CHILD WELFARE MANUAL

Section 3, Chapter 1 – (Primary Prevention Program)

(Effective: 02/03/2025)

3.1.1 Mandated Reporting 

As Children’s Division employees, primary prevention workers are mandated reporters pursuant to Section 210.115 RSMo. If a primary prevention worker has reasonable cause to suspect that a child has been or may be subjected to abuse or neglect, or observes a child being subjected to conditions or circumstances which would reasonably result in abuse or neglect, the primary prevention worker is mandated to properly assess the situation and take the appropriate decisive action, including but not limited to: 

  • Submitting a hotline through the Child Abuse and Neglect Hotline Unit (CANHU), and
  • Contacting law enforcement, or 911; if the situation requires an emergency response. 

The mandated reporter requirement is an individual requirement that cannot be delegated to any other individual. The purpose of the Primary Prevention Program is not to circumvent the hotline process; and child abuse or neglect must still be reported through the hotline process. 

Primary prevention workers are required to complete mandated reporter training managed by Missouri Network Against Child Abuse. The initial training must be completed with 30-days of hire, and annually thereafter. This training is located online at: www.protectmokids.com.

For additional information about Mandated Reporter Requirements, see Section 2, Chapter 1 in the Child Welfare Manual.  

3.1.2 Safety and Risk   

The primary focus of Children’s Division is always child safety. It is important while working with families through prevention there be an understanding of the difference between safety and risk. Safety assesses the imminent danger of serious harm to the child and the interventions needed to protect the child. In contrast, risk is the likelihood or probability child abuse or neglect will occur or reoccur in the future.

The primary prevention worker should not work with a family when there are current safety threats as the primary prevention program is not appropriate when a child is not safe in the home. A safety threat is an immediate, significant, and clearly observable threat to a child that is presently occurring or likely to occur, which could result in severe harm without intervention. When safety threats are present, programs such as Family Centered Services (FCS) or Intensive In-Home Services (IIS) may be appropriate for service provision, but FCS or IIS  are only appropriate when the safety threat can be eliminated or the protective capacities of the parent may be strengthened in order to alleviate the safety threat. The primary prevention worker should consult with their supervisor on any cases where there are potential safety concerns present as ensuring child safety is the paramount consideration.

The primary prevention worker may work with a family when there are risk factors present, as long as those risk factors do not rise to the level of suspected child abuse or neglect or safety concerns.

For additional information about safety and risk, assessing safety, and identifying safety threats   see Section 1, Chapter 5 in the Child Welfare Manual.

For additional information about safety planning and identification of safety threats see  Section 1, Chapter 9 (Safety Planning) in the Child Welfare Manual.

 

 3.1.3 Primary Prevention Workers: Roles and Responsibilities

Community driven responses and protective factors are vital to the reduction of risk factors that could lead to child abuse or neglect. Primary prevention workers work with the family to develop community-based solutions that support families and target reduction of risk factors and keep child(ren) safely in their homes. The desired outcome is that children will remain safely in their own homes, family functioning will increase, and families will feel supported and able to sustain positive outcomes.

The primary prevention worker will work with communities and families in a variety of ways, including, but not limited to, receiving referrals for primary prevention, holding community meetings and facilitating TDMs.

The primary prevention worker will hold meetings within their local communities.

  • Community meetings should be held at least once per quarter; however, additional community meetings could be held more frequently based on the circuit and regional needs.
  • The goal of these meetings is to connect with community partners to identify existing and needed resources within the community and to develop strategies to address the gaps and needs identified.

The primary prevention worker will act as a back-up TDM™ facilitator for their region, completing at a minimum two TDM™ meetings a month based on circuit and regional needs. The primary prevention worker could also be trained as a Train the Trainer in the Team Decision Making® program. This applies to qualified primary prevention workers who have completed all required TDM™ trainings.

Examples of community connections and supportive services that could be provided or referred to a family, include, but are not limited to:

  • Connection to community services to address concrete needs, such as rental assistance, food banks, and clothing closets;
  • Mental and behavioral health support such as referrals to: community based mental healthcare services for parents or children, Youth Behavioral Health Liaison (YBHL), Department of Mental Health, (DMH) and mental and behavioral health agencies;
  • Substance Use Disorders (SUD) resources such as: treatment facilities, recovery programs and support groups;
  • Healthcare needs such as connection or referral to: WIC, health department, prenatal care, pregnancy resource centers, and hospitals;
  • Parental supports such as connection or referral to: Home Visiting program, COPE24 program, Family Resource Centers, and Crisis Care services;
  • Domestic Violence/Intimate Partner resources such as connection or referral to: DV/IPV shelters and Legal Aid services;
  • Referrals to educational supports such as: Parents as Teachers®, advocacy programs, Early HeadStart and HeadStart programs, and schools; and
  • Resource navigation to address the identified needs of the family and assist in application for sustainable services such as: Family Support Division (FSD) services, community support programs, workforce development, transportation, and low-income housing.

In addition to referrals for services, the primary prevention worker may work with families and the community by:

  • Building relationships with community service providers to be informed on the availability of resources;
  • Creating new community partnership opportunities;
  • Attending community events to learn about available community resources;
  • Sharing Children’s Division resources with the community;
  • Becoming experts on the available community resources, and providing support to families and Children’s Division team members to find and connect to such resources;
  • Providing direct education to families to help build parental protective capacities; this could be provided using programs such as COPE24 and others as regionally approved;
  • Providing community trainings for which they are trained and qualified, such as community orientation for Team Decision Making® (TDM™) meetings and Stewards of Children® by Darkness to Light, and other trainings as identified and approved by regional leadership.

 

3.1.3.1 Primary Prevention Workers in School Settings

There may be times when the primary prevention worker will work directly with a school district. To assist with that collaborative process, the Children’s Division has an approved template MOU (M00829) that can be used when requested by the school district.  This template MOU shall be required when a primary prevention worker will be based in a school building. The MOU template can also be utilized when requested by the school district when a primary prevention worker is not based in the school building.

When an MOU is needed for the school district, the following steps must be followed:

  1. The primary prevention worker will meet with the school and review/complete the approved MOU template. No revisions, additions or deletions can be made to the template MOU in order to follow this process. If there are requested revisions to the MOU template, the approved MOU template cannot be utilized.
  2. The MOU must be signed and dated by the school designee.
  3. The signed MOU should be emailed to the Program Development Specialist (PDS) within the prevention unit at Central Office.
  4. The PDS will review the MOU and submit to fiscal@dss.mo.gov for processing.
  5. Once approved by procurement and OA, the MOU will be assigned a tracking number, signed by procurement, and returned to the PDS.
  6. The PDS will notify the primary prevention worker, their supervisor and circuit manager, and provide the approved signed copy.
  7. The primary prevention worker will provide a copy of the finalized MOU to the school district for their records.

 

3.1.4 Primary Prevention Eligibility

Primary prevention workers work with families only when there are no current allegation(s) of child abuse or neglect. Primary prevention workers engage with families who are experiencing a family need or hardship and identified risk factors prior to it becoming a situation where there are concerns for child abuse or neglect. The primary prevention worker will connect with a family to provide services, supports and referrals to assist the family with the identified need, assist with referrals and address concrete tangible needs.   

To work with a family for primary prevention, a Primary Prevention Referral (CD-334) must be completed by the referring party. Referrals for primary prevention services may be received from families, schools, hospitals, and other community partners.

 The following criteria must be met to be considered for the primary prevention program:  

  • At least one child in the home must be under the age of 18, or an expectant parent resides in the home;
  • The identified needs and concerns for the family do not rise to the level of child abuse or neglect;
  • There are no current allegations of child abuse or neglect;
  • The referral cannot be intended to address findings of child abuse or neglect;
  • The referral must not be a substitution for reporting of suspected child abuse or neglect;
  • The referral must not be a substitution for a referral to Family Centered Services (FCS) or Intensive In-Home Services (IIS), or in conjunction with an active FCS or IIS case;
  • The need for involvement does not meet requirements for other preventative services referrals; and
  • The family must agree to participate in the primary prevention program.

 

3.1.4.1 Referrals for Primary Prevention Services

The primary prevention workers could receive referrals from various sources; including, but not limited to, schools, hospitals, families, and community organizations. These referrals are based on the needs of the family and the consent of the family to work with the Children’s Division. The work completed will focus on preventing crisis situations and risk factors from becoming safety concerns. The primary prevention worker will work alongside community partners, families and support networks to meet the needs of the family and provide resources to the family.

Referrals for primary prevention services must be received using the Primary Prevention Referral form (CD-334). The CD-334 should include the following required information: family demographics, identified family needs (including severity and frequency), services and resources provided to the family, supports available for the family, and how the concerns impact the family and child(ren).

Regional protocols and processes must be established so that each region has a prevention email to receive CD-334s and ensure oversight for timely processing. The region should make the determination as to how the inbox process is organized and managed.

The primary prevention work done with the family must be captured within the electronic case record through report creation by CANHU. The CANHU must be notified via OSCR (Online System for Child Abuse & Neglect Reporting) or by calling the hotline at 800-392-3738. It is the preference that the reporting is completed online using OSCR for streamlined processing and review.  The primary prevention worker should choose the most appropriate maltreatment pathway when entering the OSCR on the family based on the CD-334. For additional information about registering and how to use OSCR to generate a primary prevention referral a PowerPoint presentation has been created at this link.

Upon receiving the CD-334, the primary prevention worker must review the information to determine if their individual assessment causes them to believe they are required to report to the CANHU due to suspected allegations of child abuse or neglect pursuant to their statutory obligation as a mandated reporter.

  • If the worker determines there is reasonable cause to suspect child abuse or neglect, the worker must immediately report the information to the CANHU.
  • If the worker determines there is not reasonable cause to suspect child abuse or neglect, the worker must report the information to the CANHU within three business days of the receipt of the CD-334 in order to request a primary prevention referral be created within the electronic case record.

The CANHU Structured Decision Making® process should be applied by CANHU to determine if the information provided pursuant to the CD-334 rises to the level of child abuse or neglect.

  • If it is determined that the information rises to the level of a child abuse or neglect report, such report will be alerted to the appropriate Children’s Division office for assignment.
  • If it is determined that the information does not rise to the level of a child abuse or neglect report, a primary prevention referral will be created in the electronic case record for service provision by the primary prevention worker.
    • The prevention case will be assigned to the primary prevention worker identified on the CD-334.
    • Once a primary prevention referral is received on the family, the policies and procedures found in Section 2, Chapter 4, subsection 1 for P-referrals must be followed.
    • The primary prevention worker will capture the work completed with the family through the primary prevention referral created in the system.

Local protocols must be established to develop a system to ensure that the primary prevention worker noted on the CD-334 will be assigned the Primary Prevention Referral once created in the system.

Primary prevention is not intended to provide families long-term case management services.  As such, if the needs of the family cannot be resolved within 60 days the case should be reviewed with a supervisor to determine how to best move the case forward, and if the family should be referred to FCS for on-going service provision.

 

3.1.5 Consent for Primary Prevention Services

Primary Prevention services are voluntary and must be agreed to by the family. The type of work done with families through primary prevention may require different types of contacts. There may be times when the needs of the family can be addressed via phone call and other contacts that do not require face-to-face interactions.  In these circumstances only, written consent from the family is not required. However, when the primary prevention work with the family would require face-to-face interactions, such as reoccurring home visits, or interactions with the child, consent must be received. When face-to-face contact is needed, the Consent for Primary Prevention Services (CD-326) must be completed. The signed CD-326 must be uploaded to the electronic case record.

 

3.1.6 Notification to a Parent/Guardian/Custodian

Prior to communication with a child by a primary prevention worker, notification shall be provided to the parent(s)/guardian(s)/custodian(s). The primary prevention worker shall receive written consent by using the CD-326 from the parent(s)/guardian(s)/custodian(s) before communication with a child. The primary prevention worker shall upload a copy of the written consent into the electronic case record. The primary prevention worker shall document all attempted and actual contact with the parent(s)/guardian(s)/custodian(s) in the electronic case record.