San Francisco Family Violence Council

Addressing Violence throughout the Lifespan

 

 

 

 

Child Abuse Intervention Program:

 

Recommendations for Implementation for the City and County of San Francisco

Approved November 17, 2010

 

 

 

 

 

 

 

 

I.          Introduction

 

 

 

 

California Penal Code section 273a mandates that any individual convicted of committing willful injury to a child must, as a condition of probation, complete no less than 1 year of a child abuse intervention program that has been approved by the Adult Probation Department [See Appendix A for the statute.]

 

 

Currently, no treatment program meeting the criteria defined in the penal code exists in San Francisco. This proposal addresses this critical gap San Francisco’s response to child abuse by outlining the rationale for creating such a program, explaining the process used to make these recommendations, and describing the measures that must be enacted to create safety for children and families.

 

 

A.        Scope of the Issue

 

The San Francisco Human Services Agency – Family and Children’s Services (FCS) received allegations of the abuse of 5,625 children in 2009. Of these, FCS substantiated 1,102 cases (20%).  The most common form of substantiated abuse was general neglect (35%). FCS substantiated 141 cases (13%) of emotional abuse and 134 cases (12%) of physical abuse in 2009.

 

 

The Child Abuse Unit of the San Francisco Police Department Special Victims Division received 564 cases of child abuse in Fiscal Year 2009-2010 (FY09-10). Of these, 515 (91%) warranted investigation. The Child Abuse Unit of the District Attorney’s Office received 163 cases of felony child abuse and filed 69 cases in FY09-10. In that same time frame, the DA’s Office resolved 27 cases of felony child abuse – all by either guilty plea(s) or guilty verdict(s).[1] In August 2009, the Adult Probation Department reported supervising 21 probationers convicted of child abuse.[2] The majority of these probationers were convicted of physical abuse.[3]

 

 

 

B.        The Need for an Intervention Program

 

The most pressing reason for the creation of a child abuse intervention program is to comply with state law. This is a mandate that the City is legally bound to adopt and City agencies and City leaders have a duty to take the necessary steps to implement an appropriate intervention program.

 

 

Second, the City should take the proactive steps necessary to prevent future incidents of child abuse. A person convicted of child abuse once is unlikely to change his or her behavior without appropriate intervention services. Yet it is reasonable to assume that this individual will have more children in the future, or otherwise be responsible for a child. A protective order or separation from the originally abused child will not protect these future children.

 

 

A case of child abuse may progress down one of two avenues: civil measures of intervention, such as Family and Children’s Services; or criminal intervention, such as police investigation and criminal prosecution. A child abuse intervention program developed to comply with the penal code may only be mandated when a case has been criminally prosecuted. The intervention program will provide the District Attorney’s Office with additional options when prosecuting a case and recommending charges and sentencing. The existence of a program also has the potential to increase the number of sentencing options available in child abuse cases, as it provides an alternative or supplement to jail time.

 

 

II.        Family Violence Council Process

 

The Family Violence Council re-formed in 2007 with the charter mandate to address family violence, including child abuse, domestic violence, and elder/dependent adult abuse. In 2009, at the urging of child abuse prevention advocates, the Council formed the Intervention Committee to address the lack of a certified child abuse intervention program in San Francisco.

 

 

 

The Intervention Committee comprised representatives from the following agencies:

·        Adult Probation Department

·        Bay Area Legal Aid

·        Commission and Department on the Status of Women

·        San Francisco Child Abuse Prevention Center

·        Department of Child Support Services

·        Department of Public Health

·        District Attorney’s Office

·        Domestic Violence Consortium

·        Family and Children’s Services

·        First 5 San Francisco

·        San Francisco Police Department

·        WOMAN, Inc.

 

 

 

 

 

 

 

 

A.        Current Practices in San Francisco

 

 

The Council began by examining the work currently occurring in San Francisco. Though there is no formal, Probation-certified, 1-year program, several promising parenting-education and treatment programs do exist.

 

 

The Council heard from Community Works about the Parenting Inside Out program that teaches parenting skills to incarcerated parents. The Council also heard from the Parent Training Institute, which is piloting the Triple P curriculum at Family Resource Centers. Both programs are appropriate for the majority of cases handled by FCS, but neither is appropriate for the more severe cases of abuse that would be handled by the criminal justice system. [Read more about these programs in Appendix B.]

The Intervention Committee heard from one program that offered services that could meet the requirements of the penal code, the Department of Public Health’s Violence Intervention Program.

 

 

1.         Violence Intervention Program

The Violence Intervention Program (VIP) was formerly the Center for Special Problems before its current move to be co-housed with the Community Justice Center. VIP is a part of the Department of Public Health’s Community Behavioral Health Program.

 

 

All clients of VIP are in diversion programs, on probation, or on parole, though sex offenders may be seen voluntarily rather than by court order. Participants must be residents of San Francisco, and must have a diagnosed mental illness. VIP treats the whole person, incorporating case management services as well as treatment. VIP works closely with the criminal justice system, preparing progress reports to hold clients accountable.

 

 

With a highly-individualized approach, VIP uses groups as the primary modality for treatment unless a serious mental illness prevents it. The primary goal in individual treatment for these clients is to stabilize them enough to join a group. VIP operates a batterer intervention program (BIP) certified by the Adult Probation Department. In the BIP, VIP uses a feminist curriculum with a cognitive behavioral therapy approach, which is a skill-building practice rather than psychotherapy.

 

 

VIP has had success in treating individuals convicted of domestic violence, stalking, sexual offenses, and other challenging cases, and is an ideal candidate to create and operate a child abuse intervention program.

 

 

 

B.        Current Practices in Other Counties

 

After reviewing the promising programs in place in San Francisco already, the Intervention Committee researched the child abuse intervention programs administered by other counties in California, including Santa Clara, San Diego, and Tulare [see Appendix for an overview of these 3 program models]. The Committee learned that very few counties in the state offer programs compliant with the penal code.

 

 

The 3 mentioned have well-established programs and offered a number of best practices for consideration by the Committee. San Diego County has an extensive standards manual that outlines the ethical standards for treatment programs, education and training requirements, treatment approaches, evaluation standards, discharge criteria, and a number of reporting, assessment, and evaluation forms.

 

III.       Proposal

 

San Francisco has an obligation to create an intervention program for child abuse that meets state penal code mandates. San Francisco also has an obligation to its children and families to ensure appropriate treatment and intervention for those who abuse. The following policy outlines the steps San Francisco should take to address these obligations.

 

A.        Certification

• The Adult Probation Department (APD) should create certification procedures that align with the California penal code. The certification materials developed for batterer intervention programs (BIPs) can be a starting point for this process.

• Community stakeholders should also be involved in the development of certification tools to ensure the final program meets the needs of children, families, and advocates.[4]

Within 90 days of adoption of this policy, the Adult Probation Department should conduct a feasibility review to determine a timeline and action plan for creating certification procedures.

 

 

 

 

B.        Program Creation

• The Department of Public Health should create capacity at the Violence Intervention Program (VIP) to begin individual and group treatment of those convicted of child abuse. This may include an initial investment in VIP to develop the program and train staff.

• VIP should use MediCal billing and/or fee-for-service models to fund the program.

• VIP and APD should work closely during the program creation stage to ensure it meets all the requirements of certification.

Within 90 days of adoption of this policy, the Department of Public Health should conduct a feasibility review to determine a timeline and action plan for creating a child abuse intervention program at the Violence Intervention Program.

 

 

C.        Referral Process

 

• The Family Violence Council recommends that all child abuse cases be assigned to 1 judge for monitoring. The
  Domestic Violence Court
  uses this model, and this Court is an appropriate venue to hear and monitor child abuse cases as well.

• When applicable, instead of or in addition to jail time, the District Attorney shall recommend 48 months of probation for individuals convicted of child abuse per CA Penal Code section 273a (c)(1).

• Conditions of probation should include a “weapons clause” to bar possession of a weapon by an individual convicted of child abuse.

• The Adult Probation Department should assign probationers convicted of child abuse to the Specialized Division for more intensive supervision.

 

D.        Oversight and Evaluation

• APD should utilize oversight and evaluation models designed for BIPs, such as the communication protocols between programs, APD, and the courts; progress reports; and evaluation procedures as a starting point for developing child abuse intervention program oversight and evaluation tools.

• Community stakeholders should also be involved in the development of these tools and relevant components of the San Diego County standards manual can also be incorporated into San Francisco’s model.

 

Appendix A: California Penal Code

 

 

273a.  Willful Injury to a Child Statute

 

 

 

 

   (a) Any person who, under circumstances or conditions likely to produce great bodily harm or death, willfully causes or permits any child to suffer, or inflicts thereon unjustifiable physical pain or mental suffering, or having the care or custody of any child, willfully causes or permits the person or health of that child to be injured, or willfully causes or permits that child to be placed in a situation where his or her person or health is endangered, shall be punished by imprisonment in a county jail not exceeding one year, or in the state prison for two, four, or six years.

   (b) Any person who, under circumstances or conditions other than those likely to produce great bodily harm or death, willfully causes or permits any child to suffer, or inflicts thereon unjustifiable physical pain or mental suffering, or having the care or custody of any child, willfully causes or permits the person or health of that child to be injured, or willfully causes or permits that child to be placed in a situation where his or her person or health may be endangered, is guilty of a misdemeanor.

   (c) If a person is convicted of violating this section and probation is granted, the court shall require the following minimum conditions of probation:

       (1) A mandatory minimum period of probation of 48 months.

       (2) A criminal court protective order protecting the victim from further acts of violence or threats, and, if appropriate, residence exclusion or stay-away conditions.

       (3) (A) Successful completion of no less than one year of a child abuser's treatment counseling program approved by the probation department.  The defendant shall be ordered to begin participation in the program immediately upon the grant of probation.  The counseling program shall meet the criteria specified in Section 273.1.  The defendant shall produce documentation of program enrollment to the court within 30 days of enrollment, along with quarterly progress reports.

            (B) The terms of probation for offenders shall not be lifted until all reasonable fees due to the counseling program have been paid in full, but in no case shall probation be extended beyond the term provided in subdivision (a) of Section 1203.1.  If the court finds that the defendant does not have the ability to pay the fees based on the defendant's changed circumstances, the court may reduce or waive the fees.

      (4) If the offense was committed while the defendant was under the influence of drugs or alcohol, the defendant shall abstain from the use of drugs or alcohol during the period of probation and shall be subject to random drug testing by his or her probation officer.

      (5) The court may waive any of the above minimum conditions of probation upon a finding that the condition would not be in the best interests of justice.  The court shall state on the record its reasons for any waiver.

 

273d.  Corporal Punishment or Injury to a Child Statute

 

(a) Any person who willfully inflicts upon a child any cruel or inhuman corporal punishment or an injury resulting in a traumatic condition is guilty of a felony and shall be punished by imprisonment in the state prison for two, four, or six years, or in a county jail for not more than one year, by a fine of up to six thousand dollars ($6,000), or by both that imprisonment and fine.

   (b) Any person who is found guilty of violating subdivision (a) shall receive a four-year enhancement for a prior conviction of that offense provided that no additional term shall be imposed under this subdivision for any prison term served prior to a period of 10 years in which the defendant remained free of both prison custody and the commission of an offense that results in a felony conviction.

   (c) If a person is convicted of violating this section and probation is granted, the court shall require the following minimum conditions of probation:

   (1) A mandatory minimum period of probation of 36 months.

   (2) A criminal court protective order protecting the victim from further acts of violence or threats, and, if appropriate, residence exclusion or stay-away conditions.

   (3) (A) Successful completion of no less than one year of a child abuser's treatment counseling program.  The defendant shall be ordered to begin participation in the program immediately upon the grant of probation.  The counseling program shall meet the criteria specified in Section 273.1.  The defendant shall produce documentation of program enrollment to the court within 30 days of enrollment, along with quarterly progress reports.

   (B) The terms of probation for offenders shall not be lifted until all reasonable fees due to the counseling program have been paid in full, but in no case shall probation be extended beyond the term provided in subdivision (a) of Section 1203.1.  If the court finds that the defendant does not have the ability to pay the fees based on the defendant's changed circumstances, the court may reduce or waive the fees.

   (4) If the offense was committed while the defendant was under the influence of drugs or alcohol, the defendant shall abstain from the use of drugs or alcohol during the period of probation and shall be subject to random drug testing by his or her probation officer.

   (5) The court may waive any of the above minimum conditions of probation upon a finding that the condition would not be in the best interests of justice.  The court shall state on the record its reasons for any waiver.

 

 

273.1. Treatment Programs for Child Abusers Statute

 

 (a) Any treatment program to which a child abuser convicted of a violation of Section 273a or 273d is referred as a condition of probation shall meet the following criteria:

   (1) Substantial expertise and experience in the treatment of victims of child abuse and the families in which abuse and violence have occurred.

   (2) Staff providing direct service are therapists licensed to practice in this state or are under the direct supervision of a therapist licensed to practice in this state.

   (3) Utilization of a treatment regimen designed to specifically address the offense, including methods of preventing and breaking the cycle of family violence, anger management, and parenting education that focuses, among other things, on means of identifying the developmental and emotional needs of the child.

   (4) Utilization of group and individual therapy and counseling, with groups no larger than 12 persons.

   (5) Capability of identifying substance abuse and either treating the abuse or referring the offender to a substance abuse program, to the extent that the court has not already done so.

   (6) Entry into a written agreement with the defendant that includes an outline of the components of the program, the attendance requirements, a requirement to attend group session free of chemical influence, and a statement that the defendant may be removed from the program if it is determined that the defendant is not benefiting from the program or is disruptive to the program.

   (7) The program may include, on the recommendation of the treatment counselor, family counseling.  However, no child victim shall be compelled or required to participate in the program, including family counseling, and no program may condition a defendant's enrollment on participation by the child victim.  The treatment counselor shall privately advise the child victim that his or her participation is voluntary.

   (b) If the program finds that the defendant is unsuitable, the program shall immediately contact the probation department or the court.  The probation department or court shall either recalendar the case for hearing or refer the defendant to an appropriate alternative child abuser's treatment counseling program.

   (c) Upon request by the child abuser's treatment counseling program, the court shall provide the defendant's arrest report, prior incidents of violence, and treatment history to the program.

   (d) The child abuser's treatment counseling program shall provide the probation department and the court with periodic progress reports at least every three months that include attendance, fee payment history, and program compliance.  The program shall submit a final evaluation that includes the program's evaluation of the defendant's progress, and recommendation for either successful or unsuccessful termination of the program.

   (e) The defendant shall pay for the full costs of the treatment program, including any drug testing.  However, the court may waive any portion or all of that financial responsibility upon a finding of an inability to pay.  Upon the request of the defendant, the court shall hold a hearing to determine the defendant's ability to pay for the treatment program.  At the hearing the court may consider all relevant information, but shall consider the impact of the costs of the treatment program on the defendant's ability to provide food, clothing, and shelter for the child injured by a violation of Section 273a or 273d.  If the court finds that the defendant is unable to pay for any portion of the costs of the treatment program, its reasons for that finding shall be stated on the record.  In the event of this finding, the program fees or a portion thereof shall be waived.

   (f) All programs accepting referrals of child abusers pursuant to this section shall accept offenders for whom fees have been partially or fully waived.  However, the court shall require each qualifying program to serve no more than its proportionate share of those offenders who have been granted fee waivers, and require all qualifying programs to share equally in the cost of serving those offenders with fee waivers.

 

Appendix B: Evidence-Based Parenting Programs in San Francisco

 

The Council heard presentations from representatives of Community Works and the Parent Training Institute at its July 2009 meeting. Below are brief summaries of each.

 

1.         Community Works – Parenting Inside Out

The Parenting Inside Out (PIO) curriculum is backed by a 5-year study, and has been designed specifically for incarcerated parents and for adult learners. The program connects students to larger issues, such as domestic violence. The program is 108 hours in 36 lessons. In general, current program participants are not in jail because of a child abuse conviction, but some have had children removed because of circumstances surrounding that parent’s jail stay. PIO trainers work closely with FCS liaisons.

 

 

A goal of the PIO curriculum is to break the intergenerational cycle of imprisonment. It begins with general skills, such as communication and empathy, applying those skills to daily life in jail and other circumstances before helping the parents relate those skills to their roles as parents.

 

 

Parents are mandated to attend PIO in order to have child visitation at the jail. Most participants attend the program voluntarily through the charter school, as only 5% of participants are eligible to receive child visits. Anyone with a FCS case must attend PIO.

 

 

2.         Parent Training Institute

The Parent Training Institute is a collaboration of the Human Services Agency – Family and Chidren’s Services, the Department of Public Health’s Community Behavioral Health Services, and First 5 San Francisco formed to bring evidence-based practice to parenting programs in San Francisco. The collaboration targets caregivers of young children with emotional or behavioral problems or who are at risk of developing such problems. The Institute operates the Incredible Years curriculum and the Triple P (“Positive Parenting Program”).

 

 

Developed over many years in Australia, Triple P shows evidence in reducing problem behaviors and impacting child welfare outcomes. It involves a multi-level parent and family support system, utilizing a public health approach to intervention. At the highest level, the program targets parental anger and other risk factors. A CDC trial in South Carolina demonstrated reductions in emergency room visits due to child maltreatment, substantiated reports of maltreatment, and out of home placements. Family Resource Centers began offering this program to families beginning in fall 2009 in English and Spanish. It is a 12-week program.

 

 

FCS will refer appropriate parents to the Family Resource Centers to receive Triple P. However, this model is only appropriate for mild to moderate cases of abuse and neglect, and is not appropriate for parent sexual abusers or case of severe abuse. These types of cases should be referred for criminal intervention, and an appropriate intervention program should be developed.

 

 

 

Appendix C: Child Abuse Intervention Programs Statewide

 

 

1.         San Diego County

The following information comes through personal communication between San Francisco Adult Probation Department Supervising Probation Officer Art Faro and the San Diego Adult Probation Officer in charge of monitoring child abuse intervention programs. The interview took place in September 2009. Additional information comes from personal communication between Beverly Upton of the Domestic Violence Consortium and domestic violence advocates in Santa Clara County.

 

 

 

San Diego County has been operating a child abuse intervention program for approximately 10 years. The County developed the certification process through the collaboration of several organizations, including community groups and law enforcement. It was a robust process that resulted in the certification of programs, as well as sharing the monitoring functions. Over time, due to resource constraints, the collaborative disbanded, and monitoring and oversight rests with the San Diego Adult Probation Department (APD). [Note: San Francisco used a similar process to create tools certifying and evaluating batterer intervention programs (BIPs), developing the BIP Community Advisory Committee.]

 

 

In San Diego, one APD officer certifies and monitors all programs. This officer does not carry a caseload, as her time is filled with site visits and quarterly reviews at each program. San Diego has 4 certified child abuse intervention programs, with 28-30 total classes offered. According to the officer, a pitfall of having just 1 staff person monitoring programs is that the process becomes reactive rather than proactive due to time constraints.

 

 

Participants at the 4 programs include a mix of court-ordered probationers and voluntary attendees. San Diego County judges and the Adult Probation Department maintain strict oversight of probationers. The programs operate similar to BIPs, with participant paying a sliding scale fee to attend the programs.

 

 

None of the child abuse intervention programs are also BIPs, which members of the community collaboration saw as a benefit. They prioritized programs with expertise in child abuse, though they acknowledged the overlap with domestic violence and child abuse. Many of the referrals to the child abuse intervention programs come through child protective services rather than the court system. Advocates in the area see the blending of child welfare and court referrals to the intervention program as beneficial, as it shows the seriousness of the issue.

 

 

In summary, San Diego has 4 programs, with 28 total classes, and 12-20 participants per class. Only 20 participants are monitored by APD.

 

 

 

 

 

 

2.         Santa Clara County

The following information comes through personal communication between San Francisco Adult Probation Department Supervising Probation Officer Art Faro and the Santa Clara Adult Probation Officer in charge of monitoring child abuse intervention programs. The interview took place in September 2009. Additional information comes from personal communication between Beverly Upton of the Domestic Violence Consortium and domestic violence advocates in Santa Clara County.

 

 

Santa Clara APD monitors, certifies, and approves the 4 child abuse intervention programs operating in Santa Clara. One officer coordinates this work. Children and Family Services is a certified provider of intervention programs offered through satellite offices in the county. Additionally, one batterer intervention program also acts as a child abuse intervention program. Approximately 50 cases each year are prosecuted for child abuse and referred to Santa Clara APD. Providers noted that concerns of language access and cultural competency remain an issue, as no four programs can provide services to meet the full spectrum of community needs.

 

3.         Tulare County

In August 2010, Karen Cooper, director of Tulare County’s child abuse intervention program located in Visalia, CA, spoke with the Intervention Committee by phone.

 

 

Ms. Cooper discussed the basic components of Visalia’s child abuse intervention program. The program has been in operation for 5 years. Prior to that, the child abuse intervention component had been combined with the batterer’s intervention program (BIP). However, the different penal codes for each contained slightly different mandates and requirements, and it made sense to separate the groups. When creating the separate child abuse intervention program, the agency took the core components applicable to both, enhancing the parenting topics for the new program.

 

 

Most referrals for the program come from Child Protective Services (CPS). CPS reimburses the program for its participants, but referrals from CPS can be problematic. For example, a judge may order a different time period (e.g., under 1 year), or CPS may move into the reunification process prior to a participant’s completion of the 1-year program. Despite these challenges, the partnership with CPS is beneficial and has led to high usage of the program.

 

 

The child abuse intervention program is not gender divided like the BIPs. There are approximately 250-300 participants in all of the programs (including BIPs), and about 60 in the child abuse intervention program at any given time. The agency consistently operates 2 to 3 groups per week. Though the majority of cases are referred from CPS or from a judge as part of a reunification plan, there are some court referrals that don’t meet the “threshold” of abuse (e.g., no serious physical harm, simply poor judgment on the part of the parents). This can create a challenging group mix, and the agency has attempted to separate out these less severe cases of abuse into a separate group so that the other can focus more on acknowledging and ending truly abusive behaviors.

 

 

The agency uses the 1-2-3 Magic curriculum. The curriculum contains some material about substance abuse, but most participants have already been co-referred to an outpatient treatment program if they have substance abuse issues. Participants in the parenting program are charged $25 per person per group session, or CPS is billed for service. Ms. Cooper explained that the program does take out-of-county clients, some due to supervised visitation requirements, and others from nearby counties (as most counties do not have their own programs).