The 2008 Act 33 Amendment to the Pennsylvania Child Protective Services law requires state and local reviews of all child fatalities and near fatalities that result from suspected child abuse. In response, the Allegheny County Department of Human Services (DHS) conducts a comprehensive and multidisciplinary review of child fatalities and near fatalities in cases where there is suspicion of child abuse or neglect. These reviews are a component of DHS’s continuous quality improvement process.

What is this report about?

This report covers child fatalities and near fatalities (critical incidents) in Allegheny County reviewed in 2022 and 2023 with a focus on drug ingestions, which have been a growing cause of these critical incidents. The increase in child ingestions and fatalities has been a nationwide trend in recent years and has worsened amidst the nation’s opioid epidemic. The County seeks to understand how these incidents happen and the circumstances surrounding them so that it can develop strategies to minimize them.

What are the takeaways?

• There were 50 critical incidents that occurred during 2022 and 2023. Forty percent (20) of these incidents were the result of unintentional drug ingestion. Unintentional ingestion comprised one-third of the 2022 incidents, rising to nearly one-half in 2023. The number of ingestion-related incidents has been rising year-over-year since 2019 and has been the primary cause of the County’s fatalities and near fatalities since 2022, surpassing blunt force or penetrating trauma and abusive head trauma.
• In 18 of the 20 ingestion cases, at least one of the substances ingested was an opioid. Eighty-six percent of the near fatal and 100% of the fatal ingestions involved opioids.
• The majority (70%) of ingestions occurred in children below the age of three. 40% of victims of ingestions were between one and two years of age compared to 27% of victims of non-ingestion fatalities and near fatalities. This age group are especially at risk for unintentional ingestion as they begin to gain mobility, which increases the likelihood of coming into contact with substances.
• Only 4 (20%) families of ingestion-related critical incidents had active child welfare involvement at the time of the incident, though three quarters (15) of families had a history of child welfare involvement prior to the ingestion incident.
• Sixty-six percent of alleged perpetrators in ingestion cases had received publicly funded substance use disorder services prior to the critical incident.  However, there was a reduction in engagement with these services within a year (43%) and within a month (36%) prior to the critical incident.
• Of the known alleged perpetrators in ingestion cases, 41% had utilized medication for opioid use disorder (MOUD) at some point before the critical incident. There was a steady decrease in MOUD use leading up to the critical incident with 31% using MOUD within the year and 13% within the month prior to the critical incident. 

How is this report being used?

Allegheny County is taking an active role in addressing the ramifications of the opioid epidemic and the rising trend of unintentional ingestions. This includes enhanced training for Child welfare staff and access to naloxone, lockboxes and fentanyl test strips for caseworkers to provide to clients. The County, through its opioid settlement funds, has expanded convenient access to MOUD and evidence-based treatment (e.g., mobile medication, telemedicine prescribing, and incentives for abstinence from stimulants and opioids) and launched a Countywide marketing campaign in April 2024 warning about the dangers of opioid ingestions and the safety of administering naloxone to children. In addition, it has invested in preventative programming like residential substance use disorder treatment that allows families to reside together during a person’s treatment and in the Hello Baby approach, a collaboration which is designed for parents with newborns to improve family outcomes and maximize child and family well-being, safety and security.

Other information

Explore updated annual data and prior reports here.

Since 2016, the Allegheny County Department of Human Services (DHS) in Pennsylvania has utilized the Allegheny Family Screening Tool (AFST), which assists child welfare call screening caseworkers in their assessment of general protective service (GPS) referrals regarding potential child maltreatment.

What is this report about?

This report reviews the research evidence on algorithms in child welfare, specifically focusing on the causal impacts of the AFST and comparable predictive risk models (PRMs). It begins by summarizing the influence of these tools on child welfare decisions. The report then explores the discrepancies between perceived and actual effects of these models, highlighting the importance of bridging the gap between perception and reality to alleviate concerns and maximize the effectiveness of these tools.

What are the takeaways?

The impacts of predictive risk models in child welfare must be compared with alternative approaches to augmenting call screening caseworker decision-making. Traditional risk assessments in child welfare have been largely manual, prone to inconsistencies, and often omit critical information. Before implementing the AFST, Allegheny County did not employ any structured risk assessment.

The main conclusions from recent research on the AFST are:

• The AFST changed the composition of investigated referrals. The introduction of the AFST decreased the probability of investigation for referrals with low risk of removal and increased the probability of investigation among referrals with high risk of removal. The introduction of the AFST also reduced the racial gap in investigation rates, particularly among higher risk referrals.
• The AFST is reducing, not increasing, racial disparities. Researchers found that the introduction of the model reduced racial disparities in investigation rates across AFST scores, although the size and precision of the reduction varied. The AFST reduced the racial disparity in investigation rates for the highest risk referrals by 83%, from 10.6% to 1.8%. The researchers estimated that the AFST reduced the Black–White gap in removal rates of screened-in referrals by 73%, from 4.3% to 1.2%.
• Screeners use the algorithm but with caution. Researchers found that call screening case workers are integrating information from the AFST effectively, aligning their decisions more closely with predicted removal risk compared with the period before the tool’s introduction. The tool is seen as a helpful source of additional information rather than a replacement for professional judgment. 

How is this report being used?

The application of algorithms to support decision-making, especially in sensitive areas like child welfare, mandates high transparency. It is critical that the complexities of predictive risk models are communicated clearly to all stakeholders to maintain trust and prevent misuse. DHS is committed to keeping the public informed about the use and impact of algorithms at the Department and draw upon current research to shape the implementation of these tools in the field.

Read more about AFST here.

What is the Community Need Index?

The Allegheny County Department of Human Services (DHS) conducts a Community Need Index (CNI) to identify specific areas that are in greater need, and face larger socioeconomic barriers, relative to others. The newest version of the CNI index ranks neighborhoods by need level by looking at:

• The percentage of families who live below the poverty line
• The percentage of unemployed or unattached males
• The percentage of those aged 25 and up without at least a Bachelor’s degree
• The percentage of single parent households
• The percentage of households without internet access
• Rate of homicide per 100,000 residents
• Rate of fatal overdoses per 100,000 residents

The researchers used a census tract level to break up the region and assess needs. Census tracts are static, relatively small subdivisions of a county.

How can I view the findings?

An interactive map allows users to view and extract data from the 2024 CNI (which uses 2022 five-year data estimates and totals). The new report focuses on all of Allegheny County, examines changes in need over time, and places emphasis on the connection between race and community need. Earlier reports are linked below.

What are the takeaways?

• In Allegheny County, we continue to find the highest levels of need in specific sections of the City of Pittsburgh (Hill District, South Hilltop, parts of the West End, Upper East End neighborhoods, Upper Northside) as well as census tracts outside the City of Pittsburgh (Mon Valley, sections of the Allegheny County River Valley, sections of Penn Hills, sections of Wilkinsburg, Stowe-Rocks).
• There are vast discrepancies between the lowest need communities, which have an average poverty rate of 2%, and the highest need communities, where the average poverty rate is 38%.
• With few exceptions, census tract-level community need is persistent over time.
• Only about one-third of Allegheny County’s Black residents live in lower-need communities. For every other racial and ethnic group in the County, the majority of residents live in lower need communities. Black communities in Allegheny County have disproportionately high levels of need, as do a number of racially mixed communities. 
• Poverty status alone does not account for where various racial and ethnic groups tend to live by level of need; poor Black and Latino families are more likely than other poor families to live in higher need communities. Even Black families above the poverty line are many times more likely than their Asian, White and Latino peers above the poverty line to live in higher need communities.

How is this report used?

The geographic dimensions of community need can help inform many aspects of DHS’s strategic planning and resource allocation decisions, such as decisions on where to locate Family Centers or new after-school programs.

Where can I go for more information?

For more information, you can read previous reports below. Or you can reach out to DHS-Research@alleghenycounty.us with any questions.

 

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Previous reports in this series 

• 2018 update (all county)
  • 2018 Storymap
• 2014 update (suburbs)
• 2012 update (suburbs)
• 2000-2009 (suburbs)
• 2000-2012 (city)

Previous datasets in this series

• 2018 (all county)
• 2014 (suburbs)
• 2000-2012 (city)

Recently, DHS announced it was eliminating some Education Specialists Position. Read a summary of that decision and click here to find some resources if you need assistance.

DHS has set five goals to guide us and our partners in serving our community well. We aim for our network for human services to improve access to care, prevent overuse of coercive services, prevent harm, increase economic security and ensure quality.

What is this report about?

DHS can reach our goals more quickly if we devote time and attention to several big, bold initiatives that will make our systems and our organization work better for everyone we serve. This document outlines our key initiatives in 2024—which are in addition to our core work of running effective systems of care for people.

County human services includes programs from over 300 community-based agencies and is delivered by social workers, peers, and outreach staff working all throughout the county. These staff run out-of-school-time programs, answer hotlines, investigate reports of potential harm to children and vulnerable adults, deliver meals to seniors and run Senior Centers, make home visits to families with newborns, and do the administrative work that makes our human services run efficiently.

What is this report about?

This report highlights the 2023 accomplishments that stood out. There are many, many other achievements that people told us about. We chose the ones that made the biggest difference.

What is this dashboard about?

Allegheny County DHS sends text messages to county residents for a variety of reasons, including increasing awareness of services, providing timely reminders, and gathering feedback after a service experience.  In addition, DHS uses this information to help evaluate and monitor programs it delivers.  This dashboard displays information about these outreach and engagement efforts, including the subject and purpose of these and the rates of engagement.  Data on DHS’s texting efforts are available from November 2017 to the present.

What data is available?

The dashboard allows users to examine DHS text messaging as a whole as well as drill down to individual text campaigns.  It allows users to understand the purpose of each campaign, the number of messages sent and the demographics of the people being contacted by each campaign.  DHS collects this information through Community Connect Labs (CCL), DHS’s texting software, and information is updated daily. Click here for a more detailed report on DHS’s texting outreach from 2018-2022.

The Intimate Partner Violence Reform Initiative was created in May 2022 to coordinate policy and system-level work across agencies in Allegheny County to improve a complex and fragmented system for both survivors of intimate partner violence (IPV) and those who use violence.

Stakeholders from local and federal criminal justice systems, victim service organizations, community groups, healthcare and human services are working to improve the ways in which people can access help, how our systems work together and share information, and how we can prevent the most serious harm. This report outlines the progress made in the first year of the initiative, as well as plans and priorities to continue these reform efforts.

What is Hello Baby?

New information added September 2023

Hello Baby is designed for parents of new babies in Allegheny County to strengthen families, improve children’s outcomes, and maximize child and family well-being, safety and security. Hello Baby’s tiered prevention model offers a variety of supports designed to meet families’ varied needs and interests through the child’s third year.

How was Hello Baby developed?

Allegheny County Department of Human Services (DHS) undertook an extensive process to develop the Hello Baby prevention strategy. In addition to drawing from decades of experience by DHS leadership, service workers and families, the process included:

• A review of data and best practices identified in the literature
• Dozens of individual and group meetings with local service providers, families in the community, social workers, clinical specialists and local, national and international child development experts
• Two independent, comprehensive reviews by experts in the field

How is Hello Baby being used?

The resulting prevention program has a differentiated approach, with flexible service delivery that is based upon the understanding that each family is unique and has different and varying levels of needs and barriers to support. In addition to self- and community-referral pathways, Hello Baby also uses an innovative and predictive risk model (PRM) that uses integrated data to identify the highest need families eligible for services. Hello Baby includes a universal entry point designed to increase awareness of available support services for all new parents and improve overall engagement rates. It incorporates community level support and proven home visiting techniques, hiring culturally competent staff with lived experiences to support families with moderate to high needs and intensive engagement and service coordination to support families with the highest needs. An evaluation partner has already been selected to ensure that Hello Baby benefits from rapid feedback and learning throughout the implementation.

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Related materials

• Development of the Hello Baby program
  • FAQs about Hello Baby
  • Children’s Bureau grant application
  • Overview of community engagement efforts
  • Case review summary of high-risk families
  • Request for Proposals: Intensive Engagement and Case Management Service for High-Need Families of Newborns
  • Response to RFP from Healthy Start, Inc.
• Analytics in support of the Hello Baby program
  • Implementing the Hello Baby Prevention Program in Allegheny County: Methodology Report by Rhema Vaithianathan, Ph.D. (Auckland University of Technology), Emily Putnam-Hornstein, Ph.D. (University of North Carolina), and Diana-Benavides Prado, Ph.D (Auckland University of Technology)
  • Answers for parents about the predictive risk model: a guide for staff

• Ethical reviews and DHS’s response
  • Ethical review of the development and implementation of the Hello Baby program by Deborah Daro, Ph.D.
  • Ethical review of the predictive risk model use in the Hello Baby program by Michael Veale, Ph.D.
    Note: This report was written in early 2019. Since then, DHS has made several changes to the design and implementation of the Hello Baby program. An updated draft of the report will be posted when available.
  • DHS’s response to the ethical reviews
• Independent research and evaluation in support of Hello Baby
  • Request for Proposals: Process and Outcome Evaluation of Hello Baby, a Tiered Intervention Program for New Parents and Their Babies
  • Response to the RFP from The Urban Institute and Chapin Hall
  • Do Family Support Centers Reduce Maltreatment Investigations? Evidence from Allegheny County by Fred Wulczyn, Ph.D., and Bridgette Lery, Ph.D. (Chapin Hall)
• DHS policy and procedures related to Hello Baby
  • Collaboration between Hello Baby and Child Welfare
  • Hello Baby involvement for families involved with Child Welfare
  • Use and access of the Hello Baby score

For more information about Hello Baby and to access resources for new parents, visit Hello Baby online.

Recent press coverage of Hello Baby is available here.

What are Child Fatalities and Near-Fatalities?

The County is required by state law to review each death or near-death of a child and use the information to improve practice and systems. The 2008 Act 33 Amendment to the Child Protective Services law requires state and local reviews of all child fatalities and near-fatalities that result from suspected child abuse.

What can the dashboard tell us?

This dashboard and series of reports describes findings and outcomes from child fatality/near-fatality (CFNF) reviews. Information about the incidents–including victim and perpetrator demographics, cause of death/injury and families’ prior involvement with the child welfare system–is available in these reports as well as case practice and system reforms enacted to reduce the likelihood of future child abuse-related incidents.

Trouble viewing the dashboard below? You can view it directly here.

How is this information being used?

In addition to the state required reporting of child fatalities and near-fatalities, DHS has used the information to make recommendations to prevent these tragedies in the future. These recommendations include:

• Improved collaboration with medical physicians
• Upstream prevention and intervention services
• Integration of the child welfare system and the substance use treatment system
• Community and firearm violence reduction
• Applying safety science to child protection

In depth explanations of these recommendations can be found in the “current documents” section above.

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Previous reports

• 2018
• 2017
• 2016
• 2014-2015
• 2013
• 2012
• 2011
• 2009-2010

What is this report about ?

From June to October of 2021, Allegheny County Department of Human Services (DHS) provided a cash assistance program for transition-aged youth called Older Youth Pandemic Relief (OYPR). This report describes the methodology and results of a series of surveys that evaluated the impact of the cash assistance program.

What are the takeaways?

• 76% (n = 1,901) of the people who were eligible to receive the Older Youth Pandemic Relief (OYPR) payment applied for and received the money.
• The money went to young adults with a high level of need. 85% of recipients were enrolled in Medicaid, and 49% received Supplemental Nutrition Assistance Program (SNAP) benefits.
• Young adults planned to spend the money on meeting basic needs; top categories were bills, housing, car, food and clothing.
• The program re-engaged young adults with services. 587 of the people who applied for (and received) the OYPR payment qualified for other services available to transition-aged youth but were not using them.
• By filling out the OYPR application, they provided updated contact information and information about the types of assistance they need.
• The percentage of recipients who reported having enough money to meet their basic needs increased from 25% at baseline to 34% after receiving the money. This increase was larger for Black and female demographic groups, which reported lower ability to meet their basic needs at baseline.

How is this report being used?

Findings from this program and report are being used internally at DHS to advocate for new income assistance programs. These include both direct cash cash transfers and other forms of income support, such as subsidized transit.

The dashboard below provides an overview of Allegheny County child welfare out-of-home placements from 2010 through 2021. Data describe yearly point-in-time counts of children in placement (“PIT” tab), characteristics of children in placement, what types of placements were used, how long children stayed there, where they went after their placement ended (also known as exits) and how many returned to the child welfare system after returning home (also known as re-entries). The dashboard is updated annually when a full year of data becomes available.

A related report provides analysis of placement trends over the past decade.

Trouble viewing the dashboard? You can view it directly here.

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Related materials

• Report: Child Welfare Placement Dynamics, 2008-2017 data
• Brief overview of findings: 2008-2017 data

The National Center for Education Evaluation and Regional Assistance at the Institute of Education Sciences (US Department of Education) examined data from Allegheny County students to better understand predictors of near-term academic risks. The goal of this research to provide information for administrators, researchers, and student support staff in local education agencies who are interested in identifying students who are likely to have near-term academic problems such as absenteeism, suspensions, poor grades, and low performance on state tests.

What is this report about? 

The report describes an approach for developing a predictive model and assesses how well the model identifies at-risk students using data from two local education agencies in Allegheny County, Pennsylvania: a large local education agency and a smaller charter school network. It also examines which types of predictors— in-school variables (performance, behavior, and consequences) and out-of-school variables (human services involvement and public benefit receipt)—are individually related to each type of near-term academic problem to better understand why the model might flag students as at risk and how best to support these students.

What are the takeaways?

The study finds that predictive models using machine learning algorithms identify at-risk students with moderate to high accuracy. In-school variables drawing on school data are the strongest predictors across all outcomes, and predictive performance is not reduced much when out-of-school variables drawing on human services data are excluded and only school data are used. However, some out-of-school events and services—including child welfare involvement, emergency homeless services, and juvenile justice system involvement —are individually related to near-term academic problems. The models are more accurate for the large local education agency than for the smaller charter school network. The models are better at predicting low grade point average, course failure, and scores below the basic level on state tests in grades 3–8 than at predicting chronic absenteeism, suspensions, and scores below the basic level on high school end-of-course standardized tests. The findings suggest that many local education agencies could apply machine learning algorithms to existing school data to identify students who are at risk of near-term academic problems that are known to be precursors to school dropout.

National research shows that young adults transitioning out of foster care into adulthood face more challenges than their peers. This report examines outcomes for Allegheny County young adults who had been in a child welfare placement and exited the system from 2006 through 2016. Outcomes examined include achievement of legal permanency, education, employment, early parenting, homelessness, involvement in mental health and/or substance use disorder treatment, unexpected violent deaths (homicides, overdoses and suicides) and criminal justice involvement. The goal of the analysis was to provide a barometer of those outcomes that affect transition-aged youth and to record County resources that have been directed toward this population.

Read the report here.

What is an out-of-home placement? 

The Allegheny County Department of Human Services (DHS) is mandated by law to protect children under the age of 18 from abuse and neglect. When a child welfare investigation finds that a child is at risk of abuse or neglect, a case is opened, and DHS works with the family to identify natural supports and other supportive services that will help the child remain safely in the home.

If DHS finds that the child cannot continue to reside safely in the home, the case is brought before a judge, who may determine that a temporary home, called an out-of-home placement, is necessary. Whenever possible, out-of-home placements are in homes of relatives or friends of the family (known as kinship care) or in foster homes. Less often, children are placed in congregate care in either a group home or a residential treatment facility. At the end of an out-of-home placement, DHS aims to reunite children with their families whenever possible. If a child cannot return home, DHS works to identify other permanent options such as adoption or permanent legal custodianship.

What data is tracked?

This report and related dashboard provide an overview of child welfare placement dynamics during the decade 2008-2017. Data describe characteristics of children in placement, what types of placements were used, how long children stayed there, where they went after their placement ended (also known as exits) and how many returned to the child welfare system after returning home (also known as re-entries).

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Related materials

• Report: 2000-2009 data