Allegheny County, Pennsylvania, is poised to implement a major change in the way families are hooked up with social services come January 2020. If “Allegheny County” sounds familiar, it’s probably because the county recently received significant attention for its child welfare investigative process. In 2015, it incorporated a predictive algorithm called the Allegheny Family Screening Tool into its child welfare program. That algorithm analyzes parental and family data to generate a risk score for families who are alleged to have maltreated a child.
In 2020, Allegheny will begin applying a similar algorithm to every family that gives birth in the county, with the goal of linking families in need to supportive services before a maltreatment case is opened. But some critics insist that it will be just another way for government to police the poor.
The new program is called “Hello Baby.” The plan is to eventually apply it across the county, but the January launch will begin in only a select few hospitals. Like the Allegheny Family Screening Tool, the Hello Baby algorithm analyzes family data to apply an individual family score.
Emily Putnam-Hornstein, who helped design both programs, told TalkPoverty that Hello Baby uses slightly different data than the child maltreatment algorithm, which was criticized for targeting poor families because much of the data used was available only for people who used public services.
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“This is a universal program,” explained Putnam-Hornstein. “In the [child services] model the county was being forced to make a decision after an allegation had been received; in this case we’re taking about more proactively using data … so we wanted that to be built around universally available data.”
But these exclusions don’t guarantee that the data will not end up targeting low-income families again. “They rely on data where the county has the potential to have records for every family,” said Richard Wexler, the executive director of the National Coalition for Child Protection Reform. “The county acknowledges they will probably use data from [Child Protective Services], homeless services, and the criminal justice system, so yes, theoretically everyone can be in that, but we know who’s really going to be in it.”
An overview provided by the county online cites “birth records, child welfare records, homelessness, jail/juvenile probation records” as some of the “available service data” incorporated into the predictive risk algorithm, indicating that Wexler’s assessment was absolutely correct. Although that data is potentially available about anyone, several of these systems are known to disproportionately involve low-income people and people of color.
Putnam-Hornstein said via email that the Hello Baby process is “truly voluntary from start to finish.” A family can choose to drop-out of the program or discontinue services at any time.
The option to drop out will be presented at the hospital, when families are first told about the program. A second notification, and chance to opt-out, will then be made by postcard. If a family doesn’t respond to the postcard, they are automatically included in the next phase of the program, which involves running available data through the system to determine how much social support each family needs.
According to Putnam-Hornstein, scores will be generated about four to six weeks after birth for families that do not choose to opt out (or who are too busy to realize they want to). Once a family is scored, what happens next varies based on which of three tiers they fall into.
Under the “universal” tier, the most basic approach, families receive mail notifications about resources available throughout the county. Families grouped in the second, “family support,” tier will receive a visit from a community outreach provider and an invitation to join one of 28 Family Support Centers located around the city of Pittsburgh.
The “priority” tier engages families with a two-person team made up of a peer-support specialist and a social worker who will work closely with the families to identify their needs and partner them with appropriate providers. It is designed to be an individualized program that grants families access to the full range of support services available on a case-by-case basis. That could mean helping a parent navigate the complexities of applying for housing assistance or ensuring timely placement in a substance use treatment program. The county said in its promotional material — which was reinforced by Putnam-Hornstein over the phone and by email — that choosing not to engage with any aspect of the program will not lead to any kind of punitive action.
But parents who need supportive services still have reasons to fear intervention from child services. The reality is that any program putting families in contact with social service and medical providers means, by default, also putting those families at greater risk of being reported to child services by placing them in more frequent contact with mandated reporters.
A mandated reporter is someone who is legally required to report any suspicions of child maltreatment they encounter. The intention is to ensure timely detection of as much child abuse and neglect as possible, but data have not shown that an uptick in mandatory reporting equates to more child safety.
In Pennsylvania, nearly anyone who regularly interacts with children in a professional or semi-professional capacity is legally considered a mandated reporter. An unfortunate side-effect of the mandated reporter system is that even though a referral program like Hello Baby is not directly involved with child services, participating families will always be haunted by the possibility of coming under investigation.
Putnam-Hornstein assured that family’s scores will not be retained or shared with child services, even for families under investigation — but noted that “it is possible that child welfare workers could infer the level of risk if the family has voluntarily agreed to participate in Hello Baby Priority services and a child welfare worker learned that when gathering family history.”
It’s clear that the new program is not designed to get families involved with child services, although it is spearheaded by the Department of Human Services, which oversees the Office of Children, Youth, and Families that conducts child maltreatment investigations and responses. Rather, Hello Baby was created with the goal of offering a more equitable way to expedite service referrals for families with new children who need them.
“Universalizing the assessment of social needs at birth is the only way to avoid discrimination,” said Mishka Terplan, an obstetrician and addiction medicine physician, who was not talking specifically about the Hello Baby program. He observed that patients with obvious social needs, such as those suffering from acute addiction, were often screened and referred for other issues, like postpartum depression or housing assistance, while other parents’ needs were going undetected and unaddressed. “That seemed unfair,” he lamented. Terplan believes that universal screening programs would eliminate both the disparity between services rendered, and reduce the stigma attached to needing behavioral health treatment and other social supports.
Hello Baby’s creators hope that offering families these programs before there is a child maltreatment complaint can help keep them out of the system altogether. But by using imbalanced data points like child welfare history, homeless services, and county prison history to auto-generate scores, it assumes poverty as the main basis for family need. While poverty does generate certain needs, it is not the only indicator for the whole range of unique social supports that new parents require, such as mental health screening or child care assistance.
A system that continues to embed data that target the poor may only end up automating the social inequities that already exist, while placing vulnerable families under increased scrutiny by mandated reporters for the child welfare system — even if it intends to serve as a universal screening process that helps families avoid punitive interventions.
“As long as the system confuses poverty for neglect, any form of such screening is extremely dangerous,” said Wexler.