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ARIZONA CITIZEN REVIEW
PANEL
Eleventh Annual Report
Prepared for
Arizona Department of Economic Security
Division of Children Youth & Families
Phoenix, Arizona
Contract No: DE091156001
January 2010
Prepared by
Vicki Staples, M.Ed.
Lisa Moen, B.A.
Judy Krysik, Ph.D.
Michael Shafer, Ph.D.
Center for Applied Behavioral Health Policy
with
School of Social Work
College of Public Programs
Arizona State University
500 North 3rd Street
Suite 200
Phoenix, Arizona 85004-2135
(602) 496-1470

This publication can be made available in alternative format. Please contact the Arizona Citizen Review
Panel Program at (602) 496-1480. Please visit www.cabhp.asu.edu for more information. Permission to
quote from or reproduce materials from this publication is granted when acknowledgment is made.

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Acknowledgements
This report was prepared by the Center for Applied Behavioral Health Policy (CABHP), Arizona
State University. This project was supported by the Arizona Department of Economic Security,
Division of Children, Youth and Families through a grant awarded by the Child Abuse and
Prevention Treatment Act (CAPTA). Vicki Staples and Lisa Moen were responsible for the
content, analysis and writing of the report. Thanks to Judy Krysik and Michael Shafer for
contributing to the report.
The authors also wish to thank the members of the Arizona Citizen Review Panel and staff of
the Division of Children, Youth and Families for their ongoing cooperation and assistance with
this project. In particular, we would like to thank Linda Johnson, Jacob Schmitt, Sandra Lescoe,
Karin Kline, and Minerva Gant for their assistance.
Points of view represented in this report are those of the Arizona Citizen Review Panels and do
not necessarily represent the official position or policies of the Arizona Department of
Economic Security or Division of Children, Youth and Families.

©2009 by the Arizona Board of Regents for and on behalf of Arizona State University and its Center for Applied
Behavioral Health Policy.

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TABLE OF CONTENTS

Executive Summary..................................................................................................................... 5
Panels' Recommendations.......................................................................................................... 6
Arizona Citizen Review Panel Overview ................................................................................... 10
Arizona Citizen Review Panel Program Structure ..................................................................... 11
CAPTA Requirements of Citizen Review Panels ........................................................................ 14
Case Record Review Process..................................................................................................... 15
Summary of Citizen Review Panels’ Case Record Review Findings .......................................... 18
Areas of Focus for 2010 and Upcoming Enhancements ........................................................... 22
Appendix A: Agency Response to Citizen Review Panels’ 2008 Recommendations ................ 24
Appendix B: 2009 Annual Meeting Calendar and Agendas ..................................................... 33
Appendix C: Citizen Review Panel Members ........................................................................... 36
Appendix D: Citizen Review Panel Case Record Summary Form.............................................. 43
Appendix E: Policies Examined Through Case Record Reviews ................................................ 50
Appendix F: Arizona Citizen Review Panel Program Brochure ................................................. 53
Appendix G: Citizen Review Panel Quarterly Activities ........................................................... 56
Appendix H: Citizen Review Panel Survey ............................................................................... 62

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EXECUTIVE SUMMARY
The Center for Applied Behavioral Health Policy at Arizona State University (CABHP),
through an interagency service agreement with the Arizona Department of Economic
Security (ADES), began administering the Arizona Citizen Review Panel (ACRP) Program in
December of 2008. The Arizona Department of Economic Security/Division of Children
Youth & Families (DCYF) is the state agency responsible for provision of child protection
services. Working in conjunction, DCYF and CABHP are responsible for meeting all federal
requirements specified in the Child Abuse Prevention and Treatment Act (CAPTA) regarding
Citizen Review Panels. Panels develop recommendations for improvement of Arizona’s
child welfare system, including Child Protective Services (CPS), through independent,
unbiased system reviews. The Panels are composed of citizens; social services providers;
child advocates; adoptive and foster care parents; legal, medical, education, mental health
professionals; and faith-based representatives.
Citizen Review Panels review CPS state policies, current practices, pertinent data, and case
record information on child fatalities and near fatalities due to maltreatment. In addition,
the Panels evaluate the CPS relationship with foster care, adoption and other related
agencies. The Panels make recommendations to CPS for system changes and improvements
through the submission of the annual report.
This year was a transitional period as CABHP was awarded the contract for the
administration of the ACRP program. CABHP developed a new approach to the
coordination and support of the Panels based on interviews with key stakeholders (i.e.
Panel members, advocates, representatives from other states, DCYF staff, and ADHS staff
who formally administered the program); review of Panel member surveys and past
reports; observation of Panel meetings; consultation from representatives from the
National Citizen Review Panel Program at the University of Kentucky; and examination of
the National Guidelines and Protocols created for ACRPs. Based on the information
collected, a comprehensive work plan was developed which focused on the following four
key goals:
Goal 1: Centralize responsibility for staffing, coordinating and supporting the ACRPs in
meeting their legislative mandate.
Goal 2: Strengthen the ACRPs in order to fulfill CAPTA requirements.
Goal 3: Provide data from various sources to assist the ACRPs in making
recommendations that improve the CPS system.
Goal 4: Enhance coordination, communication, and reporting of child welfare data to
maximize public input and interagency collaboration.

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The Eleventh Annual Citizen Review Panel Report summarizes the accomplishments,
activities, findings, and recommendations of the three ACRPs (Northern, Central and
Southern) in Arizona.

ACCOMPLISHMENTS
Highlights over the past year are detailed below:
Centralized logistical and staff support and instituted a process to strengthen the
Panels (e.g. annual calendar of meeting, terms of membership, and new member
application);
Developed a program brochure that was distributed to over 500 people and also
dispersed via various community list serves to solicit volunteer members;
Increased membership by 47% statewide including recruiting family members and
youth formerly served through the child welfare system and providing supports for
continued participation (i.e. mileage reimbursement);
Provided orientation to new members;
Created an intranet site to provide meeting materials and other pertinent
information (e.g. reports, presentations, information from the National Coordinating
Center, etc.);
Developed a public web site for public information and public comment;
Developed a structured protocol for conducting case record reviews and a process
for facilitating case record presentations during Panel meetings;
Execution of a data sharing agreement between CABHP and DCYF;
DCYF designated a Practice Improvement Specialist to two of the three regional
Panels;
DCYF designed a DCYF Central Office liaison to each of the three regional Panels; and
Established ongoing coordination meetings between DCYF and CABHP.

PANELS’ RECOMMENDATIONS
Each of the three Panels developed recommendations for improvement of the child welfare
system in Arizona based on policy review, case record presentations, materials distributed
and updates provided by representatives from the ADES/DCYF (see Appendix G).
Recommendations are combined, prioritized, and then divided into four categories based
on input from DCYF and Panel members. The first category is the recommendations that
require a formal written response from DCYF as required by the CAPTA. Recognizing the
ongoing efforts of DCYF to improve the practices and services, only those areas not
currently addressed, or those which Panels identified as benefiting from additional
enhancements were included in this category.
The second category includes recommendations that are currently being addressed through
practice improvement activities. DCYF has dedicated Practice Improvement Specialists in all
districts. Practice Improvement Specialists in the districts lead case reviews, provide data

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and performance information to district management and the DCYF’s Quality Improvement
Manager, facilitate district action planning, and monitor and lead district practice
improvement activities. The Panels want to avoid duplication and monitor progress in these
areas in the upcoming year.
The third category is recommendations that require further monitoring. Due to the limited
sampling of case records, caution was used to avoid making inferences based on a limited
amount of information. These items will continue to be monitored and explored to assess
whether there are system trends. DCYF Practice Improvement Specialists will also assist the
Panels in determining whether observations are rare occurrences or if there could be a
possible trend that requires additional attention.
Recognizing that the child welfare system is not solely the responsibility DCYF, the final
category includes recommendations for system improvement that are directed toward
system partners. Panel members and DCFY staff are encouraged to advocate and promote
collaborative efforts with system partners to incorporate these recommendations.
The following is a summary of the findings and recommendations by the regional Panels in
an effort to improve the CPS system:

RECOMMENDATIONS FOR AGENCY RESPONSE
1. DCYF should seek opportunities to work collaboratively with the Arizona Attorney
General’s Office to expand the Office of Drug Endangered Children’s programs across
counties.
2. DCYF should explore opportunities to work in partnership with the Federal Regional
Office to advocate for a national registry and central depository that would aid CPS
efforts to access information in a timely manner on adults who have a history of
maltreatment reports in other states, especially those with multiple allegations of
chronic abuse and neglect.
3. Additional guidelines should be provided to assist DCYF staff in strengthening and
assessing the appropriateness of safety monitors. Provide staff with the types of
charges on the Department of Public Safety background checks that would preclude
someone from being a safety monitor. Currently DCYF staff is expected to conduct
background checks, but there is some discrepancy in how decisions are made and what
type of criminal arrest, charge and/or conviction would prevent a person from
becoming a safety monitor.
4. The ACRPs recommend that DCYF reinforce current policy and documentation
requirements on cases involving criminal conduct allegations. The ACRPs are concerned
about the lack of adequate information gathered and/or documented which indicate a

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thorough safety assessment was completed for children remaining in the home when a
criminal investigation has ended and a determination to close the case was made.

OBSERVATIONS IN ALIGNMENT WITH CURRENT PERFORMANCE IMPROVEMENT PLANS OR
AREAS BEING ADDRESSED BY THE CHILD WELFARE TRAINING INSTITUTE
1. Chronic neglect continues to be a significant concern identified by the Panel. DCFY is
currently examining this issue for future policy development. CABHP will work with
DCYF to examine differences in substantiation rates by demographic factors and
geographic location. Mechanisms to evaluate, track, and report on chronic neglect and
abuse should be explored, including reporting on number of unsubstantiated prior
investigations in cases, as well as, those cases in which repeated reports have been
received from multiple sources (e.g. school, juvenile probation, neighbors, and police).
2. Information on evidence-based practices related to behavioral health, including how
to work with family members who are receiving medication assisted treatment (e.g.
methadone) and co-occurring disorders and medications used for pain management
should be incorporated into current training curricula provided to CPS caseworkers. CPS
caseworkers should be provided continued training opportunities on how to effectively
work with families with substance abuse issues. This will also enable CPS staff to
address clients’ addiction disorders and develop case plans that address behavior
changes necessary to resolve safety threats for the children.
3. Training and ongoing supervision should emphasize skills needed for CPS staff to
identify ongoing services and mobilize resources prior to case closure. In addition, the
importance of ensuring referrals are followed through by families prior to case closure
should be re-enforced. For example, if a child is suspected or identified as having a
developmental disability, CPS should make efforts to refer the family to the Division of
Developmental Disabilities.
4. Training and ongoing supervision regarding DES Policy Chapter 2 Section 4-Safety
Assessment When There Has Been Three or More Prior Reports, should continue in order
to educate workers to properly document in the Safety Assessment detailed
information, including the evidence to support the previous findings, information on out
of state reports (including dates, whether records were received or if there were
barriers to obtaining records), behavior changes that resulted from previous services
provided, and circumstances surrounding a child’s death (e.g. unusual sleep patterns,
signs of neglect, failure to thrive, etc.).
5. DCYF should continue to focus on improving the quality of the documentation and
the transparency of the decision-making for determining whether reunification is viable.

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6. The Panels identified the need to improve concurrent case planning. The Division
recently trained all CPS staff to strengthen Concurrent Planning Practice.
7. CPS staff should continue to provide each family under investigation with a child one
year or younger with the “Safe Sleep for Your Baby” pamphlet. DCYF will send out
reminders to CPS staff to distribute these to all families involved with CPS who have a
young child in their home.
8. The Panels recommend that CPS enhance its current training to assist staff in
improving assessments related to substance exposed newborns and those related to
developmental disabilities.

THE FOLLOWING AREAS WILL BE LOOKED AT BY THE PANELS TO IDENTIFY POTENTIAL TRENDS
1. Given budget cuts and proposed additional reductions, the Panels will monitor and
request updates from DCFY in the upcoming year on the following:
a. The Panels expressed concern that mandatory reporters will be
discouraged from making reports.
b. The number of foster families that adopt children statewide and any
reduction in system capacity.
c. The availability of resources, including substance abuse treatment in
rural areas. The Panels expressed concern that the state budget crisis
is affecting organizations across the board, including donations that
support non-profit organizations.
d. The number of joint investigations including the number of cases
where there is a disagreement between DCFY and law enforcement
as to whether or not a joint investigation should occur.
2. The District Speakers Bureau should continue to visit schools, community providers
and other community stakeholders to educate them on the function of CPS, and process
of reporting child abuse and neglect, etc.

RECOMMENDATIONS FOR CHILD WELFARE SYSTEM PARTNERS
1. Medical and behavioral health providers should educate parents on the possible side
effects of drugs prescribed including the dangers of co-sleeping with infants when under
the influences of substances that inhibit responsiveness (e.g., prescription drugs and
alcohol).

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2. As DCYF has no authority to conduct follow-up checks to families once a case is
closed, it is important that community service providers are trained in identifying
families who are in distress and at-risk of abusing or neglecting their children. This also
should include conducting follow-up on families where a CPS case has been closed and
there are known future risk factors (e.g. mothers who are pregnant with histories of
confirmed substance abuse and spouses that have child abuse or neglect perpetrators
being released from the criminal justice system). In situations in which the provider
suspects child abuse or neglect, mandatory reporting requirements must be adhered to.
It is not the role or responsibility of the service provider to submit or evaluate evidence
to determine if abuse has occurred.

ARIZONA CITIZEN REVIEW PANEL OVERVIEW
The ACRP was established in 1999 in response to the 1996
amendment to the Child Abuse Prevention and Treatment
Act (CAPTA) requiring states to develop and establish Citizen
Review Panels. The purpose of ACRP is to determine whether
state and local agencies are effectively discharging their child
protection responsibilities. Panel members develop
recommendations for improvement of CPS through
independent, unbiased case record and data reviews.

The promise of Citizen Review
Panels is realized when vulnerable
children are better protected as a
result of new
perspectives on old problems.
-Panel Member

The creation of the ACRP Program is an acknowledgment that protection of our children is
the responsibility of the entire community, not a single agency. Although the primary focus
of oversight is ADES/DCYF, the ACRP takes into consideration the impact of other entities
and assesses whether they support or hinder the state’s efforts to protect children from
abuse and neglect.

CHILD ABUSE PREVENTION AND TREATMENT ACT
The Child Abuse Prevention and Treatment Act (SEC.106 [42 U.S.C. 5106a]) was enacted in
1974 to provide grants to states to support innovations in state child protective services and
community-based preventive services, as well as research, training, data collection, and
program evaluation. CAPTA requires states receiving a Basic State Grant to establish no less
than three Citizen Review Panels. Panels are comprised of volunteer members who are
broadly representative of their community, including members who have expertise in the
prevention and treatment of child abuse and neglect. Each Panel must meet at least once
every three months and evaluate the extent to which the state agency is effectively fulfilling
its child protection responsibilities in accordance with the CAPTA state plan. In addition,
Panels are required to review child fatalities and near-fatalities, and examine other criteria
important to ensure the protection of children such as the extent to which the state child
protective services system is coordinated with the foster care and adoption programs.
Section 106(c)(5)(A) of CAPTA requires states to provide each Citizen Review Panel with
access to information on cases that the Panel chooses to review if the information is
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necessary for the Panel to carry out its functions under CAPTA. Report language clarifies
that congressional intent was to direct states to provide the Panels with necessary
information to carry out these functions.
Section 106(d) of CAPTA requires that Citizen Review Panels develop reports annually and
make them available to the public no later than December 31st of each year. These reports
should contain a summary of the Panel's activities, as well as the recommendations of the
Panels based upon their activities and findings.
Citizen Review Panel members are bound by the confidentiality restrictions in section
106(c)(4)(B)(i) of CAPTA. Specifically, members of a Panel may not disclose identifying
information about any specific child protection case to any person or government official
and may not make public other information unless authorized by state statute.
The Keeping Children and Families Safe Act of 2003 amended CAPTA to include the
following requirements:
1. Each Panel shall examine the practices (in addition to policies and procedures) of the
state and local child welfare agencies.
2. Panels shall provide for public outreach and comment in order to assess the impact
of current procedures and practices upon children and families in the community.
3. Each Panel shall make recommendations to the state and public on improving the
child protective services system.
4. The appropriate state agency is required to respond in writing no later than six
months after the Panel recommendations are submitted. The state agency’s
response must include a description of whether or how the state will incorporate
the recommendations of the Panel (where appropriate) to make measurable
progress in improving the state child protective services system. The ADES response
to the 2008 Citizen Review Panel Report is included in Appendix A.

ARIZONA CITIZEN REVIEW PANEL PROGRAM STRUCTURE
The CABHP centralized responsibility for staffing, coordinating and supporting the ACRPs to
improve communication across Panels and with DCYF.
At the state level, the CABHP administers and supports the three regional Panels located in
Phoenix (Central), Tucson (Southern) and Flagstaff (Northern). Previously each of the
Panels was coordinated by separate organizations. In addition, there were two regional
Panels (Pima County and Yavapai County) and a statewide Panel (Maricopa County). The
statewide Panel had a dual role as it was responsible for both the central region and also
the entire state. Each of the Panels represent specific DCYF district(s) and counties (see
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Figure 1) and CABHP staff are responsible the coordination and sharing of information
across the three Panels.

QUARTERLY ACTIVITIES
Figure 1
The three ACRPs met quarterly in 2009 as
required. An annual schedule of meetings
Northern
Apache, Coconino,
was developed and consistent meeting
La Paz, Mohave,
locations were established (Appendix B).
Navajo, Yavapai
Each of the existing Panel members were
Yuma
contacted personally and engaged in
discussions regarding what was needed for
Central
I
Maricopa
Southern
II
Cochise, Greelee, Gila, their continued participation. The DES
IV
Assistant Director also sent out letters to
Graham
VI
each Panel member thanking them for
Pima, Pinal, Santa
their continued support. Monthly
Cruz
coordination meetings with DCYF and
CABHP were established to monitor the implementation of the new contract.
Panel

DES
Districts
III
IV

Counties

During the first quarter the emphasis was on establishing structures and processes for
expanding the activities of the Panels. Consensus guidelines were developed and adopted
by each Panel for decision making and signed confidentiality statements were obtained
from each member. All meetings were digitally recorded and formal meeting minutes were
prepared. CABHP also created an intranet site to provide meeting materials and other
pertinent information (e.g. reports, presentations, information from the national
coordinating center, etc.) to Panel members. Panel members stressed the need to receive
materials prior to the meetings.
Previously, Panel meetings focused primarily on conducting case record reviews and annual
recommendations were based on these findings. Because of the inordinate amount of time
needed to complete and discuss the cases, only a limited number could be examined each
year (e.g. 22 cases were reviewed in 2007 and 13 cases in 2008). New processes have been
instituted and CABHP staffs are now responsible for the review and presentation of case
records. Panel member input was obtained on thematic areas of focus (e.g. chronic neglect,
substance use, and history of multiple reports) and a structured meeting agenda was
established for the year that included the provision of information and data from various
sources including speakers and presentations, and case record and policy reviews.
•

Quarter 1- CABHP presentations on CPS System Overview, Process to Conduct a
Comprehensive Review of CPS and Prioritizing Chapters, Proposed Revisions to Case
Record Review Protocol and Sampling Criteria, Child Welfare Reporting
Requirements Semi-Annual Report 2007/2008, Arizona Child Fatality Review
Program 2009 Annual Report; and DCYF program report on 2009/2010 CAPTA plan
and DCYF budget.
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•

Quarter 2- CABHP presentations on Adverse Child Experiences (ACE) Study,
Characteristics of Substantiated vs. Unsubstantiated Reports for Children Under the
Age of Five, Chronic Child Neglect, Case Record Review Process, Substance Exposed
Newborns; and case theme on child fatalities and near fatalities under the age of
two and related policies.

•

Quarter 3- High Intensity Drug Trafficking Areas (HIDTA) Representatives provided
information on joint protocols and drug endangered children and families, joint
investigations and statutory mandates, DCYF program report on IV-B Safety
Outcomes; and case theme on children affected by methamphetamine abuse.

•

Quarter 4- Director of the Legislative Office of Family Advocacy and the Assistant
Ombudsman for Citizen’s Aid presented on the Grievance/Complaint Processes;
CABHP presented on Key Constituent Groups and Role of Panels in Outreach and
Education, DCYF program report on CAPTA Implementation Plan and Update on
Panels’ Recommendations; and case theme on children with physical, emotional
and/or developmental disabilities.

During the transition it became apparent that formal feedback mechanisms must be
developed to improve communication; facilitate collaboration; increase Panel member
satisfaction; identify opportunities for innovation; and increase accountability by tracking
and reporting on progress made on ACRP recommendations. There is now a standing
agenda item at each meeting for DCYF representatives to provide a program report to
ensure that the Panels receive information on the status of ACRP recommendations,
process improvement initiatives, new policies and procedures, budget updates, and other
relevant information. CABHP is in the process of developing a tracking system for
monitoring the implementation of ACRP recommendations and will provide updates on a
routine basis as many of the proposed changes span multiple years.

PANEL MEMBERSHIP
Panels are comprised of 10 to 20 volunteers of diverse backgrounds and experience.
Appendix C provides a listing of the ACRP members for each region with the type of agency
and discipline represented. Terms of membership were agreed upon by the Panels, and
training materials and an orientation processes established. Volunteer Panel members can
request compensation such as reimbursement for mileage costs.
During the past year significant efforts were made to expand not only the number of
individuals on each of the Panel, but also the composition of the Panels’ membership to
ensure both community representation and diversity. The membership growth in each
individual region Panel, as well as the Panel as a whole, has increased significantly over the
past year. The Central Region ACRP increased by 18% percent, while the Southern and
Northern Regional Panels had a membership increase of 73% and 67%, respectively. The
overall growth for the three Panels was 47%.

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Many of the new members in each Panel now play or have played very important roles in
Child Protective Service cases and/or law enforcement agencies, and know first-hand the
many facets of the program. Approximately nine citizens who have joined the Panel were
once served, or are family members to an individual, served by CPS. In addition, the ACRP
welcomed six individuals from different law enforcement departments throughout Arizona.
Each Panel has increased its diversity, with members representing a variety of schools,
hospitals, non-profit organizations, and government agencies.

PANEL MEMBER SURVEY
A survey of the Panel members was conducted in July of 2009 to provide CABHP staff
information on Panel member‘s level of satisfaction and suggestions for improvement.
Nineteen (19) Panel members completed the survey with 6 responses from Central (31.6%),
11 from Southern (57.9%) and 2 from Northern (10.5%) Panels. Overall, the majority of the
respondents reported being satisfied as indicated by noting that they “agreed” or
“somewhat agreed” as indicated below:
88% understood their role as a Panel Member
94% understood the mission of the ACRP
88% indicated that their regional Panel was comprised of members with diverse
community representation
87% indicated that CABHP provides effective administrative support for the Panel
82% reported understanding the current case record review process
Suggestions for improvement focused on: case record review and case presentation
process; desire to have County Attorney’s represented on the Panel; need to trend data and
compare Arizona’s performance on indicators with other states; removal of members from
the Panels who do not regularly attend; and the need for additional meetings/time. The
complete survey results are included in Appendix H.

CAPTA REQUIREMENTS OF CITIZEN REVIEW PANELS
The ACRP program evaluates the degree that CPS is effectively fulfilling its child protection
responsibilities through several means including: the review of the state plan; examining
compliance with federal child protection standards; looking at coordination between
agencies and child welfare systems of care; case record reviews of child fatalities and nearfatalities; and conducting outreach to communities. All of the findings and Panel
recommendations were based on one or more of these activities.

REVIEW OF STATE PLAN
CABHP and DCYF staff worked together to establish a process for each of the Panels to
review and provide input into the state CAPTA plan prior to the federal submission. During
the first quarter, the federal prescribed activities for which the CAPTA Basic State Grant may

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be used were reviewed with each of the Panels. The Panels’ suggestions for utilizing the
funds were collected and are included in the recommendations section of this report.

COMPLIANCE WITH FEDERAL CHILD PROTECTION STANDARDS
Compliance with federal child protection standards is examined through a review of the
DCYF semi-annual reports and information provided through DCYF updates or
presentations. During this review period, CABHP distributed and presented on the DCYF
Semi-Annual Report including: the number and type of maltreatment reports;
substantiation rates; out-of-home placements (e.g. race/ethnicity and reasons for removal)
and number of foster homes.
The ACRP case record review instrument (Appendix D) and process examine compliance
with federal child protection standards. The DCYF Practice Improvement Case Review
Instruments (PICR) and the ACRP case record review instrument were both modeled after
the Child and Family Services Review: Onsite Review Instrument and Instructions. This
instrument was created by the U.S. Department of Health and Human
Services/Administration for Children and Families used to conduct the federal Child and
Family Services Reviews (January 2007). See below for a description of the process and
instrument.

COORDINATION BETWEEN STATE AND LOCAL FOSTER CARE AND ADOPTION
SYSTEMS
Although the case record review process addresses foster care and adoptions as related to
the specific situation under review, this is an area that will be prioritized for 2010. A review
of the coordination between state and local foster care and adoptions systems during our
next review period will include examination of the implementation and outcomes of
Arizona Court Teams.

PUBLIC OUTREACH AND SOLICITING PUBLIC COMMENTS
Currently, the CABHP website hosts a link to the ACRP Program website to inform the
community about the ACRP program and to solicit public comments. Questions regarding
specific cases are directed to the appropriate state agency for assistance. CABHP also
developed an ACRP Program brochure (Appendix F) for distribution at events to inform the
public, stimulate interest in the ACRP program and solicit volunteers. The brochure and CPR
program information has also has been distributed throughout Arizona by multiple
community and advocacy email listservs (e.g., Council for Human Services Providers, RBHA,
etc.)

CASE RECORD REVIEW PROCESS
Over the past year, CABHP has worked with DCYF staff and Panel representatives to revise
the case record review process and instruments. CABHP staff reviewed tools from other
ACRPs across the United States and also incorporated recommendations from the Citizen

15

Review Panels for Child Protective System: Guidelines and Protocols (October 2001.)
Feedback from Panel members was obtained and incorporated into both the proposed
process and tools. Restructuring the case record review process included: establishing
criteria for case selection; strengthening validity by
standardizing the tool and developing
Figure 2
comprehensive instructions; and aligning the tool
Case File Sampling Parameters
with the DCYF Practice Improvement Instruments.
1. Selected from those reported after
Reviewed cases included both those in which
December 1, 2008.
children remain in the family’s home and those in
2. Investigations must be completed
which children have been removed by CPS. The
(no pending or incomplete
cases selected for review are not meant to be
investigations) and cases must be:
-Allegation of death as a result of
representative of all CPS cases, but rather an
abuse and neglect, or
examination of cases of fatalities and near-fatalities
-Determined by DCYF to be a near
and the specific steps followed during the course of
fatality as a result of abuse and
open cases.
neglect.
3.

If a region has no reported cases that
meet the above criteria CABHP will
work with the Panels to identify
criteria for cases that would
represent a key area of interest (e.g.,
neglect cases of youth under age 5,
joint investigations, teens).

Previously, the case record reviews had been
completed by Panel volunteers or one of the
program coordinators. In order to reduce the
burden on Panel members, streamline the process,
and promote consistency across Panels, CABHP staff
are now responsible for conducting the reviews.
CABHP have received training and have full access to the CPS electronic records (CHILDS)
and are able to access needed information directly.
DCYF provides quarterly lists of all investigative reports which include allegations of
fatalities and near-fatalities determined by CPS to be due to maltreatment. From this list,
the CABHP Program Coordinator selects cases for review that meet the sampling
parameters (Figure 2) and are consistent with the quarterly meeting themes. CPS staff
provides a “hard” copy file to CABHP that contains information (e.g., autopsy reports, law
enforcement records and service provider progress reports) that is not accessible through
the CHILDS.
As previously noted, the case record review process is guided by the DCYF Practice
Improvement Case Review Instruments (PICR), DCYF Quality Improvement Systems
Procedures, and any relevant DCYF policies and procedures. An additional tool is completed
on cases involving in-home or out-of-home placement. The period under review is for the
last 12, except when prior history of CPS involvement is relevant to the case. CABHP utilize
the DCYF PICR instruments to extract the information from CHILDS and as needed from the
“hard” copy files.
The Panels are provided with ACRP Case Summary Forms (Appendix D), timeline of key
events, and genograms of individual cases in advance of meetings to assist members in
preparation for discussion. In addition, Panel members receive redacted copies of the
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actual Safety and Risk Assessments completed by DCYF for each case. Information collected
and discussed includes the following sections:
1)

Timeliness of Initiating Investigation of Reports of Child Maltreatment-information
on whether responses to every child maltreatment report received was initiated within
timeframes established by policy including: identification of risk level; allegation of
maltreatment; mitigated timeframes; accuracy of Hotline reporting procedures;
whether law enforcement or other emergency personnel was notified; CPS confirmation
of child’s safety; and CPS Specialist’s attempts at face-to-face contact with alleged
victim(s).

2)

Initial Child Safety Assessment-information on whether CPS Specialist (CPSS) made
concerted efforts to gather and analyze sufficient and relevant information to accurately
assess child safety including: decision on present danger was consistent with
observations at initial contact with child and family; if concerted efforts were made to
interview or observe all relevant persons and gather to sufficient information about
each of the 6 questions to confirm or exclude safety threats from the 17 safety threats
listed in CSA; and if the CPSS analyzed all information gathered and accurately applies
safety decisions.

3)

Safety Planning to Protect Children in Home and Prevent Removal- information on
whether CPSS took sufficient and least obtrusive actions to control present or
impending danger (through protective action and safety plan) and ensure child(ren)’s
safety in-home and prevent child(ren)’s entry into foster care or re-entry after
reunification.

4)

Initial Strengths and Risk Assessment and Provision of Services to Reduce Risksinformation on whether CPSS made concerted efforts to assess the risks that were of
sufficient severity to necessitate CPS services including: gathering sufficient and relevant
information about each domain in the Family Strengths and Risks Assessment; identify
consistency of risk indicators and protective behaviors; necessity of intervention; and
case opening and closure with information gathered during the assessment and
documented in the case record.

5)

Determine Whether Maltreatment Occurred- information on whether CPSS made
concerted efforts and gathered sufficient information and accurately applied legal and
applied definitions of abuse and neglect including: determination if maltreatment
occurred; if CPSS accurately applied substantiation guidelines and identified report as
substantiated, proposed, unsubstantiated, or unknown for each report allegation.

6)

Aftercare Planning- information on whether an aftercare plan was developed with
input from family, and family was provided with adequate information on services and
supports to address continuing or foreseeable needs including: if CPSS meet with
parents or other caretakers and the child, if age 6 or older, to obtain their comments

17

and recommendations in regard to aftercare services; and if parents and children were
provided sufficient information on community or other supports.
The DCYF Practice Improvement Case Review Instrument for In-Home or Out-of-Home
section is completed for cases when in-home or out-of-home placement has occurred. The
applicable information and criteria discussed by the Panels may include:
ongoing safety and risk assessment
and management
permanency goal for child
concurrent permanency planning
independent living services
visiting with parents and siblings in
foster care
relative placement

needs and services of child, parents
and foster parents
case plan development
worker visits with child
educational needs of child
mental/behavioral health of child
foster homes (reviewed only if
allegations involve foster family
placement)

The Panel recommendations and comments section focuses on precipitating factors that may
have led to the case record event which may include:
suspected event triggers
family risk factors addressed and
resolved
factors that may have contributed to
death
joint investigation protocol

instances of inadequate CPS
supervision and communication
potential policy issues or issues not
addressed
exemplary CPS practices that should
be noted

Upon completion of each review, the Panel asks the key questions of whether state and federal
policies were followed and whether the Panel recommends any changes in policies and
procedures. Panels also comment on actions they believe could have been taken to prevent or
avoid the event and their overall recommendations on the case. The results of each review are
entered into a database that is maintained by the CABHP and included in the recommendations
section of this report.

SUMMARY OF CITIZEN REVIEW PANELS’ CASE RECORD REVIEW FINDINGS
During this reporting period, ACRPs completed reviews of 18 cases of child maltreatment that
occurred between December 1, 2008 and November 30, 2009. Eleven (11) of these cases were
fatalities and seven (7) were near-fatalities. It is important to note that findings are based on
the information available to the CABHP reviewers and presented to the Panel members.
Case record review findings summarized below are consistent with the state’s process by which
report of child abuse and neglect are received and addressed. Examination of the operations of
18

the CPS system at each of these stages as outlined below are also recommended in the Citizen
Review Panels for Child Protective System: Guidelines and Protocols (October 2001.)

PRIOR CHILD PROTECTIVE SERVICE HISTORY
DES received a total of 54 reports on the 18 cases reviewed by the Panel during the 2009
period. The number of reports received ranged from 1 to 9 with an average of three (3) reports
per case. Seven (7) of the reviewed cases had no previous reports. Of the eleven (11) records
with a previous CPS case, the number of prior substantiated cases ranged from 1 to 3. Onethird or 33% of the cases with prior abuse and/or neglect allegations were substantiated.

INTAKE AND SCREENING
The case record reviews identified this stage as a strength of the child protection system. The
Panels found that reports taken by the CPS Child Abuse Hotline were complete, accurate, and
timely in all 18 cases (100%). The timeframe for the initial response by CPS or law enforcement
or other emergency personnel were within the allotted times determined by levels of risk (high,
moderate, low, potential).

CRISIS INTERVENTION AND INITIAL CHILD SAFETY ASSESSMENT
In 11 out of 18 investigations reviewed, the Panels concluded that CPS adequately fulfilled its
role of assessing child safety. The Panels determined this stage to be an area that needs
improvement. The Panels expressed concern about CPS’ lack of thorough assessment of safety
in 8 of the investigations reviewed including: information on interviews of persons in the home
were either unclear or not included in 3 cases; the Child Safety Assessment safety threats and
factors were not complete in 3 cases; and CPS staff did not assess safety of other children in the
home in 2 cases.

FAMILY RISK FACTORS
Panel members review specific family risk factors addressed by CPS during the initial
investigation. Panels are able to determine if CPS adequately assessed, identified and resolved
risks contributing to child maltreatment. The most prevalent family risk factors identified during
the reviews were substance abuse (72.2%), lack of parenting skills (55.5%), mental health issues
(44.4%), and domestic violence (44%). Methamphetamines (44.4%), alcohol (22.2%), and
prescription drugs (22.2%) were the most prevalent types of drugs identified in case record
reviews. It is important to note that looking at individual risk factors does not take into
consideration cumulative risk. The number of risk factors per case ranged from 1 to 10 with an
average of 5 risk factors identified per case.

19

Below are the risk factors identified (more than one factor may have been identified in a single
case) in the 18 fatality and near fatality cases reviewed:

Risk Factor
Lack of Parenting Skills*

Frequency
of cases
(N=18)
10

Teen Parent

2

Substance Abuse

13

Mental Health Problems of Parent(s)

8

Domestic Violence

8

Lack of Anger Control

7

Lack of Physical/Mental Ability to Provide Adequate Care

1

Lack of Motivation to Provide Adequate Care

5

Lack of Resources for Adequate Food/Shelter/Medical/Child Care

5

Prior Child Death

0

Prior Removals by CPS/Severance of Parental Rights

6

Prior Unsubstantiated Reports

8

Prior Substantiated Reports

3

*Parenting skills should demonstrate an ability to provide for a child's basic needs and
the capability to guide, educate, and discipline in a way that facilitates a child's positive
social and emotional development.

INVESTIGATION STAGE
During case record reviews, Panel members discuss various aspects of each investigation,
identifying areas of strength and needing improvement, as well as exemplary practices, within
the CPS system. The Panels determined this stage as needing improvement in a number of
areas. Panel members concluded that thorough investigations were completed on 13 out of
the 18 cases reviewed (72.2%). Concerns noted included missing medical records in 3 cases,
psychological evaluations in 3 cases, autopsy reports in 3 cases, law enforcement reports in 3
cases, school records in 2 cases, immunization records in 2 cases, safety monitor paperwork 1
case, and home studies in 1 case where it was determined by the Panel as pertinent to the
investigation. Custody and visitation orders and results of drug tests were also absent from
some of the records. In 2 cases, CPS failed to interview all relevant persons in home, and safety
assessments did not address other children in home or documentation was incomplete.
Background checks, absent from 3 cases, should have been completed on all adults in home.

20

INVESTIGATIVE FINDING/DETERMINATION
The Panels concluded that documentation did not support the investigative findings in 7 of the
18 investigations reviewed. The Panels identified concerns regarding the inability of CPS to
substantiate allegations of abuse and neglect, in spite of strong supportive evidence. In 4 of the
18 cases, there was evidence of prenatal exposure to substance abuse, but still no allegations of
neglect were substantiated. Concerns were also noted in 1 case in which there were
unsubstantiated reports despite multiple sources (e.g. school, juvenile probation, neighbors
and police) alleging incidents of abuse or neglect. In 2 cases, the Panels found that inadequate
information was gathered in the record and failure-to-thrive was not taken into consideration.

CASE PLANNING AND IMPLEMENTATION
The Panels determined that in 10 of the 18 cases, case planning and ongoing case management
activities were appropriate and timely. Concerns included refusal by parents or guardians to
participate in services and inability of CPS to enforce case plans, as well as failure to include all
family members in case plans. Additionally, Panels were concerned that in 2 of the reviews the
case plans focused on the deceased child and did not fully address other siblings in home; and
case plan did not address substance abuse.

FOSTER FAMILY SECTION
There were no reports of child abuse or neglect involving an out-of-home caregiver.

CASE CLOSURE
Panel members concluded that 6 of the 18 cases appeared to be closed prior to adequately
resolving all safety issues. Concerns noted by Panel included lack of law enforcement
involvement and repeated unsubstantiated reports from multiple sources (school, juvenile
probation, neighbors and police); reunification plans that were premature considering the
potential safety issues; and Medical Examiner findings that cause of death was undetermined
ended further investigation of the case.

POLICY ISSUES
At the conclusion of case reviews, Panel members determine if state and federal policies were
followed. During this reporting period, the Panels concluded that state and federal policies
were followed in 10 of the 18 cases. In cases, where policies were not followed, the Panels
identified the failure to obtain pertinent records during the investigation in 2 cases, failure to
obtain background checks on all family members in 3 cases, and failure to complete summary
and review of prior reports and case histories on cases that involve three or more prior reports
in 4 cases, failure to update documents in 1 case and lack of identification of child’s failure-tothrive.

POLICIES, PROCEDURES AND PRACTICE REVIEW
Initially, CABHP proposed implementing a formal review schedule to review DCYF policies and
procedures using a “staged approach” whereby the Panel would review policies associated with
key functions and activities undertaken by CPS (e.g. Hotline, Intake & Screening; Investigation &
21

Assessment; Case Disposition; etc.). Panel members did not view that such an approach to be a
productive use of their time and requested that more flexible review method be developed.
The Panels decided to look at specific policies where practice deficits occurred as identified
through case file reviews. A matrix that outlines the policies and procedures that were
examined in each component of the case record review process is included in Appendix E.
The Panels agreed to focus on policies related to themes discussed each quarter. DCYF staff
also agreed to alert Panels to upcoming legislative policy changes. A hyperlink to the ACRP
website for Panel members and the community to access CPS policies and procedure was
created.

AREAS OF FOCUS FOR 2010 AND UPCOMING ENHANCEMENTS
CABHP is committed to providing Panel members with the information they need to fulfill the
program requirements as outlined in the CAPTA and to make certain that the program is
functioning in an efficient manner. To ensure that practices are employed consistently with a
process for continuous quality improvement, several areas for enhancing the ACRP programs
have been identified over the past year. Due to resource limitations, priorities must be
established. Suggestions identified by DCYF representatives, CABHP staff and Panel members
have included the following:
o Request technical assistance from the National Resource Center for Child
Protective Services to sponsor a facilitator to conduct strategic planning with
Panel members to facilitate the development of actions steps and strategies to
meet program requirements including:
 the examination and evaluation of the coordination between state and
local foster care and adoptions systems; and
 expansion of outreach activities.
o CABHP will begin tracking areas of concern identified in several of the case
record reviews (e.g. perpetrators responsible for caretaking while mother
working outside the home in two of the cases reviewed, parent(s) co-sleeping
with infants in four cases and investigations completed by law enforcement and
closed by CPS prior to safety factors being resolved in two cases) to determine
whether these may constitute a trend requiring additional actions.
o Explore opportunities to utilize technology for enhancing participation and
communication for Panel members and across Panels (e.g. video conferencing
and cross Panel trainings).
o Continue to update the ACRP Program Manual and augment Panel member
orientation.

22

o Identifying opportunities to recognize Panel members and their contributions to
the CPS program.
o Explore means of data extraction to identify trends and develop comparisons
across districts and construct matched comparisons (fatalities/no fatalities) to
test for differences (e.g. case characteristics, procedures, etc.).
o As recommended by the ACRPs, CPS and Arizona State University will explore
how graduate students can be utilized in the DCYF evaluation process.
CABHP and the Panel will work with the DCYF Practice Improvement (PI) Specialists in each of
the State’s six districts. The PI Specialists conduct case reviews, provide data and performance
information to management and the Quality Improvement Manager, facilitate district action
planning, and monitor and lead district practice improvement activities. District and Central
Office staff review a random sample of initial assessment, in-home services and out-of-home
cases from each district to measure the rate of outcome achievement and gauge current
practice related to the Division’s safety, permanency and well-being goals. Review of initial
assessment cases focuses on implementation of the integrated CSA-SRA-Case planning process.
In the upcoming year PI Specialists will attend at least one quarterly ACRP meeting to learn
from the ACRPs' reviews and observations about cases. PI Specialist will also assist the Panel
by filling gaps in case information, explaining relevant policies or practice standards, and
identifying trends from their case reviews. This collaboration will assist the Panel in
understanding whether or not a strength or need seen in a single case is part of a trend. Annual
updates will be provided to the Panel on the priority practice improvement areas and activities.
The ACRP Annual Report will be distributed to all the PI Specialists and the DCYF Management
Team by the DCYF Policy Manager.
As noted previously, strategic planning with each of the Panels will occur to prioritize areas to
focus on in upcoming years will be conducted during 2010. For example, this may include
researching the needs of the teenage population as teens may have endured long-term neglect
and at risk of being overlooked in the child welfare system. A copy of the strategic plan will be
included in next year’s report.

23

APPENDIX A:
AGENCY RESPONSE
TO
CITIZEN REVIEW PANELS’ 2008
RECOMMENDATIONS

24

APPENDIX A
Recommendation 1: The Citizen Review Panels recommend that Child Protective Services and
law enforcement agencies develop strategies to improve compliance with the established joint
investigative protocols for all applicable cases. Particular attention should be paid to enhancing
prompt communication and information sharing between Child Protective Services and law
enforcement agencies. A similar recommendation was made in the 2007 annual report, and
Child Protective Services has addressed these concerns through enhanced monitoring
processes and measures (see Appendix A). Also, in 2008, legislation was passed to strengthen
and clarify the development of joint investigation protocol procedures (HB 2455). The effects of
these actions will be applicable to Panel case reviews beginning with the 2009 annual report.

Response: The Department agrees with this recommendation and has taken appropriate
measures to address this concern.
In response to 2008 legislation (HB 2455), the Governor’s Office, in collaboration with the
Department of Economic Security and the Attorney General’s Office, organized and held a
statewide two-day Joint Investigation Protocols Convening on August 12 and 13, 2008. The
purpose of the Convening was to develop consensus around the basic fundamental principles
that provide the foundation for county-specific protocols to “guide the conduct of investigations
of allegations involving criminal conduct”. Participants included representatives from each
County Attorney; the County Sheriff; the chief law enforcement officer for each municipality in
each County; CPS leadership (local, District and State); the Attorney General and other
representatives of the Attorney General’s Office; and other strategic stakeholders (such as
schools, medical, mental health, child advocates, etc.)
To ensure a prompt and thorough investigation of an allegation involving criminal conduct, the
joint investigation protocols include:
1. The process for notification of receipt of criminal conduct allegations.
2. The standards for interdisciplinary investigations of specific types of abuse and neglect,
including forensic medical examinations.
3. The standards for interdisciplinary investigations involving Native American children in
compliance with the Indian Child Welfare Act.
4. Procedures for sharing information and standards for the timely disclosure of
information.
5. Procedures for coordination of screening, response and investigation with other involved
professional disciplines and notification of case status and standards for the timely
disclosure of related information.
6. The training required for the involved Child Protective Services workers, law enforcement
officers and prosecutors to execute the investigation protocols, including forensic
interviewing skills.

25

7. The process to ensure review of and compliance with the investigation protocols and the
reporting of activity under the protocols.
8. Procedures for an annual report to be transmitted within forty-five days after the end of
each fiscal year independently from Child Protective Services and each County Attorney
to the Governor, the Speaker of the House of Representatives and the President of the
Senate. This report shall include:
a. The number of criminal conduct allegations investigated and how many of these
investigations were conducted jointly pursuant to the investigation protocols.
b. Information from each County Attorney regarding the number of cases presented
for review, the number of persons charged in those cases, the reasons why
charges were not pursued and the disposition of these cases.
c. The reasons why a joint investigation did not take place.
The Convening, facilitated by Theresa Costello and Emily Hutchinson from the National Resource
Center for Child Protective Services, provided an opportunity for participants to discuss, assess,
and draw conclusions about:
 challenges surrounding the joint investigation protocols;
 roles and responsibilities;
 strategies to improve compliance with the established joint investigative
protocols for all applicable cases;
 problem resolution for the joint investigative protocols and procedures
statewide; and
 protocol development.
The results from this Convening were distributed in September 2008, and include key joint
investigation principles and mutual commitments for Child Protective Services, Law
Enforcement, and the County Attorney of how criminal conduct allegations and investigations
would be handled. Prompt communication and information sharing between Child Protective
Services, law enforcement agencies, and other professionals involved in the investigation was a
key area of focus. All the representatives from the Convening were encouraged to utilize
strategies to strengthen their county joint investigation protocols and to clarify any local
variations in procedures which may create confusion.
In September 2008, the Department strengthened and clarified the following in policy:
 joint investigation protocols will guide the investigation of child abuse or neglect
involving criminal conduct allegation;
 the CPS Specialist must notify and coordinate with the appropriate law
enforcement agency when a report alleges criminal conduct;
 the CPS Specialist must consult the appropriate county joint investigation protocols when
developing a strategy to initiate and complete the investigation
including who should be interviewed; the sequencing of interviews; who should
participate in the interviews; arranging medical examinations of child victims;
frequent and open communication to discuss the status of the case; obtaining and
sharing information in a timely manner; identifying actions needed to ensure child
safety, etc.;
26

 when law enforcement is not able to respond jointly within the Department’s response
timeframes, the CPS Specialist should explain to the law enforcement agency that the
Department must proceed with the investigation in order to ensure the child’s safety;
then proceed with the investigation; and
 CPS staff must protect the child’s rights as a victim of crime by not allowing the alleged
abusive person or any other person to threaten, coerce, or pressure the child victim, or to
be present during interviews, family meetings, or other Departmental actions with the
child victim.
Recommendation 2: The Citizen Review Panels recommend that Child Protective Services more
closely review its decisions when determining investigative findings. In cases where additional
information has been received after a finding has been made to comply with statutory
timeframes, Child Protective Services should review and amend the finding as necessary. A
similar recommendation was made in the 2007 annual report, and Child Protective Services has
addressed these concerns through improved quality assurance processes and measures (see
Appendix A). The effects of these actions will be applicable to Panel case reviews beginning
with the 2009 annual report.
Response: The Department agrees with this recommendation and has taken appropriate
measures to address this concern.
The Department has addressed this concern through implementation of a quality assurance
program. The quality assurance process includes a thorough review and evaluation of the
evidence collected to support or not support the finding, and whether concerted efforts were
made to gather pertinent information to determine if an allegation of child abuse or neglect
should be substantiated.
The quality assurance of practice continues to occur at all levels of the Department as follows:
 The review instrument includes an assessment of whether the agency made a concerted
effort to gather sufficient information to determine whether maltreatment occurred, and
whether the field unit accurately applied the substantiation guidelines to the information
obtained to identify the report as substantiated or unsubstantiated.
 Each month, the outcome of each review is discussed with the District Program Manager
or Assistant Program Manager and the assigned Supervisor and CPS Specialist. If the
review found this to be an area needing improvement, the CPS Specialist and Supervisor
are provided information about the specific practice standards relevant to the case, the
substantiation guidelines, and/or resources for consultation about investigation findings,
according to the Specialist’s identified needs. Practice areas needing improvement are
identified and a worker specific performance improvement plan may be developed and
implemented.
 Each district’s aggregated case review findings are provided in monthly reports to the
District Program Managers and Central Office leadership. Program Managers distribute
the findings within their districts, and discuss the results at monthly district leadership
meetings.
 Statewide aggregated case review findings are provided in quarterly reports to the
27

District Program Managers and Central Office leadership. Program Managers distribute
the findings within their districts, and discuss the results at monthly district leadership
meetings. Central Office leadership reviews the results to identify necessary additional
program or practice improvement actions. These reports are also provided to the Child
Welfare Training Institute so that identified needs can be addressed in initial, refresher,
or advanced training.
 If the review identifies a case in which a finding is not supported by the evidence, the
Practice Improvement Manager consults with the Protective Services Review Team and
subsequently recommends to the Supervisor and CPS Specialist that the finding be
amended accordingly.
The Protective Services Review Team continues to provide training to unit field staff regarding
the evidence required to substantiate child abuse and neglect. Evidence required and
documentation “tips” are accessible under public folders where all staff can refer to for clarity.
Implemented in February 2008, the Division’s revised Critical Incident Review process continues
to include an assessment of the evidence collected to support or not support the finding, and
whether concerted efforts were made to gather pertinent information to make a finding. This
process includes a thorough review of the facts regarding a critical incident. If the review
indicates that the decision to substantiate or not to substantiate an incident of child abuse or
neglect was not supported by the evidence, the District is directed to revise the finding
accordingly.
In September 2008, the Department clarified and strengthened its policy regarding
obtaining and reviewing information when determining investigative findings. The following
areas of policy were reinforced:
 Fatality and Near Fatality: Guidance was provided to assist the CPS Specialist in
gathering information from a medical professional (physician, doctor of osteopathy,
physician’s assistant, or licensed nurse practitioner) when documenting whether a
child fatality or near fatality was the result of abuse or neglect.
 Collection and Review of Records: Clarifies under what circumstances medical,
behavioral health and educational records should be obtained and reviewed during the
investigation process.
Recommendation 3: The Citizen Review Panels recommend that Child Protective Services
caseworkers be more diligent in consistently documenting all steps of their investigations. The
Panels recognize that large caseloads and staff turnover affect Child Protective Services
caseworkers’ ability to document consistently all investigative activities.

28

Response: The Department agrees with this recommendation. The Practice Improvement Unit
has developed a number of tools and guides to inform and assist staff in their documentation of
all steps of their investigation. These tools, guides, and tips are distributed to district field staff
and reinforced through the case review process. The case record review instrument utilized by
the Program Improvement Specialist targets all areas of the investigation. Direct feedback is
provided to field staff when a specific practice area is lacking documentation and also when
there is outstanding documentation.
In October 2008, the “Keys to Documenting a Comprehensive Initial Assessment” guide was also
developed as an additional tool for staff to reference and utilize in improving their
documentation skills.
In 2008, the Child Welfare Training Institute developed a documentation curriculum to aid staff
in improving case record documentation. The main areas of focus include how staff should
notate relevant and complete information in the case record. This training was initially delivered
in District IV in January 2009. Additional district trainings have been suspended due to budget
constraints, but will continue once this suspension is lifted.
In February 2009, the Program Improvement Specialists, Child Welfare Training Institute staff,
and Policy staff developed a “model case example” for use as a training tool for documenting
the Child Safety Assessment and Strengths and Risks Assessment. This case example was
disseminated to district field staff. The Department will continue to assist staff in strengthening
documentation by providing ongoing feedback, training and developing additional “model case
examples” for staff use.
Recommendation 4: The Citizen Review Panels recommend that Child Protective Services
develop protocols to identify, assess, and intervene in cases of chronic neglect. Cases of
chronic neglect can extend over many years and involve multiple caregivers. These cases
require complex strategies and a high level of coordination among many agencies and
stakeholders.

Response: The Department agrees with this recommendation. The Department acknowledges
the need to augment its policy and practice to provide more informed direction to staff
regarding the identification, assessment, and intervention in cases of chronic neglect.
The Department will complete a thorough review of the literature concerning chronic neglect
including national child welfare data to determine “best practice” standards regarding:
identification of chronic neglect—how it differs from poverty,
thorough and comprehensive assessment of chronic neglect in child welfare,
fundamental impact of neglect,
the cumulative harm effect of chronic neglect, and
evidence-based practice intervention.

29

Once this review has been completed, the Department, in collaboration with designated
stakeholders and with the technical assistance via the U.S. Department of Health and Human
Services, will develop and/or augment its policy and procedures concerning chronic neglect.
It should be noted that in May 2008, the Division of Children, Youth and Families (DCYF) and the
Division of Developmental Disabilities (DDD) joined efforts to develop a protocol to collaborate
in cases involving children who have suffered abuse due to chronic neglect and who are involved
in both service delivery systems. The goal of the protocol is to improve the Department’s
response, assessment, collaboration, and intervention in cases involving special needs children.
The draft protocol focuses on the following primary scenarios:
How DCYF will respond to a report when a child(ren) has an open DDD case.
How DCYF will respond when a child was not initially known to have been involved with
DDD, but, through the course of an investigation, it is determined DDD is involved with
the family.
How DCYF and DDD will respond, when during the course of an investigation, DCYF
determines the child may be in need of DDD services.
How DCYF and DDD will collaborate to serve children involved in in-home intervention
and dependency cases.
The joint Divisional workgroup developed policy, procedures, and training for designated staff.
The changes strengthen and clearly define how the coordination between Divisions and other
stakeholders should look when working with these children. The draft protocols are pending
final approval. Implementation of these protocols has been suspended due to budget
constraints, but will move forward once this suspension is lifted.
Recommendation 5: The Citizen Review Panels recommend that Child Protective Services
develop strategies to address complex, interconnected families. These strategies should
address staff communication and consistent decision-making. Due to the increasing complexity
of family relationships (e.g. kin placements, divorces, remarriages, live-in significant others,
extended families), Child Protective Services caseworkers need the ability to better assess and
address child safety when an adult or child is involved in more than one case, household, or
family.

Response: The Department agrees with this recommendation. The Department policy and
procedures requires CPS staff to collect and thoroughly review and consider all available
information in the assessment of child safety and provision of services. Prior CPS history prepopulates the background section of the Child Safety Assessment template, and the CPS
Specialist is directed to complete an analysis of this information and determine its impact upon
child safety.
In September 2008, the Department revised its policy to clearly identify all persons that must be
interviewed and included in the assessment of child safety and risk of harm during the course of
an investigation. The following policy revisions were made to strengthen and guide decisionmaking:
30

Unless case specific circumstances indicate otherwise, the following individuals should be
interviewed. The timing and sequencing of interview, who conducts and/or participates in the
interviews, and the circumstances upon which the interview is conducted may be affected by the
respective county’s joint investigation protocols for criminal conduct allegations.
 the reporting source;
 alleged victim of child abuse or neglect;
 siblings and other children in the home where the child victim resides;
 siblings and other children in the home where the alleged abuse or neglect occurred, if
different from the child’s primary residence;
 custodial parent;
 the spouse or partner or significant other (boyfriend, girlfriend, etc.) of the custodial
parent;
 all other adults living in the home where the alleged abuse or neglect occurred;
 non-custodial parent of the child victim when the identity and whereabouts can be
reasonably determined, and such contact would not be likely to endanger the life or
safety of any person or compromise the integrity of a criminal investigation or the CPS
investigation;
 the alleged abusing or neglecting person.
 other persons known to have knowledge of the abuse or neglect, or who could confirm
or rule-out a safety threat to the child victim, or any other child in the home where the
abuse or neglect occurred, such as:
school personnel,
medical providers,
child care providers,
relatives,
other adults living in the non-custodial parents home,
neighbors.
Once an assessment of present danger is complete, proceed with the initial child safety
assessment to determine whether any child is unsafe due to impending danger. The following
individuals must be included in the Child Safety Assessment:
 alleged victim of child abuse or neglect;
 siblings and other children in the home;
o If a child who does not reside within the child victim’s primary residence
provides information that indicates he/she has been or may be abused or
neglected, a report on that child’s household must be made to the Child Abuse
Hotline. Do not include this child in the assessment for the current report.
 the alleged abusing or neglecting person;
 other adults (including the spouse, partner, or significant other including a boyfriend,
girlfriend, etc.) who have caregiving responsibilities for the child; and
 the non-custodial parent who:
o has parenting time with the child; or
o is being considered as a placement for the child.

31

Currently, Child Abuse Hotline staff searches multiple databases including CHILDS to identify
demographic data and any child welfare information that may assists in the child safety
assessment. When known, associated cases are linked to the primary report or case prior to field
assignment.
The Department will review and revise as applicable its policy, procedures and practice to clearly
articulate the expectation and requirement that the CPS Specialist will review and consider
information about a case participant that is available in another case in the assessment of child
safety and future risk of harm. Department policy will require, at a minimum, case consultation
between involved CPS Specialists and their Supervisors when a case participant appears in more
than one open case.

32

APPENDIX B:
2009 ANNUAL MEETING CALENDAR
AND AGENDAS

33

APPENDIX B

st

1 Quarter
nd
2 Quarter
rd
3 Quarter
th
4 Quarter

SOUTHERN REGION

CENTRAL REGION

NORTHERN REGION

9:00 – 12:00
March 16
June 15
September 21
December 7

9:00 – 12:00
March 13
June 12
September 11
December 11

1:00 – 4:00
March 23
June 22
August 31
November 30

1ST QUARTER MEETING AGENDA
Welcome and Introduction
CABHP Data Presentation “CPS System Overview”
DCYF Program Report -2009-2010 CAPTA Plan and DCYF Budget
Policy Review - Process to Conduct a Comprehensive Review of CPS/ Prioritizing Chapters
Discuss Proposed Revisions to Case Record Review Protocol and Sampling Criteria
Recommendations from 1st Quarter Meeting
Identify Requests for Next Meeting

2ND QUARTER MEETING AGENDA
Welcome and Introduction
Review of 1st Quarter Meeting Minutes
Data Presentation “Characteristics of Substantiated vs. Unsubstantiated Reports -Arizona Data
Under the Age of Five”
Chronic Child Neglect and Discussion
Case Record Review Presentation “Child Fatalities and Near Fatalities Under the Age of Two”
and Related Policies
DCYF Program Report-IV-B Safety Outcomes
Recommendations from 2nd Quarter Meeting
Identify Requests for Next Meeting

3RD QUARTER MEETING AGENDA
Welcome and Introduction
Review of 2nd Quarter Meeting Minutes
Data Presentation “Joint Investigations and Statutory Mandates” and “Methamphetamine and
Drug Endangered Children Protocols ”
Case Record Review Presentation and Related Policies/Data Presentation
DCYF Program Report - Joint Investigations of Criminal Conduct Allegations and IV-B Safety Outcomes
Recommendations from 3rd Quarter Meeting
Identify Requests for Next Meeting

4TH QUARTER MEETING AGENDA
Welcome and Introduction
Review of 3rd Quarter Meeting Minutes
Data Presentation “Key Constituent Groups & Role of Panel in Outreach and Education”
Case Record Review Presentation and Policies Related to Case Record Review/Data Presentation
Internal Quality Assurance and Grievance/Complaint Processes
DCYF Program Report - CAPTA Implementation Plan and Update on Panels’
Recommendations
Recommendations from 4th Quarter Meeting
Identify Requests for Next Meeting and Identify Priorities for 2010

34

Arizona Citizen Review Panel
2009 Meeting Locations
SOUTHERN REGION
La Paloma Family Services
870 West Miracle Mile
Building A
Tucson, AZ 85705
(520) 750-9667
http://www.lapalomakids.org
Free parking located on site.
CENTRAL REGION
School of Social Work
Arizona State University
Downtown Phoenix Campus
University Center (UCENT)
411 North Central Avenue
Suite 822A, 8th Floor
Phoenix, AZ 85004-0698
(602) 496-0800
http://ssw.asu.edu/portal/
Free parking located at Valley Youth Theater at the southeast corner of Fillmore and 1st Street.
NORTHERN REGION
Catholic Charities Community Services
460 North Switzer Canyon Drive
Suite 400
Flagstaff, AZ 86001
(928) 774-9125
http://www.catholiccharitiesaz.com/coconino.aspx
Free parking located on site.

If you have questions or need additional information, please contact:
Lisa Moen
Program Coordinator, Sr.
Phone: (602) 496-1480
Email: lisa.moen@asu.edu

35

APPENDIX C:
CITIZEN REVIEW PANEL MEMBERS

36

APPENDIX C
CENTRAL REGION
CITIZEN REVIEW PANEL MEMBERS

Beth Rosenberg
Children’s Action Alliance
Cindy Copp
ADES/Administration for Children,
Youth & Families
Gary Brennan
Quality Care Network

Minerva Gant
ADES/Administration for Children,
Youth & Families
Nancy Logan
Social Security Administration/
Office of Disability
Natalie Miles Thompson
Crisis Nursery

Ivy Sandifer, M.D.
Jo Fuhrmann
CHEERS, Inc.
Joelle Minitti
ADES/Administration for Children,
Youth & Families
Kara VanHise
Ombudsman’s Office
Linda Madrid
Arizona State University
Lisa Barrientos
Mesa Police Department
Mikayla Bailey-Null
Citizen

Pamela Fitzgerald
Citizen
Pamela Ruiz
Hospice of the Valley
Princess Lucas-Wilson
ADES/Division of Developmental Disabilities
Roger Marshall
Maricopa County Sheriff’s Office
Roy Teramoto, M.D
Indian Health Services
Samantha Nordvold
Madison School
Simon Kottoor
Sunshine Group Home

37

CITIZEN REVIEW PANEL MEMBERS REPRESENTATION - CENTRAL
Private
Citizens

Educators

Mental
Health
Care

Legal
Professionals

Law
Enforcement

Health Care
Professionals

Social
Services

Child &
Family
Advocates

Adoptive
Parents

Adoptees

Foster
Parents

Foster
Care
Alumni

Faith
Based

Tribal

District
Rep
DCYF

DCYF

X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X

38

SOUTHERN REGION
CITIZEN REVIEW PANEL MEMBERS

Amy Gomez
Pima County Attorney’s Office
Anna Binkiewicz, M.D.
Citizen
Barbra Quade
Jewish Family Services
Carla Hinton, Ph.D.
Amphitheatre Public Schools

Linda Johnson
AZDES/Administration for Children,
Youth & Families
Lisa Jacobs
Casa de los Ninos
Lynn Kallis
Pilot Parents of Southern Arizona
Martha McKibben
Northwest Medical Center

Christie Kroger
ADES/Administration for Children, Youth &
Families

Marty Fuentes
Tohono O’Odham Police Nation Department

Cindy Graupmann
Citizen

Sandy Guizzetti
Arizona Supreme Court/Foster Care Review
Board

Cynthia Killion
Amphitheatre Public Schools
David Reynolds
Sunnyside High School
Gloria Bernal
Sycamore Elementary School
Jaymie Jacobs
Office Pima County School Superintendant
Joan Mendelson
Citizen
Joanne Karolzak
Casa de los Ninos
Joy Subrin
Northwest Medical Center
Karen Harper
Southern Arizona Children’s Advocacy Center

Scott Gamble
Tohono O’Odham Police Nation Department
Stacy Meade
Citizen
Susan Anderson
UPH Hospital
Susan Eazer
Pima County Attorney’s Office
Susie Huhn
Casa de los Ninos
Tish Kleiman
Citizen
Yariet Camarena
ADES/Administration for Children,
Youth & Families

Laurie San Angelo
Office of the Arizona Attorney General

39

CITIZEN REVIEW PANEL MEMBERS REPRESENTATION - SOUTHERN
Private
Citizens

Educators

Mental
Health
Care

Legal
Professionals

Law
Enforcement

Health Care
Professionals

Social
Services

Child &
Family
Advocates

Adoptive
Parents

Adoptees

Foster
Parents

Foster
Care
Alumni

Faith
Based

Tribal

District
Rep
DCYF

DCYF

X
X
X
X

X
X

X

X
X
X
X

X
X

X
X
X
X

X

X

X

X
X

X
X
X
X
X

X

X

X

X

X

X

X
X
X

X
X

40

NORTHERN REGION
CITIZEN REVIEW PANEL MEMBERS

Beya Thayer
Citizen
Gene Shantz
Coconino County Sheriff’s Office
Jill Sanchez
Coconino County Superior Court
Judy Gideon
Citizen
Julie Wood
Arizona’s Children Association
Mary Ellen Sandeen
Yavapai Regional Medical Center
Maura Cluff
Catholic Charities Community Services
Sandra Lescoe
ADES/Administration for Children,
Youth & Families
Suzette Vigil
ADES/Administration for Children,
Youth & Families

41

CITIZEN REVIEW PANEL MEMBERS REPRESENTATION - NORTHERN
Private
Citizens

Educators

Mental
Health
Care

Legal
Professionals

Law
Enforcement

Health Care
Professionals

Social
Services

Child &
Family
Advocates

Adoptive
Parents

Adoptees

Foster
Parents

Foster
Care
Alumni

Faith
Based

Tribal

District
Rep
DCYF

DCYF

X
X
X
X
X

X

X
X
X
X
X

42

APPENDIX D:
CITIZEN REVIEW PANEL
CASE RECORD SUMMARY FORM

43

APPENDIX D
CABHP Summary and Case Presentation
Arizona Citizen Review Panel
Quarter ___, 20__,
_____Region, Case # ___
Purpose: Highlight key data and findings extracted from CPS CHILDS system and other documentation to provide information to
the regional Citizen Review Panels so that recommendations can be developed and areas of exemplary practice identified. Panel
members will receive a copy of this document with copies of the Practice Improvement Case Review Instrument and the In-Home
or Out-of-Home (if applicable). All personal identifying information will be redacted from the materials before distribution. The
period under review will be the last 12 months except for items that are related to history of CPS involvement an /or may be
relevant to the current case being reviewed (e.g. substance use, criminal history, etc.)
Narrative Overview of Case Description - allegation(s)/what trigger the call, age, gender and race/ethnicity of victim(s), reporter,
perpetrator(s), summary of history of CPS reports and findings, relevant factors (e.g. substance use, mental illness, physical health,
developmental disability), manner and cause of death (specify per medical report, autopsy and/or death certificate), relevant
toxicology testing performed including results and any charges filed, summarize services received and/or needed but not received.

A. DCYF Practice Improvement Case Review Instrument Summary - review should use the directions in the tool also refer to
the DCYF Quality Improvement System Procedures, Training Manual and any relevant DCYF policies and procedure.
Significant information - summary of information reviewed in the copy of the DCYF record and/or collected from CHILDS.
Key Findings-document findings of safety & risk assessment and investigations, plus any relevant decisions made by DCYF
and the courts. Comments- additional information that would be beneficial to share with ACRP members, DCYF
Administration and/or CABHP staff.
44

Item
Item 1
Timeliness of Initiating
Investigation of Reports
of Child Maltreatment
Item 2
Initial Child Safety
Assessment
Item 3
Safety Planning to
Protect Child(ren)
in Home and Prevent
Removal
Item 4
Initial Strengths & Risk
Assessment and
Provision of Services to
Reduce Risks
Item 5
Determining Whether
Maltreatment Occurred

Significant Information, Key Findings & Comments
Consider also the relevance and sufficiency of the information gathered during current or prior CPS
investigations and case planning

-ATTACH COPY OF CSA FROM CHILDS-

-ATTACH COPY OF CSA FROM CHILDS-

Document whether services offered and/or provided addressed the identified safety threats and risk
factors and any outcomes as a result of services received. Also need to consider whether actions were
taken in a timely manner to ensure the safety of other children remaining in the home.
-ATTACH COPY OF SRA FROM CHILDS-

Item 6
Aftercare Planning
B. DCYF Practice Improvement Case Review Instrument-In Home or Out of Home- review - should use the directions in the
tool and any relevant DCYF policies and procedure. Key Finding- should include information that justifies the rating.
Comments- additional information that would be beneficial to share with ACRP members, DCYF Administration and/or
CABHP staff.
45

Item
Item 1- Ongoing Safety and Risk
Assess. And Safety Management

Significant Information, Key Findings & Comments
-ATTACH UPDATES OF SRA FROM CHILDS-

Item 2- Permanency Goal for Child
Item 3- Concurrent Permanency
Planning
Item -Independent Living Services
Item 5-Visiting with Parents &
Siblings in Foster Care
Item 6- Relative Placement
Item 7- Needs &Services of Child,
Parents and foster Parents
Item 8- Case Plan Development
Item 9- Worker Visits with Child
Item 10- Worker Visits with Parents
Item 11- Educational Needs of the
Child
Item 12- Physical Health of the Child
Item 13- Mental/Behavioral Health
of the Child
Foster Homes

Complete only if allegations involve foster family placement. Identify any findings from
foster care review board on their barriers.
46

C. Panel Recommendations and Comments
Precipitating Events and/or Suspected Triggers:
____Commission of Another Crime
____Family Violence
____Revenge
____Gang Activity
____Other: _______________________________

____ Crying
____ Disobedience
____ Feeding Difficulty
____ Toilet Training

Family Risk Factors:
____ Substance Use
____ Mental Health Problems
____ Domestic Violence
____ Violence Outside the Home
____ Lack of Physical or Mental Ability to Provide Adequate Care
____ Lack of Anger Control
____ Prior Removals by CPS or Severance of Parental Rights
____ Prior Substantiated Reports
____ Other: ____________________________________________

____ Lack of Resources for Adequate Food/Shelter/
Medical/Child Care
____ Lack of Parenting Skills
____ Teen Parent
____ Prior Child Death
____ Lack of Motivation to Provide Adequate Care
____ Co-sleeping with Infant

Were all risk factors identified in the record? Yes___ No___
If not, specify additional risk factors identified by the Panel members:
Were all identified risk factors addressed and/or resolved? Yes___

No___ If not, describe:

Joint Investigation: Reference the joint investigation protocol for the applicable region and note any areas in which the protocol
was not followed.
Was a thorough investigation completed? Yes___

No___

If no describe:

Supervision: note any instances or documentation that indicates that there was inadequate communication (e.g. reporting facts,
clear instructions) between the CPS worker and their supervisor. Also specify any decisions/findings were overturned.

47

Potential Policy Issues: indicate whether there are any specific policy issues, concerns or recommendations. 1) Areas where
policy not followed or quality concerns; 2) Policy followed but still bad outcome or concern identified (may need to re-evaluate or
modify the policy); 3) Issue not addressed in the policy.
Exemplary Practices: note any practices that should be shared to encourage the continued practice.
Other: note any known circumstances that you believe may have impacted the outcome (e.g. lack of services, support services, case
load size, training). Document any barriers outside the CPS agency that impacted the agency's ability to ensure a continuity of
consistent, timely and adequate services.
What actions does the Panel believe could have been taken to prevent/avoid this event:
Recommendations:

Demographics
Age of Child: __________

Race: __________

Hispanic/Latino: __________

Prior CPS involvement: __________ Number of prior complaints: __________ Number of substantiated complaints: _______
Age of Parents/Gender (e.g. 43F 51M): _________________

Marital Status: __________________

Does mother work out of the home? ___Yes ___No
If Yes, was perpetrator primarily responsible for caring for Target Child during mother’s absence? ___Yes ___ No
Birth Order of Target Child: _____________

Number of Children Under Age 5: ____________

Was substance abuse a risk factor for this family: ___Yes ___ No

Identify substance(s):_____________________________

Was the target child identified as having a behavioral health disorder? ___Yes ___No If yes, specify:____________________
48

Time Line
Date

Significant Events for the Target Child

Notes

49

APPENDIX E:
POLICIES EXAMINED THROUGH
CASE RECORD REVIEWS

50

APPENDIX E
Practice Improvement Case Review Instrument
Item
1-Timeliness of Investigation of reports of
Child Maltreatment

Chapter
1

2-Initial Child Safety Assessment
3-Safety Planning to Protect Child(ren) in
Home and Prevent Removal
4-Initial Strengths & Risk Assess. Provision of
services to Reduce Risks

2
2

5-Determining Whether Maltreatment
Occurred

2
2

6-After Care Planning

9

2
3
5

Sections
Section 3 Prioritizing Reports and Response
Section 4 Disposition of Reports
Section 1 Interviews With The Child, Family And Collateral Contacts
Section 3 Efforts To Locate The Child Victim And Family
Section 2 Conducting The Child Safety Assessment
Section 2 Conducting The Child Safety Assessment
Section 3 Safety Planning
Section 13 Assessing the Risk of Future Harm: Using the Family
Centered SRA
Section 2 Providing Emergency Intervention
Section 1 Determining Whether to Open the Case for Ongoing Services
Section 12 Determining Whether Maltreatment Occurred
Section 3 Efforts to Locate the Child Victim and Family
Exhibit 11-Substantiation Guidelines
Section 19 Accessing Services Required by the Case Plan: Provision of
Aftercare Services

In Home or Out of Home Tool
Item
1-Ongoing Safety and Risk Assess. and Safety
Management
2-Permanency Goal for Child

Chapter
2
2
9
11
12
15
15

Sections
Section 2 Conducting The Child Safety Assessment
Section 13 Assessing the Risk of Future Harm: Using the Family
Centered SRA
Section 2 Determining the Permanency Goal for a Child
Section 5 Changing the Permanency Goal from Family Reunification
Section 3 Petitioning for Termination of Parental Rights
Section 1 Selecting Guardianship as a Permanency Goa
Section 8 Long-Term Foster Care as a Planned Permanent Living
Arrangement
51

Item
3-Concurrent Permanency Planning
4-Independent Living Services
5-Visiting with Siblings in Foster Care

Chapter
9
16
6
7

6-Relative Placement

6

7-Needs and Services of Child, Parents, and
Foster Parents

6
9
16

8-Case Plan Development

9

9-Worker Visits with Child

6

10-Worker Visits with Parents

9

11-Educational Needs of the Child

6

12-Physical Health of the Child

6

13 -Mental/Behavioral Health of the Child

9

Sections
Section 3 Developing and Implementing Concurrent Permanency Plan
Independent Living Services and Supports
Section 20 Locating Children on Runaway Status
Section 1 Ensuring Visitation Between Children in Out-of-Home Care
and Their Family
Exhibit 26 Visitation Supervision Continuum
Section 4 Assessing the Placement Needs of Children Who Require Out
of Home Care
Section 5 Selecting an out of Home Caregiver
Section 6 Providing Kinship Foster Care Services
Section 2 Finding Missing Parents, Relative, and Other Significant
Persons
Providing Out-of-Home Services Under a Dependency Petition
Developing the family-Centered Case Plans
Independent Living Services and Supports
Developing the Family-Centered Case Plan
Exhibit 27 Ensuring a Meeting with the Family is Family-Centered
Exhibit 39 Cultural Competence: Starting Where the Family Is At
Section 8 Providing Supervision of Children in Out-Of-Home Care
Exhibit 23 Supervision and Contacts with Children in Out-Of-Home Care
Section 4 Planning and Implementing Services and Supports Necessary
to Achieve the Permanency Goal
Section 10 Meeting the Educational Needs of the Children in Out-OfHome Placement
Section 11 Meeting the Medical Service Needs of the Children in OutOf-Home Placement
Sections 12-14 on accessing behavioral health services

52

APPENDIX F:
ARIZONA CITIZEN REVIEW PANEL
PROGRAM BROCHURE

53

54

55

APPENDIX G:
QUARTERLY ACTIVITIES

56

APPENDIX G
CITIZEN REVIEW PANEL 1ST QUARTER ACTIVITIES
In early February 2009, the office of the Assistant Director of the Division of Child, Youth and Families mailed letters to all ACRP
members introducing CABHP as the coordinators for the statewide Panels. The ACRP Program Coordinator followed up with
personal phone call to members. CABHP staff centralized logistical and staff support of three regional Panels in Central, Southern,
and Northern Arizona, and developed an annual 2009 calendar of meetings.
Meeting facilities were established at Arizona State University School of Social Work in Phoenix, La Paloma Family Services in Tucson,
and Catholic Charities Community Services in Flagstaff. The 1st Quarter Panel meetings were held on March 13th, 16th and 23rd
respectively. Agendas, policies, presentations and other materials were emailed to members prior to each meeting. Mileage
reimbursement was offered to Panel members who are former CPS’ clients, family members and family advocates. Attendance
included 15 participants on the Central Panel, 11 on the Southern Panel, and 9 on the Northern Panel.
DCYF staff provided a program report on the CAPTA plan and the DCYF budget. CABHP presented an overview of CPS and engaged
the Panels in discussion of case record and policy review procedures. Panels established terms of membership, training and
orientation plans for new members and revisions to the ACRP Manual. The Panels were involved in redesigning the case record
review tool. Initial considerations on how to examine coordination between state and local child protection systems and state and
local foster care and adoption system was also introduced. Strategies were briefly discussed with Panels on how to develop
collaborative relationships with the ACRP’s and foster care, adoption and other related agencies. Recruitment to target a diverse
community representation for each regional Panel was begun through Panel members’ referrals, networking, and advertising.
The Panel meetings were tape recorded, formal meeting minutes were transcribed and posted, along with other meeting materials,
to a newly created ACRP Intranet website.
CABHP staff began discussions with DCYF staff on collecting information in preparation for conducting data analysis activities,
including the mining of informatics from the CHILDS and ADES CPS Child Fatality databases.

57

CITIZEN REVIEW PANEL 2ND QUARTER ACTIVITIES
CABHP continued to centralize logistical and staff support for the three regional Panels. Members were notified in advance of the
2nd Quarter meeting via email, intranet and personal phone calls by the CABHP Program Coordinator. Members who were not in
attendance at the 1st Quarter meeting were personally contacted. Meeting materials were emailed to members in advance and
provided at the 2nd Quarter meetings held in Phoenix on June 12, Tucson on June 15 and Flagstaff on June 22. The Central Panel
had 19 participants; the Southern Panel had 17 participants; and the Northern Panel had 11 participants. Recommendations from
1st Quarter meetings and Action Items were compiled and presented to the Panels for their comments.
CABHP staff meets once a week or more often, if needed, for planning and discussion around the ACRP. CABHP staff also attended a
training workshop in April on the investigation of child physical abuse crimes and homicides offered by Childhelp Children’s Center of
Arizona. In addition, staff registered for a teleconference on evidence based practice in child welfare sponsored by the National
Child Welfare Resource Center for Organizational Improvement in May.
CABHP staff held a meeting with DCYF data specialists to discuss CHILDS and other databases with information on child fatalities and
near fatalities, as well as criteria for case selection and review. CABHP staff completed required DCYF computer based training and
CHILDS training. CABHP staff also met with an ADES Child and Family Services Manager for instruction on CHILDS and Practice
Improvement Case Review Instruments and other assessment tools. At each of the 2nd Quarter Panel meetings two cases were
presented on child fatalities and near fatalities under age two, followed by Panels’ discussions. Chronic child neglect data and
characteristics of substantiated vs. unsubstantiated reports for children under age five were also presented and discussed. A refined
case record review protocol was implemented with recommended mechanisms to examine current policies, procedures and
practices of CPS.
A Confidentiality Agreement was signed by all Panel members. Consensus guidelines were provided in draft form at the Panel
members’ request. Recruitment efforts targeted at diverse populations in all three regions resulted in a gain of three new members
to the Central Panel, six new members to the Southern Panel and three new members to the Northern Panel. An application form
was made available, along with the ACRP brochure and orientation Power Point.
CABHP utilized the National Citizen Review Panel listserve to request information from other states’ ACRP on their public outreach
and education experiences. CABHP and DCYF also coordinate responses to the National Panel’s requests for information that will be
incorporated into various research projects and publications on Citizen Review Panels.
58

CITIZEN REVIEW PANEL 3RD QUARTER ACTIVITIES
A meeting with DCYF was scheduled on July 10, 2009 to discuss policy development related to chronic child neglect which is an area
of concern to Panels. CABHP offered a variety of resources to the CPS Policy and Program Development Specialist for research
purposes including literature reviews, numerous articles, and pertinent websites.
Meeting materials were emailed to members in advance and provided at the 3rd Quarter meetings held in Phoenix on September
11, Tucson on September 21 and Flagstaff on August 31. The Central Panel had 12 participants; the Southern Panel had 14
participants; and the Northern Panel had 9 participants. Guest speakers from High Intensity Drug Trafficking Areas (HIDTA) program
presented Methamphetamine and Drug Endangered Children (DEC) Protocols. A DCYF Child and Family Services Manager presented
a report on IV-B Safety Outcomes and CABHP presented Joint Investigations and Statutory Mandates.
Two case records were reviewed at each Panel meeting with a focus on methamphetamine abuse. A case record document checklist
was included in the request for case record copies to CPS. The checklist identifies the documents that CPS includes in the file copies
and reasons that other documents are missing. Genograms clarifying complex family relationships in CPS case investigations were
provided to Panels with copies of the seventeen safety factors and Six Fundamental Questions for Information Collection and
Assessment to Identify and Understand Possible Safety Threats, to assist in following the case record review and safety assessments.
A survey link was emailed to Panel members on July 14, 2009 asking for comments on the ACRP and suggested areas for
improvement. The survey closed on July 31st. Panel members who completed the survey were entered into a drawing to receive a
copy of Interventions for Children Exposed to Violence. See Citizen Review Panel Survey section.
CABHP incorporated consensus guidelines requested and approved by the Panels. CABHP continues to explore opportunities to
utilize faith-based and social service organizations to stimulate public outreach and the solicitation of public input. The National
Citizen Review Panel Virtual Community provides a listserve, through the University of Kentucky College of Social Work, to request
information from other states’ ACRPs on their public outreach and education experiences. The National ACRP gathers information
from states Panels that will be incorporated into various research projects and publications on Citizen Review Panels.
Arizona provider network listserves are utilized to promote the ACRP and recruit new volunteers and brochures are distributed at
key meetings and local conferences.

59

CITIZEN REVIEW PANEL 4TH QUARTER ACTIVITIES
The 4th Quarter Citizen Review Panel meetings were held on November 30, 2009 with the Northern Panel, December 7 with the
Southern Panel, and December 11 with the Central Panel. The Northern Panel meeting location was changed to the United Way of
Northern Arizona. The Southern Panel added a new member, while the Central Panel gained six new members representing
education, health care, behavioral health and private citizenry.
Maria Hoffman, Director of the Legislative Office of Family Advocacy, and Kara VanHise, Assistant Ombudsman with Citizen’s Aid
(also a member of the Central Region Panel) presented information on grievance and complaint processes within their respective
agencies. Ms. Hoffman provides a communication bridge between constituents, who have been referred by legislators, children and
Child Protective Services. Ms. VanHise mediates solutions to complaints that her office receives from Child Protective Services’
clients through various forms completed at the time of initial investigation of a report. Other sources are legislators, other agencies,
the Governor’s Office and Ms. Hoffman. Ms. VanHise and Ms. Hoffman work collaboratively in resolving multi-faceted issues. They
offered to provide updates to the Panels every three months. CABHP will also chart the advocacy organizations for Panels.
Vicki Staples presented Key Constituent Groups and Role of Panels in Outreach and Education. Panel members discussed various
ideas for outreach such as distributing the Arizona Citizen Review Panel Annual Report to statewide professional organizations,
educational institutions, law enforcement, medical and behavioral health communities, court judges and the general public.
Members suggested linking the Annual Report with the release of the Arizona Child Fatality Report, agencies concerned with child
welfare. Other public outreach ideas included development of a program video and appearances on radio talk shows.
Two Child Protective Services case records were presented and discussed at each Panel meeting for a total of six cases. In response
to Panels’ requests to clarify the case record reviews, CABHP staff included redacted copies of the Child Safety Assessments, Safety
Plans and Family Strengths and Risk Assessments from CHILDS. Genograms were improved to understand complex family
relationships, and timelines of the target child’s significant events were attached to each case summary. Members requested that
future timelines also reflect any changes in CPS staff during investigation. In addition, a Medical Examiner with child maltreatment
experience from the Maricopa County Forensic Science Center agreed to be a consultant to the Panels on questions regarding
autopsy reports.
The Southern Panel requested that CABHP conduct a survey of agencies to gather information on types of training currently
available regarding mandatory reporting. The Central Panel was interested in learning more about CPS’ Team Decision Making
60

(TDM) process at a future meeting. The Northern Panel would like to invite a speaker from the Foster Care Review Board and obtain
additional information on CPS reports around the Colorado City area of Arizona.
The DES Program Report on the CAPTA Implementation Plan and Update on Panels’ Recommendations was rescheduled for the first
quarter meeting in 2010 at the request of DES staff.
CABHP drafted the Arizona Citizen Review Panel 11th Annual Report and reviewed it with the Panel members at the 4th quarter
meetings and with DES staff on December 14, 2009. CABHP received responses to the recommendations in the draft report from
DES. On January 13 and 19, 2010, CABHP will conduct meetings via telephone and in office to discuss the report with participating
Panel members and DES staff. The final version of the report is due to DES on January 22, 2010.

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APPENDIX H:
CITIZEN REVIEW PANEL SURVEY

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APPENDIX H
On July 14, 2009 Panel members received an email request from the Citizen Review Panel Program Coordinator asking them to
complete a short Survey Monkey to provide CABHP staff information on Panels’ level of satisfaction and suggestions for
improvement in the program. Nineteen (19) Panel members completed the survey with 6 responses from Central, 11 from Southern
and 2 from Northern Panels. The majority of the respondents were satisfied with the performance of CABHP administrative support
and understood the Citizen Review Panel mission and members’ roles. Most of the comments and/or recommendations concerned
the case review process. The survey results are summarized as follows:
Question #1

Question #1
Comments:
I have a better understanding now. To my recollection, I had not had any orientation to the role until the ASU Center began
conducting the meetings.
As a member I have received written and verbal information about my role on the Panel.
I was very impressed with the Panel and looking forward to working with the group.
I want to be involved, however, I am not getting the information in enough time to participate.

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Question #2

.

Comments:
The mission of the Arizona Citizen Review Panel was made clear during my first meeting.
I have been provided the mission information.

Question #3

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Comments:
The Panel needs more diversity from community agencies. Also, I would like to recommend an emancipated young
adult/older adult who has been in Foster Care to be part of the Panel.
I enjoy the diversity. However, the reliance on voluntary participation is a potential vulnerability.
If everyone could attend the meetings, I would likely agree that there is enough diversity. In my limited experience, I am
seeing little representation from many sectors, specifically because most of the committee does not attend the meetings.
Not very diverse.
Question #4

Comments:
The administrative support has been excellent.
In the brief time that they have been coordinating, the organization of the meetings has improved. I believe there are also
less frequent meetings (which is appreciated, but it also can hinder some interactions among members and the “flow” of the
meeting).
I would like a year of support before making a final judgment.
Since we have changed administration to the ASU Center, I have not been able to attend one meeting. I do feel as though I
am waiting to see how ASU will administer our program.
Certainly good administrative support, but I think that we are all learning through this new process.

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Question #5

Comments:
As the process is new, we are still learning. However, I see a lot of potential regarding its effectiveness.
In the past, one of the members reviewed the cases which was time consuming and also burdensome. On the other hand (in
my opinion), it gave the person who reviewed the case a much better idea of the processes involved.
I think it’s still somewhat under development. There is always room for improvement in this time consuming and detailoriented process.
At the last meeting we did review a case. However, we had a number of gaps in the information that we needed to discuss
the case fully.
Certainly good administrative support (assuming you mean notifications, meeting, set-up, etc.). I think we are all learning
through this new case review process.

Question #6
What additional information would be helpful in the case review process?
Times and dates of occurrences within the case, clarify regarding who made decisions and points in time when collaboration
occurred with other entities, agencies, etc.
Often times, very important information is not available, like medical records. In some instances, the records have not been
provided or are not available. However, the more information available at the time of the review, the better the members
can evaluate whether policies were followed and the quality of the process and documentation. However, information
“gaps” also point out the constraints and conditions that the case workers often have to deal with.
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Better clarity on priors and family relationships.
Basic information: police and pathology reports; a more detailed summary of the case.
More time with each case. I’m confused on which part we are reviewing – the actions that lead up to the incidents or CPS’
actions afterward.
Input from County Attorney’s Office.
Review more cases.
I can’t think of any additional information I would want.
No additional information is needed.
None at this time.
Getting the information on how to be involved.
Question #7
My Regional Panel meetings would be more productive if (please specify):
I feel the meetings are very organized and productive.
We could compare to other states’ “best practices” and track trends either in Arizona or nationally.
Definite improvements by ASU in bringing literature and evidence-based practices to the attention of members.
Would like more frequent meetings to help us be more cohesive, more detailed summary of cases, and a more thorough
presentation and better understanding of cases.
We are getting off the ground with the new format but I believe it is more productive.
I have a hard time committing 3 hours of time; condense the material into 2 hours. For reviews involving law enforcement or
medical reports, have the reviewer consult with someone on the Panel before the meeting to make sure material is
complete.
Make sure that case documentation is complete before presentations.
Reviewing the cases is rushed.
Perhaps provide some of the case specific information prior to the meeting.
Re-evaluate long-standing members and either have them re-commit to attending or allow them to be removed from Panels.
I don’t think enough meetings are scheduled to be able to review an adequate number cases.
Review more cases and want to see the results or an update on the ones that were reviewed.
I have no suggestions for increased productivity.

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To obtain further information, contact:
Arizona Citizen Review Panel Program
Center for Applied Behavioral Health Policy
College of Public Programs
Arizona State University
500 North 3rd Street
Suite 200
Phoenix, Arizona 85004-2135
Tel: (602) 496-1480
Fax: (602) 496-1494

Information about the Arizona Citizen Review Panel Program can be found on the Internet through the
Center for Applied Behavioral Health Policy at:
http://www.cabhp.asu.edu/

This publication can be made available in alternative format.
Please contact the Arizona Citizen Review Panel Program
at (602) 496-1480.

CENTER FOR APPLIED BEHAVIORAL HEALTH POLICY
COLLEGE OF PUBLIC PROGRAMS
ARIZONA STATE UNIVERSITY
500 North 3rd Street, Suite 200
Phoenix, Arizona 85004-2135
(602) 496-1470
Printed on Recycled Paper
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