How did the blind removal process in Nassau County, N.Y., address disparity among children entering care?
Data indicate that not enough progress has been made nationally to reduce the overrepresentation of children of color in the child protection system and address implicit bias. This comes despite decades of research on disproportionality and racial bias, and also the implementation of strategies and services designed to meet the needs of families of color. Black children represent almost one-quarter of the children in foster care in the United States, but only 14% of the general population. Although the number of Black children entering care has declined over the past decade, the rate remains much higher than white children. For American Indian/Alaska Native children, the rate of children entering care remains consistently higher than any other racial/ethnic group. At state and local levels, these persistent disparities may be even more pronounced.
An examination of the history of child welfare policy and practice indicates that racial disparities within the child protection system can be attributed to longstanding institutionalized racism and discrimination toward families of color. At every major decision point in the child protection system, research shows that Black children continue to be more likely than their white peers to experience negative outcomes.1,2
Black children are more likely to:
- Be reported for maltreatment.
- Have their case investigated and substantiated.
- Be placed in foster care.
- Experience longer stays in foster care.
Black children are less likely to:
- Experience placement stability.
- Engage with caseworkers.
- Reunite quickly with their families.
- Have access to resources and services to promote permanency.
When determining what the system can do to mitigate the impact of biases on decision-making, child welfare leaders frequently have turned to implicit bias training. Some research has found, however, that implicit bias training alone may not always be successful in correcting implicit bias.3,4,5 Alternatively, there is preliminary evidence that “blinding,” or removing information that would activate implicit bias, along with continued training and coaching for staff, may be a technical strategy that can have an impact on racial inequities and disproportionality at a specific point along the child welfare continuum.6 Further statistical tests and a comparison group analysis are essential for determining if Blind Removals can be associated with a significant decrease in removals. To truly achieve racial justice, technical improvements such as blind removals should be implemented along with deeper, upstream strategies that address institutionalized policies and practices. In addition, to better address social determinants of health and community conditions, resources should be deployed and neighborhood asset-building should be encouraged.
Nassau County (N.Y.) Child and Family Services7 introduced a blinding practice into its child welfare removal meetings and, within five years, the number of Black children removed from their families was reduced considerably, representing the most significant decrease in racial disproportionality within the county system ever.8 In addition, the rate of children removed per 1,000 children in the general population also declined for Black children, from 5.5 per 1,000 in 2009, to less than 2.0 in 2019.9
Motivation for change
In 2009, the New York State Office of Children and Family Services (OCFS) provided Disproportionate Minority Representation grants to 14 counties, including Nassau, to develop and implement strategies that would reduce the overrepresentation of Black children in out-of-home care. At the time the grant was awarded, Black children in the state of New York were 2.2 times more likely to be the subject of a report of maltreatment, 2.3 times more likely to have a substantiated case of abuse and/or neglect, 3.6 times more likely to be removed from their home, and 4 times more likely be in foster care, when compared to white children. In Nassau County specifically, Black children were 15 times more likely to be placed in out-of-home care than their white peers.
In response to the troubling data, child welfare staff in Nassau County decided to focus the grant on the removal of children. In addition, staff recognized that removal committee meetings — where decisions are made about whether to remove a child from his/her home — offered a key opportunity to address the impact of bias not just in regard to race and ethnicity, but also against families that had frequent or multigenerational involvement in the child welfare system.
Applying the blind removal process
In Nassau County, investigative staff traditionally present case details to a committee made up of supervisors, managers, and an attorney before the decision is made to remove a child from his or her home. After hearing the details, participating staff evaluate the facts of the case, including whether there is evidence of high risk to determine if safety is an imminent concern. The committee then makes a recommendation about whether the child should be removed from the home.
Blind removal meetings follow the same practice but with a key difference: staff de-identify the case file and present details without any mention of demographic information that may illicit implicit bias, including removing names, races, ethnicities, and addresses. In addition to investigative staff, home-finding staff also are made aware of the family’s demographics and neighborhood information so they can immediately begin locating a kinship or community-based placement if a decision to remove is made. These staff are asked to refrain from participating in removal decisions, however. Overall, the blind removal process eliminates potential for implicit bias and ensures that decisions are based on an assessment of safety and risk that includes consideration of the family’s strengths, relevant history, and caregiver ability to protect the child.
While racial disparity continues to exist and removals are still disproportionately high for Black children in Nassau County, progress has been made across the county. Additionally, the commissioner, directors, supervisors, and caseworkers from Nassau County reported that the blind removal process and related trainings have increased staff awareness of institutionalized racism and implicit bias, and reinforced the values of self-examination and cultural diversity.
Throughout the pilot, Nassau County child protective staff and leadership learned a number of lessons about what it takes to successfully address racial disparities at key decision points along the child protection continuum.10,11
- Collect and analyze data and outcomes at each decision point, disaggregated by race, ethnicity, and neighborhood, in order to identify where disproportionality exists, where blinding processes can be applied, and desired outcomes.
- Develop and leverage support from all levels of leadership — including commissioners, directors, and supervisors — that includes a commitment to utilizing the blind removal process for a minimum of one year in order to accurately assess impact.
- Conduct a needs assessment to examine policies, practices, and organizational factors that contribute to racial disparities. As the blind removal process does not address institutionalized racism throughout the child protection agency, it cannot influence decision-making prior to removal decisions (who is reported or investigated), or reduce bias in subsequent decision points once children enter foster care (placement and permanency). The OCFS Race Equity Cultural Competency Assessment is a tool for gathering this type of information. Community-wide efforts that build on the strengths and assets of individual neighborhoods are key to reducing inequalities, facilitating lasting transformation, and achieving racial justice. Likewise, cross-systems efforts to understand historic and systemic racism are critical for the effective investment of resources and the identification of opportunities for meaningful change.
- Utilize an implementation team to provide oversight and structure during the rollout of the blind removal process, and support staff preparedness. In Nassau County, due to a rapid rollout, the initial implementation of the blind removal process was met with some pushback and feelings of anger and confusion from staff who felt they were being identified as racist. A lack of preparation, training, and engagement of staff in the implementation plan further contributed to the early challenges. While staff resistance may occur during implementation of racial equity initiatives, the preparation of staff can mitigate that resistance both initially and on an ongoing basis.
- Provide training, coaching, and support to staff at every level to develop skills and knowledge, including engaging staff around the concepts of implicit bias and cultural competence through an initial mandatory training, ongoing trainings, and intentional individual and group follow-up.
- Use data as a guide. Continued tracking of outcomes is crucial to assess the impact of the blind removal process and document results. Jurisdictions should compare removal rates from before the blind removal process to data after implementation, usually at the six-month and one-year marks. At each interval, jurisdictions may want to revisit the desired outcomes, target any areas where additional attention may be needed, and determine if a different strategy should be considered. Comparative data also can encourage staff support of the process, and demonstrate how it is positively impacting children and families.
A toolkit is being developed to support adaptation and potential implementation in other jurisdictions, as Nassau County routinely fields questions about its approach from agencies across the country. The toolkit contains information about the county’s experience, as well as an organizational readiness assessment tool and step-by-step implementation guidance.
In October 2020, New York Gov. Andrew Cuomo issued an administrative directive to implement the blind removal strategy statewide. The development of the toolkit and the lessons learned from implementation in Nassau County will be paramount in successfully implementing this strategy in counties across the state. In addition, following significant declines in racial disparities, Nassau County has experienced a recent increase in the number of Black children entering foster care. On closer examination, staff recognized both the need to ensure model fidelity and create a foundation for real and sustainable culture change to eliminate bias. Nassau County is committed to ongoing improvement, and to reducing disparities for children of color within the child welfare system. The toolkit offers a valuable guide to ensure ongoing model fidelity, and Nassau County plans to continue to monitor and assess the application of blind removals to achieve the best outcomes for children and families.
Editor’s note: This brief was updated on April 8, 2021, to address the interpretation of a data point regarding the proportion of reduction in removals.
1 Pryce, J., Lee, W., Crowe, E., Park, D., McCarthy, M., & Owens, G. (2018). A case study in public child welfare: County-level practices that address racial disparity in foster care placement. Journal of Public Child Welfare, 13(1), 35-59.
2 Boyd, R. (2014). African American disproportionality and disparity in child welfare: Toward a comprehensive conceptual framework. Children and Youth Services Review, 37, 15-27.
3 DeAngelis, T. (2019). How does implicit bias by physicians affect patients’ health care? American Psychological Association CE Corner, 50(3). Retrieved from https://www.apa.org/monitor/2019/03/ce-corner
4 Khatric, U., Zeidan, A., LaRiviere, M., Sanchez, S., Weaver, L., Lynn, J., Shofer, F., Todd, B., & Aysola, J. (2019). An evaluation of implicit bias training in graduate medical education. Retrieved from https://www.researchgate.net/publication/333331750_An_Evaluation_of_Implicit_Bias_Training_in_Graduate_Medical_Education
5 Sherman, M. D., Ricco, J. A., Nelson, S. C., Nezhad, S. J., & Prasad, S. (2019). Implicit bias training in residency program: Aiming for enduring effects. Family Medicine, 51(8): 677- 681.
6 Pryce, J., Lee, W., Crowe, E., Park, D., McCarthy, M., & Owens, G. (2018). A case study in public child welfare: County-level practices that address racial disparity in foster care placement. Journal of Public Child Welfare, 13(1), 35-59.
7 Content of brief largely based on interviews with leaders from the New York State Office of Children and Family Services and Nassau County Health and Human Services on April 17, 2020.
8 Crowe, E., & McCarthy, M. (2020). Blind removal toolkit. New York State Office of Children and Family Services.
9 Data from the Adoption and Foster Care Analysis and Reporting System analyzed by Casey Family Programs staff, August 2020. Data from the Adoption and Foster Care Analysis and Reporting System analyzed by Casey Family Programs staff, August 2020. As this data doesn’t necessarily distinguish between those that received a Blind Removal meeting and those that didn’t (although Nassau County indicates that 70-90% of children considered for removal receive a Blind Removal meeting), further analysis will be helpful to clarify how the blinding process may have impacted the reduction specifically.
10 Crowe, E., & McCarthy, M. (2020). Blind removal toolkit. New York State Office of Children and Family Services.
11 Pryce, J. A., Lee, W., Sellati, Park, D., & McCarthy, M. (2016). Race equity: Nassau and Onondaga County: Report. Social Work Education Consortium, University of Albany.