approach does enough to keep children safe. Other states, including Illinois, have backed away from it, for reasons ranging including financing and political opposition.
Joan Little, chief attorney for the Maryland Legal Aid Bureau child advocacy unit in Baltimore, said the success of the so-called Alternative Response track will depend on whether families can access services, such as mental health care and substance abuse treatment, to overcome their barriers.
"As long as the state makes the commitment to put resources up front, it's a very workable program," Little said. "The challenge is, what is the level of need of these families and how far do we have to go to reach out to them, and can we do it in a voluntary system?"
Maryland began splitting cases into the two tracks a year ago; so far, an average of 44 percent of cases have been assigned to the Alternative Response track.
Baltimore, which averages 442 new cases a month, or about 20 percent of the state's maltreatment reports, is the last locality to adopt the practice.
Under the program, cases deemed to be the most serious, including those with alleged sexual or physical abuse, will remain on the Investigative Response track, which involves formal findings and referrals to prosecutors for criminal action when necessary.
The state Department of Human Resources — which says the new approach will not increase costs — began to shift lower-risk cases in Baltimore to the Alternative Response track last week. Under that approach, caseworkers will work with families to assess their needs and develop plans to overcome challenges, which could include accessing child care, treating addiction or providing sufficient food.
The cases on the low-risk pathway won't be subject to an investigation initially. But if a situation is determined later to be more serious, the case can be switched to the investigative track.
Theodore Dallas, secretary of human resources, said the Alternative Response track allows the state to react better to each family's challenges. That, in turn, will help families get help more quickly and prevent low-risk cases from becoming graver, he said.
"You're more likely to engage with [family members], and they're more likely to be open and more likely to get the services they need," Dallas said. "Sometimes, in Investigative Response, they might be more standoffish and less likely to be cooperative."
Another benefit of the Alternative Response track, Dallas said, is that it avoids attaching the stigma of a formal maltreatment report to a parent who may be well-intentioned but overwhelmed or struggling to live in poverty. Such reports can block people from holding jobs in certain fields.
While many states have adopted the tiered approach, some have since abandoned it amid questions about the impact on child safety, said Richard P. Barth, dean of the University of Maryland School of Social Work.
States have implemented such programs in different ways, and those discrepancies make it difficult to measure outcomes, he said. Some states, such as Wyoming and West Virginia, have three tracks.
Barth said analyses show that parents tend to be satisfied with the approach, and "it's reasonable to assume that it's not leaving children more unprotected, but we don't know."
Illinois dropped its Differential Response approach in 2012 after funding from a five-year federal government grant ended, according to a spokeswoman for the state's Department of Children and Family Services. The decision was made primarily based on money — the agency's budget was slashed by $60 million that year — but also because the approach didn't show that children diverted to the Differential Response tracks were any safer than under traditional case management, according to the spokeswoman.
Elizabeth Bartholet, a professor at Harvard Law School, said an emerging body of research shows that claims about the success of alternative approaches might not be what they seem.